The URL can be used to link to this page

Home My WebLink About03-09-11IN THE COURT OF COMMON PLEAS, ORPHAN'S COURT DIVISION, CUMBERLAND, PENNSYLVANIA n r,.w IN RE: JOHN STANLEY PAUKOVITS (a minor child) ~ , ' ~ ~ ? ~ ~y ~ ~~ ~ .~ ~O I J O - ~~ ~ J ~--~ T ` :GUARDIANSHIP c~c~ ; ~-, c - ' _. _ -~, to °~ t PETITION FOR GUARDIANSHIP/APPOINTMENT OF CONSERVATOR AND NOW come Katie Paukovits and Keith Paukovits, by and through counsel, Lawrence J. Rosen, Esquire, and offers the following averments in support of her Petition for Guardianship/Appointment of Conservator of the minor child, John Stanley Paukovits: Petitioners, Katie Paukovits and Keith Paukovits, who reside at 906 Acri Road, Mechanicsburg, Cumberland County, Pennsylvania, aze seeking to be named guazdian/conservator of the person and estate of the minor child, John Stanley Paukovits (DOB 01/15/2005) 2. Petitioners are the pazents of the minor child. 3. The minor child resides with Petitioners at 906 Acri Road, Mechanicsburg, Cumberland County, Pennsylvania. 4. The parents of the minor child are Katie Paukovits and Keith Paukovits who reside at 906 Acri Road, Mechanicsburg, Cumberland County, Pennsylvania. They agree that it is in the best interests of the minor child that the subject Petition be granted and that they act as guardians/conservator of the person and estate of the minor child (See Exhibit A) 5. The appointment of a guazdian/conservator for the minor child is necessary as the deceased grandfather of the minor child left a sum of monies through an annuity naming the minor child as beneficiary. The subject company is requiring an Court Order naming his guazdian/conservator of the estate of the minor child before it will release the funds due and owing to the minor child. (See Exhibit B) IN THE COURT OF COMMON PLEAS, ORPHAN'S COURT DIVISION, DAUPHIN COUNTY, PENNSYLVANIA IN RE: JOHN STANLEY PAUKOVITS (a minor child) : NO. :GUARDIANSHIP CONSENT We, Katie Paukovits and Keith Paukovits , do hereby assert that we are the natural parents of the minor child, John Stanley Paukovits (DOB 1/15/OS). By our signatures affixed hereto, it is our intention to consent to our being named as guardians of the person and the estate of our son. Our consent is given freely and with full understanding of the legal implications attendant thereto. We believe that it is in the best interests of our son that we be named as his guardians/executors and ask that Your Honorable Court grant the subject Petition. SIGNED: tie Paukovits /+J ~~ Keith Paukovits DATED: 3~}>>~ 3 } ~ VITESTERN ~ NATIONAL Life Insurance C o m p a n y Western National IJre Insurance Company P. O. Box 871 Amarillo, Texas 79105 Telephone: 800.424.4990 February 4, 2011 KATIE PAUKOVITS 906 ACRI RD MECHANICSBURG PA 17050 Re: Name of Deceased: Contract Number: Beneficiary: Dear Sir or Madam: Stanley Chimock VP224988 John Stanley Paukovits Thank you for your response to our initial claims packet. However, the claim information we received was either incorrect or incomplete. In order to process your claim, please follow the enclosed instructions and/or forward the following items to our office. A return envelope is provided for your convenience. According to the laws in the minor beneficiary's state, we must have the signature of a conservator or guardian. Please complete and return the enclosed claim form with the signature of the minor's conservator or guardian. Please include a copy of the Letters of Guardianship. We appreciate your prompt attention to this matter. Should you have any questions or require further assistance, please contact our Client Care Center by using our toll free number of 1-800-424-4990. Sincerely, `~'~ . B.M. Graves Annuity Claims Manager Enclosure(s) WNL Addtl Info Ltr VNESTERN ail NATIONAL L l f e Insurance C o m p a n y Western Natloual IJre Insurance Company P. O. Box 871 Amarillo, Texas 79105 Telephone: 800.424.4990 Policy Holder: Stanley Chimock PolicylCertificate !f: VP224988 MINOR BENEFICIARY INSTRUCTIONS In the event the beneficiary entitled to receive death benefits is a minor child, the following stipulations and options apply. • The claim proceeds may be paid to a court appointed conservator or guardian of the minor's estate. A copy of the court document attesting to such an appointment must be subnutted to the company for verification. • The claim proceeds may be paid to a trustee for the minor appointed in the Deceased's will. A copy of the probated will of the deceased must be submitted. The trustee must sign the claim form in the following manner: "(Trustee's Signature), as trustee for (minor child's name) pursuant to (Name Decedent) will." The trustee will need to sign a trustee's affidavit. • If the deceased appointed a custodian under Uniform Transfers to Minors Act (iJTMA) for the minor beneficiary, the full amount of the claim proceeds will be payable to the custodian. A copy of the probated will of the deceased or other document which names the custodian and is signed by the deceased must be submitted to the company for verification. In order for the company to accept the returned claim forms, the custodian must sign in the following manner: "(Custodian signature) as custodian for (minor child's name) under (name of state) UTMA." • If neither a conservator nor custodian has been appointed, the claim proceeds may be paid to an adult family member or trust company in accordance with UTMA of the minor's state of residence. The maximum amount payable is state specific. Please consult a legal advisor for information regarding this option in the minor's residential state. This option is not available in Georgia, Indiana, Ohio, South Carolina or Vermont. The information listed below provides alternative payment options for these states; the state of Vermont offers no alternatives. • Georgia: Death benefits not exceeding $15,000 may be paid to a parent if the parent executes and submits an affidavit to the company. Please consult a legal representative as to the contents of such an affidavit. • Oregon or South Carolina: Up to $10,000 of the death benefits per year may be transferred to a person having custody of the minor with whom the minor resides. Proof of custody may be required before payment of the death benefit is processed. • Ohio: (1) Up to $5,000 of the death benefits per year may be transferred to a person having custody of the minor with whom the minor resides. Proof of custody will be required before payment of the death benefit is processed; or (2) Up to $10,000 of the death benefits may be transferred to a parent pursuant to a court order. A copy of the court documents ordering said transfer must be submitted to the company. Indiana: Up to $10,000 of the death benefits may be transferred to a person having care and custody of the minor with whom the minor resides. Proof of custody will be required before payment of the death benefit is processed. Please consult with a legal representative about other possible options for payment under Indiana UTMA. The minor's representative may choose the Open Claim option if the minor will reach the age of majority within five years of the deceased's date of death. With this option, the minor beneficiary will not be the contract owner and therefore, may not name new beneficiaries. In the event of the minor's death prior to obtaining the age of majority and receiving the death benefits of the contract, the proceeds will be payable to the minor's estate. Upon attaining the age of majority, the beneficiary's signature will be required for withdrawals. Based on the information provided above, please complete and return the enclosed Annuity Claimant Statement with information pertaining to the minor beneficiary, not that of the custodian or conservator. This includes listing the minor's date of birth and social security number in the taxpayer identification number section. Also, indicate the payout option in the option section provided. The signature of the minor's representative affixed to the form must be notarized. A copy of the minor beneficiary's birth certificate is required for verification of age. Please note that the taxable portion of the death benefits is taxable to the minor in all cases. Neither Western National Life Insurance Company nor its employees and agents are permitted to give tax or legal advice. There may be additional laws in your state that may apply to your situation. Please consult your tax or legal advisor regarding your specific situation. WNL 826 (9/09) IN THE COURT OF COMMON PLEAS, ORPHAN'S COURT DIVISION, DAUPHIN COUNTY, PENNSYLVANIA IN RE: JOHN STANLEY PAUKOVITS (a minor child) :NO: :GUARDIANSHIP CONSENT We, Katie Paukovits and Keith Paukovits, do hereby agree and consent to become guardians/conservators of the person and estate of our son, John Stanley Paukovits. We are executing this consent voluntarily and with full knowledge of the legal implications attendant hereto. We assure the Court that we will make all efforts to provide John Stanley Paukovits, our son, with the love, stability and nurturing that he requires to mature into a responsible and productive adult and to protect and manage his assets in his best interests. SIGNED: Katie Paukovits ert i Paukovits DATED: 3~~f -~ 3~~J-/