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HomeMy WebLinkAbout02-0714 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ELIZABETH M. LUCIUS, a minor child NO. ~1.02•'11~1 ORPHANS' COURT DIVISION NOTICE AND ORDER FOR HEARING RE: PETITION FOR APPOINTMENT OF CUSTODIAN PURSUANT TO 20 P.A. C.S.A.§5318(d) NOW, THEREFORE, it is ordered that a hearing on the Petition for Appointment of Custodian of the Pennsylvania Uniform T fers to Minors Act Account ~~ rr of Elizabeth M. Lucius, a minor, shall be held on the day of T 2002, at = 0 .m./p.m. in Courtroom _~ of the Cumberland County Courthouse, Carlisle, PA. BY THE COURT: J. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ELIZABETH M. LUCIUS, NO. ~ ~'O2'1iy a minor child ORPHANS' COURT DIVISION DECREE AND NOW, this day of , 2002, upon consideration of the Petition of Lori J. Lucius, it is hereby Ordered and Decreed that Lori J. Lucius is appointed Custodian of all accounts established for the benefit of ELIZABETH M. LUCIUS under the Pennsylvania Uniform Transfer to Minors Act, 20 Pa. C.S.A. §5301, et. seq. BY THE COURT: ~ _ - -~ ,- ~ U~ ~, ' IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ELIZABETH M. LUCIUS, NO. ;ZI-02' -1~`'1 a minor child ORPHANS' COURT DIVISION PETITION FOR THE APPOINTMENT OF CUSTODIAN OF ACCOUNTS CREATED UNDER THE PENNSYLVANIA UNIFORM TRANSFER TO MINORS ACT PURSUANT TO 20 PA. C.S.A. §5318 TO THE HONORABLE JUDGES OF SAID COURT: AND NOW comes Lori J. Lucius, by her attorneys, METTE, EVANS & WOODSIDE, and respectfully represents that: 1. Petitioner, Lori J. Lucius, is the natural mother of the minor child. 2. Elizabeth M. Lucius, a minor, resides at 2019 Dickinson Avenue, Camp Hill, PA 17011-5926, with Petitioner. 3. This Honorable Court has jurisdiction pursuant to §5318(d) of the Probate, Estate and Fiduciaries Code, 20 Pa. C.S.A. §5318. 4. The minor, Elizabeth M. Lucius, was born on January 14, 1992. A true and correct copy of the Certification of Birth is attached as Exhibit 1. 5. The minor's father, Philip D. Lucius, is deceased, having passed away on May 2, 2002. An original Certificate of Death is attached as Exhibit 2. 6. The minor child, Elizabeth M. Lucius, is the owner of an account established under the Pennsylvania Uniform Transfer to Minors Act. 7. The account is held at Solomon Smith Barney and has a value of $1,395.81. A true and correct copy of the June 30, 2002 statement is attached as Exhibit 3. 8. It is necessary that a Custodian be appointed for the account because the deceased custodian did not designate a successor and the child has not attained the age of 14. 9. The proposed Custodian has no interest adverse to the minor child. The consent of the proposed Custodian is attached as Exhibit 4. WHEREFORE, Petitioners request that an Order of Court be issued appointing Lori J. Lucius as Custodian of all accounts held by Elizabeth M. Lucius under the Pennsylvania Uniform Transfer to Minors Act. METTE, EVANS & WOODSIDE ~/~~ ~ Vicky A n Trimmer, Esquire Sup. Ct. I.D. No. 49679 3401 North Front Street Harrisburg, PA 1 71 1 0-0950 (717) 232-5000 DATED: ~" ( ~/ ~ ~- Attorneys for Petitioner VERIFICATION LORI J. LUCIUS, the Petitioner in the foregoing matter, state the facts in the foregoing Petition are true and correct to the best of her knowledge, information and belief. This statement is made subject to penalties of 18 Pa. C.S.A. §4904, relating to unsworn falsification to authorities. 1 ~ DATE: ,> f` 5 c' ~- `~~~~ i~ ~ _~. t, ~_._ LORI J. L C US a V"x mZ 0 mz' p~ i- w = o ~..i ~ "` ~ ~ ~ .. .i ~ ~, AN ~ Y ~ 9~ ff~ O~ + ~'Y /.~+s ~ ~ jam'? _ w ~ } O L O E ~ ~ , ... ~ 6 K n .r, ~.F Yi ~£ ~ T F mi~~, ~n0 4~ O o rte. N .. ~ mm '~C„.. o J 3 5 ~i ~~ m u ~ A .rs W i,rrl - - • N,c ~_ ~ ~ - ~ O ' ~. j ~, v ~ 'LT`S C ~ `yV ~i V~ ~ 0> W ~ ~ t Y? _ . { ~, 9 i ~ { y i ~ T _... i+ _ ~'S Y'} S ~ h ~ S w ~ G ~ b ' t m " 1 Y1 I ~ ~:I~ Chi; is•ro certih~ char t})e information here given is correctly copied from an origin.:)l certificate of death duly filed with •me as Llical Registrar. Z~he original certificare will 6e forwarded to the Sr)te ~`iral Records Office for permanent tiling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 820625 No. f Hev 218) focal Registrar ~~~~~ MAY ~ 6 ZnO~ l~~tte COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATN NAME Of DECEDENT {Rrv. M,dae. Leal ~ _^ ~ SEx ~ SGGIAL SECURITY NUMBER V DATE OF DEATN ,MCnm. Day, rear) '~ ~ ' Male ]~ 169 44 - 2555 e. L C>C~~Z AGE (Last Bnnday UNDERt VEM UNDERI DAY GATE OF BIgTH BIATNPLACE rCdy antl PLACE OF DEATN ICI+ecF avy nne--gee invnrel~a~s on erne, Ybe/ Momha . Days Fbura t MntNp iMOnm. Day. 'reed Stales Fcregn~~ HOSPITAL: OTHER: 50 Yn. April 28, 5 Springfield OIMr Inpatient ~ ER,otdpawnl Ci oo.. ^ N ^ ^ ^ 5. 6. 7. ome , Res,Wnw (sixcdYl N. COUNTY OF DEATH CITY 8pgp, TWP OF DEATH FACILfTY NAME Ot not mvIUlan. g,ve street antl rwmoen WAS DECEDENT OF HISPANIC ORIGIN? RACE ~ AmerKan Indian, Black. WhAa. etc. ital "° ~ "' ^ "'"'' `0°""OuOa"• (speo~r, Maalr n Cumberland Pwno Rican ac East Pennsboro ~ ~ ~ Hos ~ ,b• , , . k ,~ p f II f. 10. DECEDENT'S USUAL OCCUPATK)N KIND OF BUSINESS)INDUSTRY WAS DE EDENT VER IN DECEDENT'$EDUCATtON MARITAL STATUS~MarneO SURVIVING SPOUSE (Give kmtl d work dons dlK mast ~ U.S. ARMED f CEST S prN h r can ed Novq Monied. Witlowe4 In wAa. g,ve mamen namal of working Mo; do red use ~lal t }~ ^ Elamantary/Secondary Cdlege Divorced (Spealy) • V (P,2) 5+ ILaa5~1 Public Affa . „ Department of N ei "° ~] a. „,, '. 13, ,]. DECEDENT'S MAILWG ADDRESS (Street. ClrylTOwn, Slate. Zip Code) DECEDENT'S ACTUAL /7a. Stan Pa pp 17a^ Yaa, oocoMra lives in ,yvp. 2019 Dickinson Avenue RESIDENCE deced,M Can Hill Pa 17011 Iseamvrucr,p"a 6veln• Camp HIll p on Omer s~tle, Cuumberland tpwnsnipT No. acawrw grad /•. t7h. Coon 170.^ wahm,ICtrw kmaa of p ~ c y„ ,p_ FATHER'S NAME (FirSf. Mgde. Last) MOTHER'S NAME 1Fvs1. Mdtlle. Madan Surname) ,•. John Lucius „• Elizabeth Morin INFORMANT'S NAME (Typw•Prinp INFORMANT'S MAfLING ADDRESS ISrreet. CAy/ravn. Slats, Zrp Cotle) :a. Lori Lucius sgb. 2019 Dickinson Avenue Camp Hill, Pa 17011 METHOD OF DISPOSITION DATE OF DISPOSITION PLACE OF DISPOSITION ~ Mama d Cemebry, Crematory LOCATION-Ciryliown, Stale, Zp Coda ^ (Mwrh Da Year) Oln Pl ~ ^ , y, ey or ace BtKiel Cremation RYTOVaI Irom Stale Donalim^ an.rls oa ) ^ w v ],a. ,,,. Ma 6 2002 ,,,. WOOdlawn Memorial Garden ,, Harrisbur Pa , , . ' S EOFF MLSERVIC E ER CTINGASSUCN LICENSE NUMBER NAME ANDADORESSOFFACILITY 1903 ~'ket St t " :~,. :]b. 011654-L x: C Hill Pa ~l~1~11 , _ Co pleb c only wMn niyi To tM bawl of my knowledge, deatn occurre0 al fns I,me, dale and place stated. LICENSE NUMBS DATE SlGAIED pnysician n red available it hme al dealn to (S,grWlme ar,d Tllla) • certdy cause d Mom. (Mann. DaY. Year) 2L. ]]b. 23c. Uems 21-25 muY W completed Dy TIME OF DEATH DATE PRONOUNCED DEAD IMonm. Day, year) WAS CASE REFERRED 70 MEDICAL EXAMINERICORONER? • person wno prortounws Matn. 1r,,--~~ vea ^ No{dT 2e D M \ . . gi. - K. ` ]T. PART l: Enbr tree daeases, injures or compkcations which caused the death Do rot emer Ina mode of dying, s as carduc or respiratory arrest, snoCk or Head IaiWn. i Approaimya pAgT II: Omar signilloam condniona mmributing to daatn. bw Liel ody ono cause on each krN . ~ intarwl bNwwn na rssuaing in dte underlying uwa given kl PART 1. - 1 onset and Oeam IMMEDIATE CAUSE (Final ^,~ r/1~ D ~.- I ^ I d,seasea condom ~`'1 /'~5(~ E L~rrll~G~ M1-C 1~.. ^ ~ resWlaq n deem) --- a. ~+.A ~ /V r, ~]O IOR AS/A CONSEQ~U.E.~NC~E OFN I ') ~ /~ (~,~/ _ /~ /~,.. -! • $a Uemtaa k l COntl ~ Q ~~/'f " t ' /`•') i`~) LV wi ~ ~/ t yt ~ s v y s ll orw b. R . l l / l -- .J l- it any. loading to Knmedeb DUE TO (OR AS A CONSEQUENCE OF): I cause. Emer IINDERLYIND • t CAUSE ID~swse a,nryry c _-~ • Isar vwutetl evwda DUE TO (OR AS ACONSEOUENCE GFl: I resuevy r deem) LAST d WAS AN AUTOPSY PERFORMEDT WERE AUTOPSY FINDINGS AWIUBLE PRK)R 70 MANNER OF DEATH DATE OF INJURY TIME OF INJURY INJURY AT WORKT DESCRIBE MOW INJURY OCCURRED. COMPLETK)N OF CAUSE (Mmm. Oay Vear) OF DEATM7 ^ Natural ~ HOmiciG ACCbeM ^ PerWirg lnveaegalan ^ Yea ^ Na ^ Ws ^ N Yea ^ No ^ Suicide ^ Co Wd not W tletermmed ^ ]ga. ]OD. M. 30c. ]Od. PLACE GFINJURY AI h g l aa. xsb. xs. - ome, rin, shear. adary, oMico LOCATKJN (Street. C,gJlown. Slate) buildng, etc ISpecdvl ]a. ]a. CERTIFIER ICneck miy onel 'CERTIFYING PNYSICIAN IPnys,nan cerktymg cause M deem wren anaher pnys,aan has prorwurxed death and cCTpleled Item 231 SIG UR D TITLE OF CERTIF ^ To Iho WN of my knowNdga, deem ooeurred due to IW causeta) arW manner ae elatW ..................................................... J I,~ ]tb. ' 'PRONOUNCING AND CERTIFYING PHYSICIAN IPhys¢ian rwln p,~r,ounung uealh and cerLfy,ng to cause or dealnl T LICE E BER ~ ,_ ~~ .-QZ ~ (.+Q ~ IGNED~/Amm, ~aar) ri ~~~y ome Wet of my knowledge, dealn Occurred al tree Ilme, date, and place, and duo to the cause(el and manner ae elated ....................... ... '(_I r 77~~ 1 t te ]td. 'MEDICAL EXAMINER/CORONER ~ NAME AND ADORES$Of ERSON WHO COMPLETEC~p~ISE g~DEATH (Item P)7ypam Print~ ~ Z/ !r !K'-T /{~~ On IN basis o, e:aminatl n anN i ti i ~ ti ~ / ` ` ' o or nves gat on, in my opinion, death occurred al Ire Ilene, dab, and place, and due,o tree cause(s) and ^ manner as sbtW ...................................................... . .. ; ~~ ~ 1 G~ ~ ~ Q ('_ C N '' . . .................................... ... ]ta. J ` ~ ~ ]2 ~ '[ vJ REGISTRAR'S SIGNATURE AND NUMBER -~^ . DATE FILFD IMONh. 0 , Y ar 3~ a n O O~ N 0 [D CD CD 'O N W O y. 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O ° ° -•I 6g ,-. ? ~ f~i, co ~ ~ y y 4 cs N 0 0 o ~ fD fD ° y 0 ~ ~ y ? ° cn ~ i 'a ~ ~ ~m o m ~. y D C y cD y~ o• °' 4 y' m ~ o o ~ o a ,• C1 ~ OOy ? ~~ cn O o.~ O~ o°°~~ ~ ~p a ~m R ~ ~ m N 4 o0 3• rn O O ' 'a ~ c i n ~~ ~ ~o.m ~ m ~ ~c m ~ N o ~ o c p co 3 cq ~ ~ 3 ~m O~ ~. ~ n fD ` n y O• O ~ C T` • . + C1 O' A y y v c: a N rn N 0 N m~ C D Z Q 2 Z N ~ ~ ~ DZ c -~ c D r z C m -i O w 3 3 w Z rn IO x m z 0 m a ~n (D D 0 'O r- v r G n c a n n n n C a• m N W V O N !O O 0 0 0 0 0 W N w 0 0 0 m O z ~~ 0 0 c ~~ N ~• CO ~ ~ .-~ L .~a- C ~ ~~ (D w O ~ N O O N 9~ m W O IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ELIZABETH M. LUCIUS, NO. a minor child ORPHANS' COURT DIVISION CONSENT OF PROPOSED CUSTODIAN I hereby consent to act as Custodian of the accounts held by Elizabeth M. Lucius, a minor, under the Pennsylvania Uniform Transfer to Minor's Act. DATE: ~~~ ~ a c ~ .-~'~ -~. ,i... '6~~ ~. ~, LORI J. ~UCIUS :300646 1