HomeMy WebLinkAbout04-02031N RE: APPOINTMENT OF A TRUSTEE FOR
THE REX TODD RUDY, JR., TRUST
IN THE COURT OF COMMON PLEAS
ORPHANS' COURT DIVISION
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-2004-203
RULE
WE COMMAND, you that laying aside all business and excuses whatsoever, you be and appear in your
proper person before the Honorable Judges of the Court of Common Pleas, Orphans' Court Division at a
session of the said Court there to be held, for the County of Cumberland to show cause why Kathleen
Dawn Yasalonis should not be appointed Trustee and Shirley Arlene Stahler appointed Successor Trustee
of the Rex Todd Rud¥, Jr. Trust, as set forth in said Petition.
Rule returnable 20 days after service thereof.
Wimess my hand an official seal of office at Carlisle, Pennsylvania, this 8th day of March, 209_4_..
/ Clerk, Orphans' Court Division -
Cumberland County, Carlisle, PAs~
My Commission Expires on the i Monday
January, 2006
APPOINTMENT OF A TRUSTEE
FOR THE REX TODD RUDY, JR.
TRUST
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,
COMMONWEALTH OF PENNSYLVANIA
ORPHALxlS' COURT DIVISION
No. Z/-O%203
ANDNOWthis b~ ORDER
day of.]~l~?~*- ~, 1[- ., 2004, upon
consideration of the within Petition pursuant to Pennsylvania Orphans' Court Rule 12.6
for the Appointment of a Trustee, a Rule/Citation is hereby issued upon Rosalie Jo
Robison, Kathleen Dawn Yasalonis, and Shirley Arlene Stahler to show cause, if they
have any, why Kathleen Dawn Yasalonis should not be appointed Trustee and Shirley
Arlene Stahler appointed Successor Trustee of the Rex Todd Rudy, Jr. Trust, as set forth
in said Petition.
Rule retumable~O
days after service thereof.
BY THE COURT,
· Rosalie Jo Robison
3627 North 5th Street
Harrisburg, PA 17110
· Kathleen Dawn Yasalonis
219 Center Street
Enola, PA 17025
· Shirley Arlene Stahler
4807 Delbrook Road
Mechanicsburg, PA 17050
IN RE:
APPOINTMENT OF A TRUSTEE
FOR THE REX TODD RUDY, JR.
TRUST
PETITION FOR THE APPOINTMENT OF A TRUSTEE ~
PURSUANT TO Pa. O.C. RULE 12.6 -~ : :: ,~'.,
TO THE HONORABLE, THE JUDGES OF SAID COURT: ~
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,
COMMONWEALTH OF PENNSYLVANIA
ORPHANS' COL~_ ~DIV~ION COT
NO. r.,:~ '~' }~.,.. ~
1. The Petitioner, Rex Todd Rudy, Jr., is a minor child (D.O.B. January 4, 1987).
2. The Petitioner, is, and has been for years, a resident of Cumberland County.
3. Petitioner's current address is 302 Louisa Lane, Mechanicsburg, PA 17055.
4. Petitioner, by and through his Father, petitions this Court to appoint Petitioner's Aunt,
Kathleen Dawn Yasalonis, as the Trustee, and Petitioner's other Aunt, Shirley Arlene
Stahler, as the Successor Trustee, of the Rex Todd Rudy, Jr. Trust. (A copy of the
Trust Instrument to be executed is attached as Exhibit A.)
5. Petitioner is a co-beneficiary of the Death Claim on the Catherine H. Rudy Structured
Settlement.
6. The Erie Family Life Insurance Company, the Administrator of the Catherine H.
Rudy Structured Settlement, will not begin to disperse benefits from the Claim until a
Court has appointed a guardian or Trustee for Rex Todd Rudy, Jr.'s portion of the
Claim. See Erie Family Life Insurance Company letter and Structured Settlement
Claimant's Statement attached as Exhibit B.
7. The Rex Todd Rudy, Jr. Trust has been established to hold Petitioner's share of the
Catherine H. Rudy Structured Settlement benefits, until Petitioner reaches the age of
majority or until the Petitioner reaches the age of twenty-five if the Trustee decides
that doing so is in the Petitioner's best interest.
8. In addition, the Trustee shall have discretion to make disbursements from the Trust if
necessary for the beneficiary's health, education, or support.
9. Petitioner's share of the Catherine H. Rudy Structured Settlement benefits is reported
to be $500.00 per month, continuing until 09/01/2010. See Erie Family Life
Insurance Company letter attached as Exhibit B.
10. Petitioner desires to have his monthly share of the Catherine H. Rudy Structured
Settlement made payable to The Rex Todd Rudy, Jr. Trust.
11. The parties in interest are:
· Rex Todd Rudy, Sr., Petitioner's Father
302 Louisa Lane
Mechanicsburg, PA 17050
· Rex Todd Rudy, Jr., Petitioner and Co-beneficiary
302 Louisa Lane
Mechanicsburg, PA 17050
· Rosalie Jo Robison, Petitioner's Mother
3627 North 5th Street
Harrisburg, PA 17110
· Kathleen Dawn Yasalonis, Proposed Trustee, Co-beneficiary, and
Petitioner's Aunt
219 Center Street
Enola, PA 17025
· Shirley Arlene Stahler, Proposed Successor Trustee, Co-beneficiary
and Petitioner's Aunt
4807 Delbrook Road
Mechanicsburg, PA 17050
12. Kathleen Dawn Yasalonis has been chosen to be appointed Trustee by Petitioner and
his family due to her maternaMike relationship with the Petitioner and her awareness
of his personal situation and desires.
13. Additionally, Kathleen Dawn Yasalonis had the opportunity to converse at length
with Catherine H. Rudy, the Petitioner's Grandmother, about how the Structured
Settlement moneys should be preserved for, and spent on, the Petitioner.
14. These conversations took place the months before Catherine H. Rudy's death, during
which period Catherine H. Rudy reaffirmed her desire to have Rex Todd Rudy, Jr.,
benefit from the structured settlement.
15. Shirley Arlene Stahler has been chosen to be appointed Successor Trustee by
Petitioner and his family due to her maternal-like relationship with the Petitioner and
her awareness of his personal situation and desires.
WHEREFORE, Petitioner requests that this Court appoint Kathleen Dawn Yasalonis as
Trustee and Shirley Arlene Stahler as Successor Trustee of the Rex Todd Rudy, Jr. Trust.
Date:
John C. Porter
Attomey for the Petitioner
PA Supreme Court ID No. 90152
61 West Louther Street
Carlisle, PA 17013
(717) 249-1177
Consent to Appointment As Trustee
I, Kathleen Dawn Yasalonis, hereby consent to my appointment as Trustee of the
Rex Todd Rudy, Jr. Trust. I affirm that I will abide by the dictates of the Trust provisions
and that I will:
1. Exercise my powers under the Trust for the benefit of the beneficiary;
2. Keep the Trust assets separate from my assets;
3. Exercise reasonable caution and prudence; and
4. Keep a full and accurate record of all actions, receipts, and disbursements on
behalf of the beneficiary.
Date:
Kathleen Dawn Yasalonis
Consent to Appointment As Successor Trustee
I, Shirley Arlene Stahler, hereby consent to my appointment as Successor Trustee
of the Rex Todd Rudy, Jr. Trust. I affirm that I will abide by the dictates of the Trust
provisions and that I will:
1. Exercise my powers under the Trust for the benefit of the beneficiary;
2. Keep the Trust assets separate from my assets;
3. Exercise reasonable caution and prudence; and
4. Keep a full and accurate record of all actions, receipts, and disbursements on
behalf of the beneficiary.
Shirley Arlene S{~
VERIFICATION
We verify that the statements made in this petition are tree and correct. We
understand that false statements herein are made subject to the penalties of 18 Pa. Cons.
Stat. § 4904 relating to unswom falsification to authorities.
Date
Petitioner-, Rex/T~odd Ru-dy, Jr.
D~te - ,~J '
Petitioner's Father, Rex Todd Rudy, Sr.
EXHIBIT A
THIS AGREEMENT AND DECLARATION OF TRUST, made effective the
day of ,2004, by Rex Todd Rudy, Jr., Beneficiary; Rex
Todd Rudy, Sr., the beneficiary's Father; Kathleen Dawn Yasalonis, Trustee; and Shirley Arlene
Stahler, Successor Trustee is established upon the conditions and for the purposes that follow.
ARTICLE ONE
TRUST NAME
This trust shall be known as the Rex Todd Rudy, Jr., Trust.
ARTICLE TWO
TRUST PROPERTY
This trust shall be funded by a structured settlement payout, which is being administered
by the Erie Family Life Insurance Co. and which is designated #663-225.
This trust may also be funded by property which shall be titled in the name of this Trust,
as well as all property described in the attached Schedule A.
The Trustee may at any time receive into the Trust additions of cash or property from any
source whatsoever, after consideration of the possible tax consequences to all concerned.
The property in this Trust may be transferred to, or merged with, the property of another
trust within the limitations set forth below under the Powers of the Trustee.
All of the Trust property shall be used for the benefit of the beneficiary of the Trust and
shall be managed and distributed in accordance with this Declaration of Trust.
The primary purpose of this trust shall be to save funds for the beneficiary's future use.
The Trustee shall have full and exclusive discretion to release funds from this Trust at
any time, if the Trustee finds it necessary to do so for the health, education, or support of the
beneficiary.
Page 1 of 11
The Trust property shall not be subject to anticipation or pledge, assignment, sale, or
transfer in any manner (except as otherwise provided herein), nor shall the beneficiary have the
power in any manner to charge or encumber his interest.
ARTICLE THREE
DURATION OF THE TRUST
The Trustee shall maintain this trust for the benefit of the beneficiary at least until the
beneficiary reaches the age of majority.
The Trustee shall have full and exclusive discretion to continue the Trust beyond the date
the beneficiary reaches the age of majority, subject to the following provisions.
Full decision making power over the Trust shall be transferred to the beneficiary on
January 4, 2012, at which time the beneficiary shall become the Trustee, subject to the following
provision.
If at any time a Trustee contemplates transferring to the beneficiary the position of
Trustee of this Trust and the beneficiary is determined by his Family Doctor to be incompetent,
no such transfer shall be made and the duration of the Trust shall be extended through the period
of incompetency or until the Trust res is exhausted.
In the event that the beneficiary passes away before the natural termination of this Trust,
this Trust shall then terminate and any assets held in the Trust shall be distributed to the
beneficiary's heirs.
Once the beneficiary of the Trust becomes Trustee, the beneficiary shall have the
exclusive power to continue the Trust or to revoke and terminate the Trust.
Page 2 of 11
ARTICLE FOUR
TRUSTEES
The Trustee of the Rex Todd Rudy, Jr. Trust shall be Kathleen Dawn Yasalonis.
The Successor Trustee shall be Shirley Arlene Stahler.
The beneficiary shall succeed to the position of Trustee as stated in Article Three above.
Should the Trustee become unwilling or unable to serve as Trustee, the Successor Trustee
shall succeed to all of the powers, duties, and liabilities stated herein.
The Trustee may resign at any time by signing a notice of resignation and by delivering
the notice to the Successor Trustee.
All Trustees are to serve without bond. No Trustee shall receive any compensation for
serving as Trustee. No Trustee shall be liable for actions taken in good faith with respect to the
exercise or non-exercise of discretionary powers granted by this Declaration of Trust. The
Trustees may receive reimbursement from the Trust Estate for any liability, whether in contract
or tort, incurred in the administration of the Trust Estate, if such administration was in
accordance with the provisions of this Declaration of Trust. The Trustee may, within the bounds
set forth in 20 Pa. C.S.A. §1331, contract so as to be exempt from personal liability and so as to
limit the liability to the Trust Assets. Any successor Trustee shall have the same powers, duties,
and liabilities as the initial Trustee.
The term Trustee shall be construed to read "Trustees" when the situation is such that
more than one Trustee is serving the Trust.
ARTICLE FIVE
BENEFICIARIES
Rex Todd Rudy, Jr., shall be the sole beneficiary of this Trust.
Page 3 of 11
ARTICLE SIX
AMENDMENT AND REVOCATION
This Trust shall not be amendable.
This Trust shall only be revocable after the beneficiary has reached the age of majority,
except as otherwise provided herein.
ARTICLE SEVEN
TRUSTEE POWERS, DUTIES, AND LIABILITIES -- GENERAL
The Trustee shall have the powers, duties, and liabilities as provided under 20 Pa. C.S.A.
{}7133, and the other statutory sections referred to therein, or any successor statute(s) to {}7133.
ARTICLE EIGHT
TRUSTEE POWERS -- SPECIFICALLY
o
The provisions of the Pennsylvania Uniform Principal and Income act shall not apply to
this Trust.
The Trustee may retain in the Trust any property for any period, whether or not the same
be of the character permissible for investments by fiduciaries under any applicable law,
and without regard to any effect the said retention may have upon the diversification of
the assets in the Trust Estate.
The Trustee may render liquid the Trust Estate, or any Trust or Share created hereunder,
in whole or in part, at any time and may hold cash or any readily marketable securities of
little or no yield (unless otherwise provided in this instrument), for any such period as the
Trustee may deem advisable.
Page 4 of 11
The Trustee may invest and reinvest the Trust Assets from time to time in any property,
real, personal, or mixed, including without limitation, securities of domestic and foreign
corporations and investment trusts or companies, bonds, debentures, preferred stocks,
common stocks, mortgages, mortgage participation, and interests in common trust funds.
The Trustee shall have complete discretion to convert realty into personalty or personalty
into realty or otherwise change the character of the Trust Estate, even though such
investment (by reason of its character, amount, proportion to the total Trust Estate, or
otherwise) would not be considered appropriate for a fiduciary apart from this provision
and even though such investment caused part or all of the total Trust Estate to be invested
in investments of one type or of one business or company. The Trustee's investment
flexibility and power shall not be limited by Pa. C.S.A. §3319(b), but shall include the
parameters permitted under Pa. C.S.A. §3319(c). The Trustee's investment flexibility
and power shall be as authorized by this governing instrument.
The Trustee may hold property in the Trustee's name, as Trustee, or in the name of a
nominee without disclosing the Trust.
With respect to securities held in the Trust Estate, the Trustee may exercise all the rights,
powers, and privileges of an owner, including but not limited to, the power to vote, give
proxies, and to pay assessments and other sums deemed by the Trustee necessary for the
protection of the Trust Estate. In addition, the Trustee may participate in voting trusts,
foreclosures, reorganizations, consolidations, mergers, and liquidations, and in
connection therewith, may deposit securities with and transfer title to any protective or
other committee under such terms as the Trustee may deem advisable. In addition, the
Trustee may exercise or sell stock subscription or conversion rights and may accept and
retain as an investment any securities or other property received through the exercise of
any of the foregoing powers, regardless of any limitations elsewhere in this instrument
relative to investments by the Trustee.
The Trustee may employ one or more agents to perform any act of administration,
whether or not discretionary, including attorneys, auditors, investment managers, or
others, as the Trustee shall deem necessary or advisable. The Trustee may compensate
agents and other employees and may delegate to them any and all discretions and powers.
Page 5 of 11
10.
11.
The Trustee may lease any Trust Assets generally, even though the lease term may extend
beyond the term of the Trust of which the property is a part. The Trustee may enter into
any covenants and agreements relating to the property so leased or concerning any
improvements which may then or thereafter be erected on such property.
The Trustee may possess, manage, insure against loss by fire or other casualties, develop,
subdivide, control, partition, mortgage, lease, or otherwise deal with any and all real
property. The Trustee may satisfy, discharge, or extend the term of any mortgage
thereon, and may execute the necessary instruments and covenants to effectuate the
foregoing powers, including the giving or granting of options in connection therewith.
The Trustee may make improvements, repairs, or modernizations, structural or otherwise,
to buildings or other Trust assets. The Trustee may use Trust principal for any such
improvements, repairs, or modernizations. The Trustee may abandon any real property if
it is deemed to be worthless or not of a sufficient value to warrant keeping or protecting,
in the Trustee's reasonable discretion. The Trustee may abstain from the payment of any
taxes, water charges, rents, assessments, repairs, or maintenance and upkeep of any real
property and may permit any real property to be lost by a tax sale, or any other
proceeding. The Trustee may convey the same for a nominal consideration, or without
any consideration.
The Trustee may make ordinary and extraordinary repairs and alterations to buildings or
other Trust Assets.
The Trustee may make any distribution contemplated by this Declaration of Trust to the
Beneficiary. If a Beneficiary is under a legal disability or if the Trustee determines that a
Beneficiary is unable to properly manage his or her affairs, the Trustee may make any
distribution contemplated by this Declaration of Trust to a person furnishing support,
maintenance, or education for the Beneficiary or with whom the Beneficiary is residing
for expenditures on the Beneficiary's behalf. Alternatively, if the beneficiary is under a
legal disability or is unable to properly manage his or her affairs the Trustee may apply
all or a part of the distribution for the Beneficiary's benefit. Any distribution under this
paragraph will be a full discharge of the Trustee's duties and liability with respect thereto.
On any partial or final distribution of the Trust Assets, the Trustee may apportion and
Page 6 of 11
12.
13.
14.
15.
allocate the assets of the Trust Estate in cash or in kind or partly in cash and partly in
kind.
The Trustee may, for the benefit of the Trust, borrow money from the Trust Estate and
others. To secure the repayment thereof, the Trustee may mortgage, pledge, or otherwise
encumber part or all of the Trust Assets, and in connection with the acquisition of any
property, the Trustee may assume a liability or may acquire property subject to a liability.
The Trustee may retain a residence and other property for the personal use of the
Beneficiary and may allow a Beneficiary to use or occupy the retained property free of
rent and maintenance expenses.
If at any time the Trustee of any trust created hereunder shall also be acting as Trustee of
any other trust for the benefit of the same beneficiary and upon substantially the same
terms and conditions, the Trustee is authorized and empowered, if in the Trustee's
discretion such action is in the best interest of the Beneficiary, to transfer and merge all of
the assets then held under such Trust created pursuant to this Trust Agreement. As a
result, if necessary, the Trustee may thereupon terminate the Trust created pursuant to
this Declaration of Trust. The Trustee is further authorized to accept the assets of any
other Trust which may be transferred to any Trust created hereunder and to administer
and distribute such assets and properties so transferred in accordance with the provisions
of this Declaration of Trust.
The Trustee will have full power and authority to determine if dividends payable in stock
of the issuing corporation, stock splits, interest on bonds, capital gains, and the like will
be treated as principal. Except as herein otherwise specifically provided, the Trustee will
have full power and authority to determine the manner in which expenses are to be borne
and in which receipts are to be credited as between principal and income. The Trustee
shall have the power to determine what will constitute principal or income and may
withhold from income such reserves for depreciation or depletion as the Trustee may
deem fair and equitable. In determining such matters, the Trustee may give consideration
to the provisions of the Pennsylvania Statutes (or its successor statutes) relating to such
matters, but it will not be bound by such provisions.
Page 7 of 11
16.
In the administration of the Trust hereunder, its Fiduciaries shall exercise all available tax
related elections, options, and choices in such a manner as they, in their sole but
reasonable judgment (where appropriate, receiving advice of tax counsel), believe will
achieve the overall minimum total combined present and reasonably anticipated future
administrative expenses and taxes of all kinds.
ARTICLE NINE
SEVERABILITY
In the event a court finds any provision of this Declaration of Trust to be void, invalid,
unenforceable, or contrary to law the remaining provisions of this Declaration of Trust shall
continue to be in effect.
ARTICLE TEN
HEADINGS
The use of headings in connection with the various articles and sections of this Trust
Agreement is solely for convenience and the headings are to be given no meaning or significance
whatsoever in construing the terms and provisions of this Agreement.
ARTICLE ELEVEN
PENNSYLVANIA LAW GOVERNS
Questions pertaining to the validity, construction, and administration of the Trust created
under this instrument shall be determined in accordance with the laws of the Commonwealth of
Pennsylvania.
Page 8 of 11
SIGNATURES
The signature of each party below indicates that she understands and agrees to the terms
of this Declaration of Trust.
WITNESS:
Trustee
Successor Trustee
Beneficiary
Beneficiary's Father
Page 9 of 11
REX TODD RUDY, JR. TRUST
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA :
: SS
COUNTY OF CUMBERLAND :
We, Rex Todd Rudy, Sr., and Rex Todd Rudy, Jr., whose names are signed to the
attached or foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that we signed and executed this instrument as The Rex Todd Rudy, Jr. Trust, that
we signed it willingly, and that we signed it as our individual free and volumary act for the
purposes therein expressed.
Rex Todd Rudy, Sr.
Rex Todd Rudy, Jr.
Sworn or affirmed and acknowledged before me by Rex Todd Rudy, Sr. and Rex Todd
Rudy, Jr., this day of ,2004.
NOTARY PUBLIC
Page 10of 11
REX TODD RUDY, JR. TRUST
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA :
COUNTY OF CUMBERLAND :
SS
WE, and ,
the witnesses whose names are attached to the foregoing document, being duly qualified
according to law, do depose and say that we were present and saw Rex Todd Rudy, Sr., and Rex
Todd Rudy, Jr., sign and execute the instrument as The Rex Todd Rudy, Jr. Trust; that they
signed willingly and that they executed it as their individual free and voluntary act for the
purposes therein expressed; that each subscribing witness could hear and see Rex Todd Rudy,
Sr., and Rex Todd Rudy, Jr., as witnesses; and that to the best of our knowledge Rex Todd Rudy,
Sr., and Rex Todd Rudy, Jr. were at the time of sound mind and under no constraint or undue
influence.
WITNESS
WITNESS
and
Sworn or affirmed and subscribed before me by.
this day of
,2004.
NOTARY PUBLIC
Page llof 11
EXHIBIT B
ERIE FAMILY LIFE INSURANCE COMPANY
Member · Erie ir~turar~ce Gro~p
Home Olfice · 100 Ene Insurance Place · Ene, Pennsylvania 16530 · (814) 870-2000
Toil Free 1-800-458-0811 · Fax (814) ;J70-2099 · www.eriemsuraflce.com
John C. Porter
61 West Louther Street
Carlisle, PA 17013-2936
February 5, 2004
Dear Mr. Porter:
Re:
Death Claim on
Catherine H. Rudy
Structured Settlement #: 603-225
In order for us to begin the claim proceedings for the above contract,
please send me the following documents as soon as you can:
* The enclosed Claimant's Statements, completed and signed by Kathleen
Yasalonis and the guardian/trustee for Rex Rudy Jr;
* The enclosed Direction of Payment form, completed by the above;
* Court appointed Guardian/Trustee papers;
* The original Settlement Certificate, 603-225. If you can't find the
certificate, note this fact on the Claimant's Statement.
Please note that I have received the claim information and death
certificate from Shirley Lee Stahler. The Structured Settlement payout
of $1,500.00 a month will be divided between the three beneficiaries.
The payments will continue until 09/01/2010.
Enclosed you will find a postage-paid envelope for your convenience. If
you have any questions, please call me at 1-800-458-0811, extension
2243, or Melody Bokshan at extension 2922.
SLA:SLA
Enclosures:
Reply Envelope (s)
Claimant's Statement
Direction of Payment form
Sincerely,
Sally Austin
Life Claims Specialist
Life Policy Administration
*PY06032250'
Tile ERIE Is Above All In sERvIcEe . Since 1925
ERIE FAMILY LIFE INSURANCE COMPANY
Member · Erie Insurance Group
Home Office · 100 Erie Insurance Place. Erie, PA 16530
.STRUCTURED SETTLEMENT CLAiMANi~S;STATEMENT
The following documentation, in addition to this completed Claimant's Statement, is necessary in order for Erie Family Life Insurance
Company to process a death claim on a structured settlement.
· DEATH CERTIFICATE - A certified copy of the death certificate must be obtained and forwarded to the Home Office.
· ORIGINAL SETTLEMENT CERTIFICATE - The original settlement certificate should be secured and forwarded
with the Claimant's Statement and the death certificate. If the original certificate cannot be located, it should be
indicated on the Claimant's Statement.
· A DIRECTION OF PAYMENT FORM completed and signed by beneficiary.
INSTRUCTIONS FOR COMPLETING CLAIMANI~S STATEMENT
This form must be executed before a WITNESS by the person or persons to whom the structured settlement is payable.
If the structured settlement payments are payable to the ESTATE or EXECUTORS or ADMINISTRATORS of the certificate holder, the
statement should be completed by the executor or administrator, a certificate of whose appointment and qualifications must be
furnished. The tax identification number of the estate should also be used for beneficiary information.
If the structured settlement payments are payable to a MINOR or a MENTALLY INCOMPETENT PERSON, the statement should be
completed by the COURT APPOINTED guardian. An official certificate of appointment and qualifications must be furnished.
Structured settlements are not assignable.
PLEASE BE ADVISED, ALL GUARANTEED PAYMENTS WILL BE MADE TO THE DESIGNATED BENEFICIARY AS
SCHEDULED ON THE ORIGINAL SETTLEMENT CERTIFICATE. THIS SCHEDULE CANNOT BE CHANGED.
P~~;HOLDER~'iNFORMATION ~COMPLET~THIS(SEC'IIoN~FOR~.~i~.~CI.~iMs~~,i!.i~i
STRUCTURED SETTLEMENT NUMBER: 603-225
DECEASED'S NAME: Catherine H. Rudv
DECEASED'S DATE OF DEATH: 09 / 15/2003
PLEASE INDICATE IF CERTIFICATE IS: [] ATTACHED [] LOST
Claimant Name: Rex Rudy Jr.
Claimant's Address:
Phone Nos. (Home): (Work):
Taxpayer Identification No. (Social Security Number):
Relationship to Certificate Holder: Claimant's Date of Birth:
I declare that I have read and understood all the statements shown on this form, that they are true and complete to the best of my
knowledge and correctly recorded.
Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or
statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any
fact thereto commits a fraudulent insurance act, which is a crime and subjects the person to cdminal and civil penalties.
EFL-799 4/03
Witness
Claimant's (Beneficiary's) Signature
Date
APPOINTMENT OF A TRUSTEE
FOR THE REX TODD RUDY, JR.
TRUST
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,
COMMONWEALTH OF PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. Z ~ - ~Cl - ~.o ~
CERTIFICATE OF SERVICE
I, John C. Porter, Counsel for Rex Rudy, Jr., hereby certify that tree and correct
copies of the Petition For The Appointment of a Trustee Pursuant to Pa. O.C. Rule 12.6;
the Court's signed Order dated March 6, 2004; and the Orphans' Court's Rule dated
March 8, 2004, were served this lo'P,',- day of ]~.qC~ , 2004, by First Class Mail,
upon those listed below.
Rosalie Jo Robison,
Petitioner's Mother
3627 North 5th Street
Harrisburg, PA 17110
Shirley Arlene Stahler
Proposed Successor Trustee
and Petitioner's Aunt
4807 Delbrook Road
Mechanicsburg, PA 17050
Kathleen Dawn Yasalonis,
Proposed Trustee
and Petitioner's Aunt
219 Center Street
Enola, PA 17025
Johr~C. Porter, Esq.
Counsel for Petitioner
PA Sup. Ct. ID# 90152
61 W. Louther St.
Carlisle, PA 17013
717-249-1177
APPOINTMENT OF A TRUSTEE
FOR THE REX TODD RUDY, JR.
TRUST
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,
COMMONWEALTH OF PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. Z..I -~ 0q-- gO~
CERTIFICATE OF SERVICE
I, John C. Porter, Counsel for Rex Rudy, Jr., hereby certify that true and correct
copies of the Petition For The Appointment of a Trustee Pursuant to Pa. O.C. Rule 12.6;
the Court's signed Order dated March 6, 2004; and the Orphans' Court's Rule dated
March 8, 2004, were served this L~ day of [~'~.~;r,.~ , 2004, by First Class Mail,
upon those listed below.
Rosalie Jo Robison,
Petitioner's Mother
3627 North 6th Street
Harrisburg, PA 17110
John(~. Porter, Esq.
Counsel for Petitioner
PA Sup. Ct. ID# 90152
61 W. Louther St.
Carlisle, PA 17013
717-249-1177
IN RE: APPOINTMENT OF A TRUSTEE
FOR THE REX TODD RUDY, JR.
TRUST
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COLrNTY,
COMMONWEALTH OF PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21 - 04 - 203
MOTION TO MAKE RULE ABSOLUTE
TO THE HONORABLE, THE JUDGES OF SAID COURT:
1. On March 1, 2004, the Petitioner, Rex Todd Rudy, Jr., a minor child (D.O.B¥,January
4, 1987), by and through his Father, petitioned this Court to appoint Petition6i:'s Aunt,
Kathleen Dawn Yasalonis, as the Trustee, and Petitioner's other Aunt, Shirley Arlene
Stahler, as the Successor Trustee, of the Rex Todd Rudy, Jr. Trust.
2. Said Petition was made pursuant to Pennsylvania Orphans' Court Rule 12.6, which
Rule allows a party in interest to Petition this Court for the appointment of a Trustee
to a Trust that benefits a minor.
3. On March 6, 2004, this Court issued an Order, granting Rosalie Jo Robison, Kathleen
Dawn Yasalonis, and Shirley Arlene Stahler twenty (20) days to show cause, if they
had any, why Kathleen Dawn Yasalonis should not be appointed Trustee and Shirley
Arlene Stahler appointed Successor Trustee of the Rex Todd Rudy, Jr. Trust.
4. This Rule to Show Cause/Order was successfully served upon Kathleen Dawn
Yasalonis and Shirley Arlene Stahler on March 10, 2004. (See Certificate of Service
a true copy of which is attached as Exhibit A.)
5. This Rule to Show Cause/Order was successfully served upon Rosalie Jo Robison on
March 24, 2004. (See Certificate of Service a true copy of which is attached as
Exhibit B.)
6. Twenty (20) days have passed and neither Rosalie Jo Robison, nor Kathleen Dawn
Yasalonis, nor Shirley Arlene Stahler have responded to this Court's March 6, 2004
Rule to Show Cause/Order.
7. Accordingly, all parties in interest have consented to the appointments of Kathleen
Dawn Yasalonis as Trustee and Shirley Arlene Stahler as Successor Trustee of the
Rex Todd Rudy, Jr. Trust, have verified in the initial Petition that such was their
wish, or have had more than twenty (20) days to show cause why these appointments
should not be made and have not objected to the appointments.
WHEREFORE, Petitioner requests that this Court appoint Kathleen Dawn Yasalonis as
Trustee and Shirley Arlene Stahler as Successor Trustee of the Rex Todd Rudy, Jr. Trust.
Date:
fJohn C. Porter
Attorney for the Petitioner
PA Supreme Court ID No. 90152
61 West Louther Street
Carlisle, PA 17013
(717) 249-1177
EXHIBIT A
RE:
APPOINTMENT OF .-\ 'FRUSTEE
FOR THE REX TODD RUDY, JR.
TRUST
iN THE COURT OF COMMON IDLE:kS ()F
CUMBERL.x, ND COUNTY.
COMMONWE,-\LTH OF PENNSYLVANI..\
ORPHANS' COURT DIVISION
NO. l ~ -'~ct - Lo -~
CERTIFICATE OF SERVICE
[. John C. Porter. Counsel ~-br Rex Rudy. Jr.. herebv certify that tree and correct
copies of the Petition For The Appointment of a Trustee Pursuant to Pa. O.C. Rule 12.6:
the Court's signed Order dated March 6. 2004: and the Orphans' Court's Rule dated
March 8.2004. were serx, ed this ' :)-,-¢, dav of /~.< (.¼ .2004. by First Class Mail.
upon those listed below.
Rosalie .1o Robison.
Petitioner's Mother
3627 North 5'h Street
Harrisburg, PA 17110
Shirley Arlene Stahler
Proposed Successor Trustee
and Petitioner's Aunt
4807 Delbrook Road
Meehaniesburg, PA 17050
Kathleen Dawn Yasalonis.
Proposed Trustee
and Petitioner's Aunt
219 Center Street
Enola, PA 17025
John/C. Porter, Esq.
Counsel for Petitioner
PA Sup. Ct. ID# 90152
61 W. Louther St.
Carlisle, PA 17013
717-249-1177
EXHIBIT B
APPOINTMENT OF A TRUSTEE
FOR THE REX TODD RUDY, JR.
TRUST
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COU,'NTY,
COMMONWEALTH OF PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
CERTIFICATE OF SERVICE
I, John C. Porter, Counsel for Rex Rudy, Jr., hereby certify that true and correct
copies of the Petition For The Appointment of a Trustee Pursuant to Pa. O.C. Rule 12.6:
the Court's signed Order dated March 6, 2004: and the Orphans' Court's Rule dated
March 8, 2004, were served this 7..~ day of [~,~.,*,.¥~ , 2004. by First Class Mail,
upon those listed below.
Rosalie Jo Robison,
Petitioner's Mother
3627 North 6t~ Street
Harrisburg, PA 17110
John~. Porter, Esq.
Counsel for Petitioner
PA Sup. Ct. ID# 90152
61 W. Louther St.
Carlisle, PA 17013
717-249-1177
IN RE: APPOINTMENT OF A TRUSTEE
FOR THE REX TODD RUDY, JR.
TRUST
HAY [1 6 2004
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,
COMMONWEALTH OF PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21 - 04 - 203
AND NOW this,,It btday of~~ ., 2004, upon
consideration of the March 1, 2004 Petition Pennsylvania Orphans' Court
Rule 12.6 for the Appointment of a Trustee, and this Court not having received any
objections thereto, it is ORDERED AND DECREED that:
KATHLEEN DAWN YASALONIS is appointed as Trustee of the Rex Todd Rudy, Jr.
Trust and
SHIRLEY ARLENE STAHLER is appointed Successor Trustee of the Rex Todd Rudy,
Jr. Trust.
· Rex Todd Rudy, Sr.
302 Louisa Lane
Mechanicsburg, PA 17050
· Rex Todd Rudy, Jr.
302 Louisa Lane
Mechanicsburg, PA 17050
· Rosalie Jo Robison
3627 North 5th Street
Harrisburg, PA 17110
· Kathleen Dawn Yasalonis
219 Center Street
Enola, PA 17025
· Shirley Arlene Stahler
4807 Delbrook Road
Mechanicsburg, PA 17050
BY THE COURT,
APPOINTMENT OF A TRUSTEE
FOR THE REX TODD RUDY, JR.
TRUST
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,
COMMONWEALTH OF PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21 - 04 - 203
CERTIFICATE OF SERVICE
I, John C. Porter, Counsel for Rex Rudy, Jr., hereby certify that a tree and correct
copy of the Motion to Make Rule Absolute and a proposed order appointing Kathleen
Dawn Yasalonis as Trustee, and Shirley Arlene Stahler as successor Trustee of the Rex
Todd Rudy, Jr. Trust, were served this Ily~ day of, /~,~3"?--0o~, by First Class Mail
upon those listed below:
· Rex Todd Rudy, Sr.
302 Louisa Lane
Mechanicsburg, PA 17050
· Rex Todd Rudy, Jr.
302 Louisa Lane
Mechanicsburg, PA 17050
· Rosalie Jo Robison
3627 North 5th Street
Harrisburg, PA 17110
· Kathleen Dawn Yasalonis
219 Center Street
Enola, PA 17025
· Shirley Arlene Stahler
4807 Delbrook Road
Mechanicsburg, PA 17050
PA Sup. Ct. ID# 90152
61 W. Louther St.
Carlisle, PA 17013
717-249-1177
Stephanie E. Chertok, R.N., Esq.
ATTORNEY AT LAW
61 West Louther Street
Carlisle, PA 17013-2936
(717) 249-1177
FAX (717) 249-4514
Cumberland County Orphans' Court
1 Court House Square
Carlisle, PA 17013
APPOINTMENT OF A TRUSTEE
FOR THE REX TODD RUDY, JR.
TRUST: NO. 21 - 04 - 203
May 18, 2004
To Whom this may concern:
Please file the enclosed Certificate of Service for the Rex Todd Rudy Case, in the
above- Referenced Case. Thank you.
John C. Porter, Esquire
APPOINTMENT OF A TRUSTEE
FOR THE REX TODD RUDY, JR.
TRUST
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,
COMMONWEALTH OF PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21 - 04 - 203
CERTIFICATE OF SERVICE
I, John C. Porter, Counsel for Rex Rudy, Jr., hereby certify that a tree and correct
copy of the Court's May 11 th order, appointing Kathleen Dawn Yasalonis as Trustee, and
Shirley Arlene Stahler as successor Trustee of the Rex Todd Rudy, Jr. Trust, were served
this 1~¢, day of, ~00~ , by First Class Mail upon those listed below:
· Rex Todd Rudy, Sr.
302 Louisa Lane
Mechanicsburg, PA 17050
· Rex Todd Rudy, Jr.
302 Louisa Lane
Mechanicsburg, PA 17050
· Rosalie Jo Robison
3627 North 5th Street
Harrisburg, PA 17110
· Kathleen Dawn Yasalonis
219 Center Street
Enola, PA 17025
· Shirley Arlene Stahler
4807 Delbrook Road
Mechanicsburg, PA 17050
John C. Porter, Esq.
Counsel for Petitioner
PA Sup. Ct. ID# 90152
61 W. Louther St.
Carlisle, PA 17013
717-249-1177