HomeMy WebLinkAbout04-0563 LAW OFFICES OF
STEPHE~N j. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
IN RE:
ALLEGED INCAPACITATED
PERSON
WILLIAM H. MERRIAM,JR: COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
: PENNSYLVANIA
: ORPHAN COURT DIVISION
:
: NO.:
PETITION FOR GUARDIAN AD LITEM
The undersigned brings this Petition through her Attorney,
~tephen!J.. Hogg, Esquire, seeking appointment as the Guardian ,Ad
Litem of William H. Merriam, Jr. alleging the following:
1. The alleged incapacitated person is William H. Merriam, Jr. born
January 19, 1917 and whose last known address was 113
Green Ridge Lane, Newville, P,A 17241. The alleged
incapacitated person is currently an inpatient at Swain Health
Center Newville, P,A and is deemed by his physicians to be
unable to safely travel.
2. The alleged incapacitated person is married to Ila Merriam,
Petitioner herein. The alleged incapacitated person has three
children: William H. Merriam, III, 529 N. Genison Avenue,
Lansing, Michigan 48915, Robinetta M. Goold, 4395 Hales Ford
Road, Moneta, Virginia 24121 and Abigail M. Selinsky, 2717
George Mason Place, Alexandria, Virginia 22305.
3. The alleged incapacitated person is currently being treated by
Dr. Ismael, 220 Wilson Street, Carlisle, Pennsylvania 17013
LAW OFFICES OF
STEPHEN j. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
=
and Dr. Herbert Myers, Philhaven, 283 S. Butler Road, P.O. Box
550, Mt. Gretna, Pennsylvania 17064.
The Petitioner is Ila Merriam, residing at 113 Green Ridge Lane
Newville, Pennsylvania who is the wife of the alleged
incapacitated person. The Petitioner has no interest adverse to
the alleged incapacitated person and seeks to be appointed
Guardian Ad Litem to ensure the alleged incapacitated person's
continued physical and mental health treatment.
The alleged incapacitated person has been diagnosed by Dr.
Ismael as having advanced dementia.
The Petitioner alleges that the alleged incapacitated person has
shown himself to be unable to adequately care for his own
needs and would likely not pursue any physical or mental health
treatment as prescribed by Drs. Ismael and Myers.
The Petitioner requests that she be appointed Guardian Ad
Litem of the alleged incapacitated person to assure continued
needed physical and mental health treatment and over the
estate of the alleged incapacitated person to ensure that the
alleged incapacitated person does not waste or squander his
estate.
The Petitioner alleges that she is the most qualified individual to
act as the Guardian Ad Litem of the alleged incapacitated
person having his best interests in mind.
LAW OFFICES OF
STEPI-IEN j. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
10.
11.
Date:
The Petitioner seeks to be appointed the Guardian Ad Litem of
the alleged incapacitated person only so long as the alleged
incapacitated person is determined by his treating doctors, Dr.
Ismael and Dr. Myers, to be unable to take care of his own
needs.
The Petitioner estimates that the gross value of the alleged
incapacitated person estate is $5,000.00 and his current income
$1,434.00 pension and $1,004.00 per month from Social
Security.
Petitioner seeks to be appointed the guardian of the alleged
incapacitated person's estate and of his person.
Respectfully Submitted,
IN RE: William H. Merriam, Jr.
An alleged incapacitated person
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 21-2004-0563
IMPORTANT NOTICE
CITATION WITH NOTICE
A petition has been filed with the Court to have you declared an Incapacitated Person. If the
Court finds you to be an Incapacitated Person, your fights will be affected, including your right to
manage money and property and to make decisions. A copy of the petition which has been filed by II__~a
Merriam is attached.
You are hereby ordered to appear at a heating to be held in Court Room No. 5, Cumberland
County Courthouse, Carlisle, Pennsylvania, on July 14th ,2004, at 1:00 P.M. to tell the
Court why is should not find you to be an incapacitated Person and appoint a Guardian to act on your
behalf.
To be an incapacitated Person means that you are not able to receive and
effectively evaluate information and communicate decisions and that you are unable to
manage your money and/or other property, or to make necessary decisions about where
you will live, what medical care you will get, or how your money will be spent.
At the hearing, you have the fight to appear, to be represented by an attorney, and
to request a jury trial. If you do not have an attorney, you have the right to request the
Court to appoint an attorney to represent you and to have the attorney's fees paid for you
if you cannot afford to pay them yourself. You also have the right to request that the
Court order that an independent evaluation as to your alleged incapacity.
If the Court decides that you are an Incapacitated person, the Court may appoint a
Guardian for you, based on the nature of any condition or disability and your capacity to
make and communicate decisions. The Guardian will be of your person and/or your
money and other property and will have either limited of full powers to act for you.
If the court finds you are totally incapacitated, your legal rights will be affected
and you will not be able to make a contract or girl of your money to other property. If the
court finds that you are partially incapacitated, your legal rights will also be limited as
directed by the Court.
If you do not appear at the hearing (either in person or by an attorney representing you)
the court will still hold the hearing in your absence and may appoint the Guardian requested.
(/lerk, Orphans~ Court Division [~Ag/~, if fa/,} .2
Cumberland County, Carlisle, PA I' "' ' J"
My Commission Expires 1 st Monday,
January, 2006
LAW OFFICES OF
STEPHEN j. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
ALLEGED INCAPACITATED
PERSON
IN RE: WILLIAM H. MERRIAM, JR.: COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
· PENNSYLVANIA
· ORPHAN COURT DIVISION
ORDER
AND NOW, it is Ordered and Decreed that a hearing be held on
the _L~ '~jday of ~~L~~~,, 2004, at
o'clock at the Cumberland County Courthouse, Carlisle, Cumberland
County, Pennsylvania for the Petition for appointment of Guardianship
in the above captioned matter and a citation issued to William H.
Merriam, Jr. to show cause why he should not be adjudged
incapacitated and his spouse, Ila Merriam, be appointed Guardianship.
Jo
LAW OFFICES OF
STEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
PENNSYLVANIA
ORPHANS' COURT DIVISION
TO: WILLIAM H. MERRIAM, JR
IMPORTANT NOTICE
CITATION WITH NOTICE
A petition has been filed with this Court to have you declared an
Incapacitated Person. If the Court finds you to be an
Incapacitated Person, your rights will be affected, including your
right to manage money and property and to make decisions. A
copy of the petition which has been filed by Ila Merriam is attached.
You are hereby ordered to appear at a hearing to be held at the
Cumberland County Courthouse, Ciarlis_Jle, CIjmbej'land County j
Pennsylvania on ~ at ~M. ~,~)
to tell the Court why it should not find'you [o De an ~nca~pacitated
Person and appoint a Guardian to act on your behalf.
To be an Incapacitated Person means that you are not
able to receive and effectively evaluate information and
communicate decisions and that you are unable to
manage your money and/or other property, or to make
necessary decisions about where you will live, what
medical care you will get, or how your money will be
spent.
At the hearing, you have the right to appear, to be
represented by an attorney, and to request a jury trial. If
you do not have an attorney, you have the right to
request the Court to appoint an attorney to represent you
and to have the attorney's fees paid for you if you cannot
afford to pay them yourself. You also have the right to
request that the Court order that an independent
evaluation be conducted as to your alleged incapacity.
If the Court decides that you are an Incapacitated
Person, the Court may appoint a Guardian for you,
based on the nature of any condition or disability and
your capacity to make and communicate decisions. The
Guardian will be of your person and/or your money and
other property and will have either limited or full powers
to act for you.
LAW OFFICES OF
STEPHEN J. HOGG
19 S, HANOVER STREET
SUITE 101
CARLISLE, PA 17013
If the Court finds you are totally incapacitated, your
legal rights will be affected and you will not be able to
make a contract or gift of your money or other property.
If the Court finds that you are partially incapacitated, your
legal rights will also be limited as directed by the Court.
If you do not appear at the hearing (either in person or by an
attorney representing you) the Court will still hold the hearing in your
absence and may appoint the Guardian requested.
By:
Clerk, Orphans' Court
LAW OFFICES OF
STEPHEN J. HOGG
19 S, HANOVER STREET
SUITE 101
CARLISLE, PA 17013
IN RE: WILLIAM H. MERRIAM,JR: COURT OF COMMON PLEAS
ALLEGED INCAPACITATED : OF CUMBERLAND COUNTY
PERSON : PENNSYLVANIA
: ORPHAN COURT DIVISION
PETITION FOR GUARDIANSHIP
The undersigned brings this Petition through her Attorney,
'Stephen J. Hogg, Esquire, seeking appointment for Guardianship of
William H. Merriam, Jr. alleging the following:
1. The alleged incapacitated person is William H. Merriam, Jr. born
January 19, 1917 and whose last known address was 113
Green Ridge Lane, Newville, PA 17241. The alleged
incapacitated person is currently an inpatient at Swain Health
Center Newville, PA and is deemed by his physicians to be
unable to safely travel.
2. The alleged incapacitated person is married to Ila Merriam,
Petitioner herein. The alleged incapacitated person has three
children: William H. Merriam, III, 529 N. Genison Avenue,
Lansing, Michigan 48915, Robinetta M. Goold, 4395 Hales Ford
Road, Moneta, Virginia 24121 and Abigail M. Selinsky, 2717
George Mason Place, Alexandria, Virginia 22305.
3. The alleged incapacitated person is currently being treated by
Dr. Ismael, 220 Wilson Street, Carlisle, Pennsylvania 17013
LAW OFFICES OF
STEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
and Dr. Herbert Myers, Philhaven, 283 S. Butler Road, P.O. Box
550, Mt. Gretna, Pennsylvania 17064.
The Petitioner is Ila Merriam, residing at 113 Green Ridge Lane
Newville, Pennsylvania who is the wife of the alleged
incapacitated person. The Petitioner has no interest adverse to
the alleged incapacitated person and seeks appointment of
Guardianship to ensure the alleged incapacitated person's
continued physical and mental health treatment.
The alleged incapacitated person has been diagnosed by Dr.
Ismael as having advanced dementia.
The Petitioner alleges that the alleged incapacitated person has
shown himself to be unable to adequately care for his own
needs and would likely not pursue any physical or mental health
treatment as prescribed by Drs. Ismael and Myers.
The Petitioner requests that she be appointed Guardianship of
the alleged incapacitated person to assure continued needed
physical and mental health treatment and over the estate of the
alleged incapacitated person to ensure that the alleged
incapacitated person does not waste or squander his estate.
The Petitioner alleges that she is the most qualified individual to
be appointed Guardianship of the alleged incapacitated person
having his best interests in mind.
LAW OFFICES OF
STEPIffl~.N J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
10.
11.
Date:
The Petitioner seeks appointment of Guardianship of the
alleged incapacitated person only so long as the alleged
incapacitated person is determined by his treating doctors, Dr.
Ismael and Dr. Myers, to be unable to take care of his own
needs.
The Petitioner estimates that the gross value of the alleged
incapacitated person estate is $5,000.00 and his current income
$1,434.00 pension and $1,004.00 per month from Social
Security.
Petitioner seeks appointment of guardianship of the alleged
incapacitated person's estate and of his person.
Respectfully Submitted,
~Stephen J. H/~g~squire
Attorney fo ry, P'eti~oner
IN RE:
WILLIAM H. MERRIAM, JR.
AN ALLEGED INCAPACITATED
PERSON
iN THE COURT OF COMHON PLEAS
OF CUMBERLAND COUNTY,
PENNSYLVANIA
ORPHAN'S COURT DIVISION
NO. 21-2004-0563
ORDER OF COURT
AND NOW, this 14th day of July, 2004, after
hearing, we find William H. Herriam, Jr., to be
incapacitated as that term is defined in 20 Pa.C.S. Section
5501, et seq. We hereby appoint Ila Merriam as plenary
guardian ef his person and estate.
Stephen J. Hogg, Esquire
For the Petitioner
:mlc
Edward E. Guide, J.
-
Marjorie A. Wevodau
First Deputy
One Courthouse Square
Carlisle, Pa. 17013
Gienda Farner Strasbaugh
Register of Wills &
Clerk of the Orphans' Court
(717) 240-6345
FAX (717) 240-7797
Kirk S. Sohonage, Esquire
Solicitor
OFFICES OF
3aegister of Wills anti ([lerk of toe ~rpoans' ([ourt
<!Countp of <!Cumberlanb
November 30, 2005
Ila Merriam
113 Green Ridge Lane
Newville, PA 17241
IN RE: Estate of William H. Merriam, Jr., an incapacitated person
File No. 21-04-563
Dear Sir/Madam:
It has come to my attention that you have not filed the guardian reports required
by 20 Pa.C.S.A. S5521(c) in the above captioned guardianship. Enclosed you will find
the suggested formes).
Please mail those reports, along with a check in the amount of$15, payable to
the Clerk of Orphans' Court, to the following address within (30) days:
Clerk of Orphans' Court
One Courthouse Square
Carlisle, PA 17013
If you have any questions, please contact your attorney.
~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
CC: Stephen Hogg, Esquire
.....-
.
.
Clerk of Orphans' Court of Cumberland County
IN RE: W I II I fl1yL. tV! <<Yl~
An Incapacitated Person
Docket No. 2{-()L-f -l;tp3
ANNUAL REPORT OF GUARDIAN OF THE ESTATE
I, rL-Ov m err l OJYV ' was /were
appointed plenary guardian(s) of the estate of _ JtJ_~ M rr-Vlf:.VYt..-..
by Decree ofthe Honorable Judge . Dated _' This is my annual
report for the period from lz) 04- to 1210S;, ("The Report Period").
L SPM1\'IARY
A. Value of principal assets at the beginning of the Report Period? $ 0.00
B. Total amount of income earned during the report period? $ 30, Jo1.1fr/
SO ~ bl CA>>vlfl/} ) ~s CO")tG cYhlU}-
Total amount of all expenditures made for care and maintenance of the
C. incapacitated person during the Report Period?
I. From principal $
2. From income $ 17/57/.56
D. Total amount spent for all other purposes during the Report Period? $ ji. 511, 5D
,
E. Total amounts remaining at the end of the Report Period?
1. Principal $
2. Income $
Total Income and Principal $
ZZ :21 ;!J S I J~jO
{.
i
.
II. ADDITIONAL INFORMATION
A. Principal:
1. Total amount remaining at the end of the Report Period?
$
2. How is principal currently invested?
n)A
I
3. Have there been any expenditures from principal during the Report
Period?
DYes~o
If you answered YES, was there Court approval for all expenditures
from principal?
4. Did you receive any principal assets during the report period which
were not included on the inventory or a prior report filed for the estate?
DYesDNo
DYes~o
If you answered YES, did you receive Court approval prior to receiving
additional principal?
DYesDNo
5. State the sources and amounts of the additional principal you received:
$
$
B. Income:
1. State sources and amounts of income received during the Report Period (i.e., social
security, pension, rents, etc.):
s()~ ?tf~
peX' S 1/lT'vv
$ /:1. z 35: CJlSJ
,
$ 3.0, )~ 9.~1'
$
Total Income received during Report Period $
2. How is income currently invested? (Please specify, restricted bank accounts, client care
account, etc,) N ~'L~ hOTYLt ~
-.
4. .
.
. .
.
3. Specify what payments were made for the care and maintenance of the incapacitated
person (i.e., clothing, nursing home, medicine, support, etc.).
h l JU~l.~~ h 01YLe., ~ 11) 5/ J ,60
4. Specify what other payments were made during the Report Period.
ceRy.. vhCtrf\nlilUf- - ~g;1':<' (pg
~~()no,a. -1k1rvJf\!OOc+a l3t'US- !Ss. f(
~S Uf(l.XH~.QJ}etY\ ~ - ?--1 T /? J-I)
I verify that the foregoing information is correct to the best of my knowledge, information and
belief; and that this verification is subject to the penalties of 18 Pa. C.S.A. 94904 relative to
unsworn falsification to authorities.
~
Date
~ ~ ~A/~~~
Signature of Guardian
* FILING FEE $15 MUST ACCOMPANY THIS FILING,
- .
v.
\...
Clerk of Orphans' Court of Cumberland County
INRE:~II~ rYlernMb
An Incapacitated Person
Docket No. 2J..-{)Lf-!50~
ANNUAL REPORT OF GUARDIAN OF THE PERSON
I, -:1l-a (\/\-c Y'n Ctt'V\..,
plenary guardian(s) of the person of
Honorable Judge
the period from 12j04
, was /were appointed
lA) J A A lLM...- M-et'"rUtrvL) by Decree ofthe
, dated . This is my annual report for
to ~, ("The Report Period").
1.
Present age of the incapacitated person:
~s
Yrs.
2. Current address of the incapacitated person
LID 13'3 ,~YLht- Rd
~'( ~ A lclS-€.. V li~g ~
N ew vllJe l P A 1 124 J
3.
The incapacitated person's residence is:
f"o0
CJ
c::..:~)
(.:_n
C)
~~g
,J-n
';~p
- .,- III
~~
c....-:l
r-' 1
C"J
o own home/apartment
~ nursing home
01
,0')
-', I
-::1
r....)
o boarding home/personal care home
rv
o guardian's home/apartment
o hospital or medical facility
o relative's home
(Name and relationship)
4.
o other: (describe)
The incapacitated person has been in the present residence since ~ g / 03 . If
the incapacitated person has moved within the past year, state change and reason(s) for
I .
"
change:
5. Name and address of the incapacitated person's primary care giver:
(1r.tt,VL ~L~ VI L~ J~~1)CUAV\ IktL#h &nfe'r
- ----2LD~nca-rzO~_---.-m-
Ntw VI Lk I P.4 J 7ZLJ I
I
6. The major medical or mental problems of the incapacitated person are as follows:
cLtIY1f n-h ~ ) cltpy,eSSl o-v.} {l~'fh~r-vIOLLS.MJ
h~~(+t\'1c..L'DV')} 05-kb(^-(~ J iAphCiSLR-
7.
Specify what, if any, social, medical, psychological and support services the incapacitated
person IS receIvmg:
G\~ VI (A/~'L~ Cj)JLf../
24/,.
I
8.
It is our opinion as guardian of the person that the guardianship should: (check one)
~ontinue, 0 be modified, 0 be terminated. (Briefly explain your response)
9. During the past year, I have visited the incapacitated person .35~ times with the
average v"isit lasting
2 h~ vlsik:
(State number of hours 1m in utes, etc.)
em av~ .
. .
#
,"'
The repOli of a social service organization employed by the guardian to oversee and coordinate
the care of the incapacitated person for the period covered by this report may be attached to
supplement this report.
I verify that the foregoing information is correct to the best of my knowledge, information and
belief; and that this verification is subject to the penalties of 18 Pa. C.S.A. 94904 relative to
unsworn falsification to authorities.
lrzl [; / Db
. I
Date
. ~Cl~)
Signature of Guardian
* FILING FEE $15 MUST ACCOMPANY THIS FILING.