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COURT OF COMMON PLEAS ~ ~ ~:,; l : u ;
OF CUMBERLAND COUNTY, PENNSYLVANIA -~ _', ~ ~,_f ~_,.
ORPHANS' COURT DIVISION `-~! ~ ~-
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IN RE: `'
APPOINTMENT OF PLENARY
CO-GUARDIANS OF THE ESTATE AND NO. 2I-08- I
PERSON OF NICOLE M. BOUDER,
AN ALLEGED INCAPACITATED PERSON
ORDER
AND NOW, this ~
day of , , 2008, after consideration
of the AMENDED PETITION FOR THE APPOINTMENT OF PERMANENT PLENARY
CO-GUARDIANS OF THE ESTATE AND THE PERSON OF AN ADULT CHILD IN
ACCORDANCE WITH 20 PA CSA SECT. 5511; FOR WAIVERS OF BOND; HEARING;
REPRESENTATION OF COUNSEL; CERTAIN NOTICE REQUIREMENTS; AND FOR
AUTHORIZATION TO DO ASSORTED ACTS IN CONNECTION WITH THE ESTATE
AND PERSON OF THE ALLEGED INCAPACITATED PERSON, it is hereby ordered and
decreed as follows:
A. No hearing on the issues raised by this Petition shall be necessary and RANDY
BOUDER, also occasionally known as RANDALL BOUDER, and RUTH BOUDER, his wife,
are hereby appointed as permanent Plenary Co-Guardians of both the person and the estate of
NICOLE M. BOUDER, with the power to act as the same either jointly or individually.
B. No bond shall be required by said Petitioners to administer the estate of NICOLE
M. BOUDER.
C. No counsel need by appointed at this time for NICOLE M. BOUDER under the
circumstances of this case.
D. No medical testimony need be taken under the circumstances of this case.
E. It is unnecessary to have service of Notice of this Petition upon NICOLE M.
BOUDER.
F. Petitioners are authorized and empowered to take all such actions as are outlined
immediately hereinbelow and to do any other acts which may be reasonably necessary to the
management of the estate and to the care of the person of NICOLE M. BOUDER.
The Co-Guardians may need to and are fully authorized and empowered to do the
following which are listed by way of example only and not as a specific set of limitations:
A. Complete and submit claim applications for insurance and other similar benefits.
B. Disclaim an interest in property or an inheritance.
C. Establish a Special Needs Trusts or similar Trusts.
D. Close out and open bank accounts or similar accounts.
E. Sell any property real or personal and convert it to cash to make such funds
available to creditors or other service providers, or to make deposits into or to make
additions to Trusts.
F. Immediate and unlimited ability and power to use and invade principal and corpus
of property of NICOLE M. BOUDER held by her in her own right.
G. Pay bills immediately as they come due.
H. Open separate accounts if such are required by any government agencies for
direct deposit or otherwise.
I. File an Inventory.
2
Hire tax accountants to aid with preparation of tax returns and the like which
might now, previously or in the future be due.
K. Hire consultants to help with making applications to medical institutions, similar
facilities, or any other matters for which Petitioners are or might reasonably be in need of
consultants.
L. Establish a separate funeral fund.
M. Make all other decisions and do any and all other acts of whatsoever nature as
may reasonably be necessary in the management of the estate of NICOLE M. BOUDER.
N. To have full and unfettered access to medical, hospital, and similar records,
including any and all records defined and described in the Health Insurance Portability
and Accountability Act of 1996 (Public Law 104-191, ll0 Stat. 1936) more commonly
referred to as HIPAA, and/or any similar Acts or regulations as may be passed or
amended from time to time. This power shall be full and absolute and shall include the
power to grant Releases for the dissemination of such information to others. This power
shall be exercisable despite anything to the contrary in any current privacy acts or similar
acts or regulations or such as may be passed or adopted from time to time in the future.
O. In addition, in general, to make all healthcare and medical treatment decisions
which shall include but not be limited to the following:
1. To authorize NICOLE'S admission to or discharge from a medical,
nursing, residential or similar facility and to make agreements for her care and for
health insurance for her care, including hospice and/or palliative care. This power
shall include the power to enter into agreements for her care at the expense of her
Estate; to execute any consent or admission forms required by such facility which
are consistent with this paragraph, and enter into agreements for her care by such
facility or elsewhere during her lifetime or for such lesser period of time as her
Guardians may designate. This power shall also include the power to retain
nurses for her.
2. To hire and fire medical, social service and other support personnel
responsible for her care.
3. To take any legal action necessary to do what is hereinabove authorized
and empowered.
P. To do all such acts either jointly or individually.
G. Payment of counsel fees and filing costs are to be made from the NICOLE M.
BOUDER MAXIMIZER STRUCTURED SETTLEMENT ADMINISTATION TRUST.
H. This Order shall be docketed and filed in the Office of the Clerk of the Orphans'
Court and Certified copies may be made thereof from time to time as may be needed to prove the
authorities, empowerments and the appointment of the Plenary Co-Guardians. The Docketing
and filing shall be made without a copy of the above-referenced and underlying PETITION or
AMENDED PETITION which has been filed in the Prothonotary's Office under Docket No. 97-
3434, Civil Action -Law. Said file is sealed until further Order of this Court.
For purposes of reliance by third parties: A true and correct copy of this Order or
a Certified Copy of this Order, as the case may be, presented by either one of the Co-Guardians
shall be deemed to be and shall be considered to be conclusive proof that the other Co-Guardian
has failed to act, or is currently unable to ac
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
In Re: NICOLE M. BOUDER, AN ALLEGED
INCAPACITATED PERSON
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-2008-0679
CERTIFICATE OF SERVICE OF ORDER
ORDER DATE: 06/24/08
JUDGE'S INITIALS: EEB
TIME STAMP DATE: 06/25/08
IN RE: ORDER
SERVICE TO: CHARLES SHIELDS
METHOD OF MAILING: ENVELOPES PROVIDED BY:
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^ RRR ^ JUDGE
^ HAND DELIVERED ^ CLERK OF ORPHANS COURT
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MAILED: 06/25/08
SERVICE TO:
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^ USPS
^ RRR
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ENVELOPES PROVIDED BY:
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^ CLERK OF ORPHANS COURT
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Clerk of O hans' Court