HomeMy WebLinkAbout03-0084IN THE MATTER OF THE PERSON
AND ESTATE OF:
SUSAN M. MAGARO,
AN ALLEGED INCAPACITATED
PERSON
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO.
PETITION FOR APPOINTMENT OF EMERGENCY PLENARY GUARDIANS
OF THE PERSON AND ESTATE
AND NOW COMES THE PETITIONER, the Area Agency on Aging in and for
Cumberland County, Pennsylvania who represents and avers as follows:
1.
The Petitioner is the Area Agency on Aging, in and for Cumberland County, with
an office located at 16 West High Street, Carlisle, Cumberland County, Pennsylvania.
2.
The alleged incapacitated person is Susan M. Magaro, widow, age 91, who
resides by herself at 1 Chester Road, Enola, East Pennsboro Township, Cumberland
County, Pennsylvania and has resided there for a number of year.
o
The only known relatives of the alleged incapacitated person are:
A. Anthony R. Magaro - son
106 Pine Hill Road
Camp Hill, Pennsylvania
B. Gina A. Livingston - Granddaughter
C/O Dauphin County Victim Witness Assistance Program
Dauphin County Courthouse
Front and Market Streets
Harrisburg, Pennsylvania 17101
C. Irene Meadowcrofi - Niece
9 Salt Road
Enola, Pennsylvania
Nancy Stahley - Niece
29 Barnett Street
P.O. Box 215
New Bloomfield, PA 17068
Helen Clouse - Sister
31 Barnett Street
P.O. Box 215
New Bloomfield, PA 17068
Susan M. Magaro has, for at least three (3) months, been incapable of managing
and caring for herself and her financial affairs.
5.
Susan M. Magaro exhibits symptoms of mental incapacity, including but not
limited to dementia.
6.
Susan M. Magaro's mental incapacity prevents her from managing and caring for
the affairs of her person and estate.
7.
The Petitioner, through its authorized representative, has conducted an
investigation of this matter and has determined that, on January 15, 1997, the Susan M.
Magaro Family Irrevocable Trust was executed by her wherein she appointed Anthony R.
Magaro, her son, as Trustee of the trust. A copy of the Susan M. Magaro Family
Irrevocable Trust is attached hereto, marked as Exhibit "A", and incorporated herein by
reference.
8.
Further investigation by Petitioner has revealed the following:
a. That Susan M. Magaro sits in her house in the dark with windows covered
by newspapers;
b. That she is unable to cook for herself;
c. That ongoing attempts to provide nutrition under care management have
been unsuccessful;
d. That a neighbor gave her a frozen meal to warm up which she returned
still frozen, unable to prepare it;
e. That spoiled food has been found in the refrigerator and she does not
know how long she had the food; and
f. Food has been purchased for Susan M. Magaro by staff from the Area
Agency on Aging, neighbors, and Gina A. Livingston, a granddaughter.
9.
While food has been made available to Susan M. Magaro, observation has been
made that little food has been consumed and she has been seen flagging down a passing
motorist after she was told by an individual that he could not go to the store for her at that
time. The unknown motorist subsequently returned with milk for her.
10.
During the past two (2) years, Susan M. Magaro has made numerous telephone
calls to the East Pennsboro Township Police Department concerned about the following:
a. That she is frightened because she believes that men were going to stop,
pick her up and take her away to Texas;
b. That she is afraid to be there alone;
c. That someone has entered her house and has taken such things as
silverware, scissors or flashlights; and
d. That she requests police to watch her house or drive by her street.
11.
In September, 2002 Petitioner's authorized representative met with
Anthony Magaro at his mother's home to discuss services that would be available to her.
This meeting was unsuccessful and he was angry that a neighbor was providing his
mother with frozen meals from the Office of Aging and that it should stop because he did
not trust the food that was provided.
12.
During that meeting in September, 2002, Anthony Magaro also stated that another
neighbor was nosy and should not interfere with his mother even though that neighbor
was helping to buy milk and food for his mother.
13.
On or about December 20, 2002, Gina A. Livingston, granddaughter of Susan M.
Magaro contacted Petitioner with concerns regarding her grandmother because her father,
Anthony Magaro, was arrested and in jail because he could not make bail. The said
Anthony Magaro is still in jail.
14.
The granddaughter, Gina A. Livingston, stated on or about December 20, 2002
that her father, Anthony Magaro, had not been providing any care to his mother and she
was now concerned how her grandmother's bills were being paid and that the assistance
her father had been providing to his mother had declined over the past few years.
15.
On or about December 23, 2002, Priscilla Whitman, Protective Service Case
Manager for Petitioner, visited the residence of Susan M. Magaro and made the following
observations:
a. Her clothing was very dirty;
b. Her body was dirty;
c. The house was dark;
d. She cried out in pain when sitting down in a chair after answering the
door;
e. She asked Ms. Whitman on four (4) occasions who she was and the reason
for her visit;
f. She asked if her spouse was living and believed that he was living in
Wormleysburg with another woman;
g. She did not know how to contact her son and did not have his telephone
number; and
h. She did not know that Christmas was two (2) days away.
16.
On January 2, 2003, Priscilla Whitman visited the house of Susan M. Magaro and,
at that time, observed that she was still dirty, had no recollection of who Ms. Whitman
was, and did not know the day, month or year.
17.
When asked on January 2, 2003 whether her son had visited her over the holidays,
she said that he did but could not say when.
18.
On January 17, 2003, Petitioner was notified that Susan M. Magaro had called
another party, was very upset because she was dizzy and needed blood pressure
medicine. Arrangements were made for her to see Dr. Lynn Cornelius.
19.
A physical examination conducted by Dr. Lynn Cornelius revealed the following:
a. Malnutrition;
b. Abnormal weight loss;
c. Dementia, multi-infarct;
d. Alzheimer's, delirium possible;
e. Peripheral vascular disease;
f. High blood pressure;
g. Inability to attend to daily living needs;
h. Poor hygiene;
i. Mycosis; and
j. Debility.
20.
Susan M. Magaro has had a psychological evaluation conducted by Riverside
Associates, which evaluation reveals the following diagnoses:
a. Dementia of the Alzheimer's type with depressed mood;
b. Severe, social isolation with regard to primary support group; and
c. Mrs. Magaro's current Global Assessment of Functioning score is
estimated to be approximately 22, indicating a need for almost constant
supervision due to gross impairment in reality testing, communication,
cognition, effect, and personal hygiene.
21.
Under the terms of the Susan M. Magaro Family Irrevocable Trust, she
irrevocably transferred assets listed on Schedule "A" which assets are referred to
hereinabove in Exhibit "A".
22.
Petitioner does not know the status of said Trust.
23.
The Petitioner believes that Susan M. Magaro has monthly income from Social
Security and a pension from the Commonwealth of Pennsylvania which are deposited
into a bank account for her but that she has no control over the money.
24.
Petitioner believes and, therefore, avers that allowing Susan M. Magaro to
continue living in her home and wandering would place her in imminent danger of death
or serious bodily harm.
25.
Petitioner believes and, therefore, avers that Susan M. Magaro has not been
properly cared for by her son, Anthony Magaro, and that she should be placed in a
nursing home facility.
26.
Less restrictive alternatives are not available because there is no one able to care
for her.
27.
Nancy Stahley, niece of Susan Magaro, is willing to accept the appointment of
Emergency Plenary Guardian of the Person and Estate of Susan M. Magaro.
28.
No other Court has ever assumed jurisdiction in any proceeding to determine the
incapacity of Susan M. Magaro.
29.
The failure to appoint Nancy Stahley, niece of Susan M. Magaro, as Emergency
Plenary Guardian of the Person and Estate of Susan M. Magaro will result in irreparable
harm to the person and estate of Susan M. Magaro.
WHEREFORE, Petitioner prays that this Honorable Court appoint Nancy Stahley,
niece of Susan M. Magaro, as Emergency Plenary Guardian of the Person and Estate of
Susan M. Magaro.
Respectfully Submitted,
Anthony L. [le. Kuca, Esquire
113 Front Street
P.O. Box 358
Boiling Springsl PA 17007
(717) 258-6844
VERIFICATION
I hereby verify that the facts and information set forth in the foregoing Petition for
Appointment of Emergency Plenary Guardian of the Person and Estate of Susan M.
Magaro are tree and correct to the best of my knowledge, information, and belief. I
understand that any false statements contained herein are subject to the penalties of 18
Pa. C.S. Section 4904, relating to unswom falsification to authorities.
Dated:
Priscilla Whitman
ent By: CUMB CO OFFICE OF AGING
o4~.~4~ DELUCA At: 92583902
,; 71 724o6118;
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T~IIS T~UST A~R~E~NT is executed in triplicate on this !~'~
day of_~--_~~~, 1997, by and between ~USAN M.-' ~, nov of 1
C/~es ter Road: East Pennsboro Townsb/p, C~erland County,
Pennsylvania (herein called "$ec~lor-), and ANT~XF~r~ R. MA~AI~O, now
of 106 ~ine PLill Road, East Pennsboro Township, Cumberland County,
Pennsylvania (herein called -Trustee~) .
ARTICLE I- TRUST ESTATE
1.01. Initial Princi~al. Settlor, desiring to establish
an irrevocable trust, does hereby irrevocably transfer, assign and
d~liver to the Trustee, and his successors and assigns, the assets
listed on Schedule "A" attached hereto arid made a part hereof. As
further evidence of such assignment, Settlor h~s executed or will
execut~ or cause to be executed such other instr%unents as may be
required for the purpose of completing the assigr~nen~ or transfer
of title to such property to the Trustee. The Trustee accepts such
~ransfer and assignment to himself as Trussee, and ~he .Trustee
undertakes to hold, manage, invest and reinvest T. he assets of this
T~ust and to distribute the income and principal of the Trust in
accordance wiLh the provisions of ~his AgreeJnent.
1.02. Additional Principal. Settlor a~d any other
person(s) ~ with the consent of t_he Trustee, shall have the right at
any time to make additions to the corpus of this Trus~ or any share
thereof hereby established. Ail such additions shall be held,
governed and distributed by the Trustee in accordance with
terms and conditions of thta Agreement.
ARTICL~ II. IRREVOCABILI~ OF TRUST
2.0!. Irr~vc~mbilit¥. Settlor has been advised of the
consequences of an irrevocable truut and h~reby de=lar~ that
Trust shall be irrevocable and shall not be altered, amended,
revok~ or termlnat~d by Settlor or any other person(s}.
ARTICLE III. TRUST DISTRItK~TIONS
3.0~. Trust ~rlnciDa/. The entire corpus of this Trust,
includ/ng the assets initially transferred ~o this Trust,
subsequent additions to th/s Trus~ and the proceeds of any sale,
~_xchAnge or investment' of such Trust assets, shall be used for the-
purposes herein contained. "
3.02. Distributions Durinq Settlor's Lifetim~.' During
Se~lor's lif~time, the Trustee shall distribute ali of t. he ne~
income ~o~-the Trust to, or for the~bene£it of, -Se~lor. The
Trustee shall make no distributions of principal to, or for the
benefit of, Settlor.
EXHIBIT "A-"
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3.03. ~era~ ~ of .. ADjUnCt. Set tlor' s ~ld,
~ ~, ~0, iS her~y grant~ ~e g~eral ~w~ to
s~e or all of ~e ~rlnct~l of t~s T~st to hi, elf, his e~Eate,
~ cra=ors or the creditor8 of h~s estate, ~n ~ch
~ u~n ~ te~ (in t~st, ~trlght gtfks or in any o~r
~er} as he de~ advis~le. T~s ~w~ sb~l no~ be ~ercis~le
~der ~s will. If Settler's ~il~ fail~, ei~ in w~e or in
~ar~, to ~ercise ~e g~ral ~w~ of aD~in~nt h~rein ~antea,
~hen ~he ~~tnted ~r~nc~l shall ~ntinue ~ t~st and shall be
a~stere~ aCcording =o the te~ of t~s
3.04. Termina~ton and Distrtbutio-. · The Trust shall
terminate upon Settler's death. Upon termination, the remaining
trust esta=e shall be distributed in fee simple to Settlor.s son,
ANTHON~ K. MAeStrO, or his surviving issue, per s.tirpes.
ARTICLE IV. POW~R~ OF TRUSTEE
4.01. ~eneral Powers. In addition to such other powers
and duties as may have been granted elsewhere in this Tr~st or by
law, but subject to any limitations connained elsewhere in this
Trust, the Trustee shall have the following powers and duties:
(A) In the management, care and disposition of this Trust,
the Trustee shall have the power to do all things and to execute
such deeds, instruments and other documents as may be deemed
necessary and proper, including the followingpowers, all of which
may be exercised without order of or re~ort no any court:
(l) To sell, exchange or otherwise dispose of any
property, real, personal or m/xed, whereaoever located,
at any rifle held or acquired hereunder, at public or
private sale, for cash or on terms as may be determined
by the Trustee, without advertisement, including the
right to lease for any term notwithstanddng the periodof
the Trust, a~d tog rant optics, including a~ option for
a period beyond the duration of the Trust.
(2) To invest all monies in such stocks bonds, ~D
· ~
securities, investment companies or trust shares,
mortgages, notes, theses in action, real estate, co
i~Drovements thereon, and other property as the Trustee c~
may deem best, without regard to any law now or hereafter ~
in. force limiting investments of fiduciaries.
(3) To retain for investment any property d~osited
with the Trustee hereunder.
(&) To vote in person or by proxy any corporate
Stock or other security and to agree to or take any other
actio~ in regard to any reorganization, merger,
consolidation, liquidation, bankruptcy or other procedure
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or proceedings affecting any stock, bond, note or other
security held by this Trust.
(5) To use lawyers, real estate brokers.
accountants and any other agents if such employment is
deemed necessar~ or desirable, and to pay 'reasonable
condensation for their services.
{6) To compromise, settle or adjust any claim or
demand by or against the Trust and to agree to any
rescission or ~od~ftcatton of any contract or agreement
af£~ctin~ the Trust.
(7) To renew any indebtedness, as well as to borrow
money, and to secure r_he same by mortgaging, pledging or
conveying any property of the Trust, including the tmDwer
to borrow from the Trustee (in r~ae Trustee's ind/widual
ca~acity) at a reasonable rate o~ interest.
(8) To retain and carry on any business in which
the ?rust may acquire any interest, to acquire additional
interests in any such business, to agree to the
liquidation in kind of any corporation in which the Trust
may have any interest and to carry on the busimess
thereof, to join with other owners in adopting any form
of managen~nt for any business or property in which the
Trust may have an interest, to become or remain a
partner, general or limited, in regard to any such
business or property and to hold the stock or other
securities as an investment, and to employ agents and
confer on them authority to manage and operate the
business, property or corporation without liability for
the acts of any su~h agent for any 'loss, liability or
indebtedness of such business if the management is
selected or retained with reasonable care.
(9) TO register any stock, bond or other security
in the name of a nominee without the add/tion of wor4s
indicating that such security is held in a fiduciery
capacity, but accurate records shall be maintained
showing that the stock, bond or other security is a trust
asset, 'and the Trustee shall be responsible for the acts
of the nominee.
(B) Whenever the Trustee is directed to distribute any trust
principal in fee sim~le to a ~erson who is then under twenty-one
(21) years of age. the TruStee shall be authorized uo hold such
property in trust for such person until h~ becomes twenty-one (21)/
years of age, and An the meantime the Trustee shall use such Dart
of ~he income and principal of the ~ru~t a~ the Trustee ~ay deem
necessary to provide for the pro. er support and education of such
person in ~he standard of living to whichhe ha~ become accustomed.
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If such Person should die before beccmting twenty-one (21) years of
age, the property then remaining ~n trust shall be distributed to
the ~ersonal representative of 3uch person's estate.
(C~ In making distributions from the Trust to or for the
benefit of any m/nor or other person under a legal disability, the
Trustee need not require the appointment of a guardian, but shall
be authorized to pay or deliver the distribution to the custodian
of such person, to pay or deliver the distribution to such person
without the intervention of a guardian, to pay or deliver the
distribution to the legal guardian of such person if a guardian has
already been appointed, or to use the distribution for the benefit
of such person.
(D) In the distribution of the Trust and any division into
separate trusts and shares, the ~rusteeshall be authorized to make
the distribution and division in money or in kind or in both,
regardless of the basis for income tax purl~oses of any property
distributed or divided in kind, and the distribution and division
made and the values established bythe Trustee shall b e binding and
conclusive on all persons taking hereunder. The Trustee may in
making such distribution or division allot undivided interests in
the same property to several trusts or shares.
(~) The Trustee ~hall have discretion to determine whether
items should be charged or credited to income or principal or
allocated between income and Drinclpal as the Trustee may deem
equitable and fair under all the circumstances, including the power
to amortize or fail to amortize any part or all of any.premium or
discount, to treat any part or all of the profit resulting from the
maturity or sale of any asset, whether purchased at a premium or at
a discount, as income or principal or apportion the same between
income amd principal, to apportion the sales price of any asset
between income and principal, to treat any dividend or other
distribution on any investment as income or principal or to
apportion the same between income or principal, to charge any
expense against income or principal or apportion the same, and to
provide or fail to provide a reasonable reserve against
depreciation or obsolescence on any asset ~ubject to depreciation
or obsolescence, all as the Trustee may reasonably deem equitable
and Just under all of the circumstances.
5.01. Gene~a.~. Provision. No beneficiary shall have the
power to anticipate, encumber or transfer his interest in the trust
estate in any maru3er other than by the valid exercise of a Dower of
appointment. No part of the trust estate shall be liable for or
charged with any debts, contracts, liabilities or torts of a
beneficiary or subject to seizure or other process by any creditor
of a beneficiary.
4
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CONSTRUCTION OF TRUST
6.02. Choice Df I~W. This Trust shall be administered and
interpreted in accordance with the laws of ~he Commonwealth of
Pemlsylvanta.
6.02. Code. Unless otherwise stated, all references in
this Trust to section and chapter numbers are to those of the
Internal Revenue Code of 1986, as amended, or corresponding
provisions of any subsequent federal tax laws applicable to this
Trust.
6.03. OtherTe__~9_~_~. Unless t~e context otherwise requires,
the use of one or more genders in =he text includes all other
genders, and the use of either the singular or the plural in the
text includes both the singular and the plural.
$.04. ~_~ons. The captions set forth in thisAgreement
at ~he beginni~ of the various diYistons hereof are for
convenience of reference only and shall not be deemed to define or
limit the provisions hereof or to affect in any way their
construction and application.
6.05. ~itus of Trust. The Trust shall have its legal
situs in Cumberland County, Pennsylvania.
ARTICL~ vii.
COmPeNSATION OF TRUSTEE AND
APPOINTN~NT OF SUCCESSOR TRUSTE~
7.01. ComDe~satio~. The Trustee shall receive as his
co~ensation for the services performed hereunder that sum of
money, based on an hourly charge or percentage rate, which the
Trustee normally and customarily charges for performing sim/lar
services during the time in which he performs these services.
7.02. Re~oval or ~ast~na~ion. 9~._Truste.. Settlor may
remove the Trus[ee at any t~me or t/mes, with or without cause,
u~on thirty (30} days writte~ not/ce given to the Trustee. After
the Settlor's death, a majority of the current income beneficiaries
may remove the Trustee at any time or times, with or without cause,
upon thirty (30) days written notice given to the Trustee. The
Trustee ~a¥ resign at any time uI~Dn thirty {30) days wrltt~ notice
glve~ to Settlor or, after Settlor's death, upon thirty (30) days
writtennottce given to the curren~ income beneficiaries, upon the
rmmoval or resignation of the Trustee, a successor trustee shall be.
appointed tn accordance with the terms set forth tn Paragraph ? 03,
below. '
7.03. ADlm3int~nt of ~Up¢essor ~stee. Upon the death,
resignation or Incapact=y of =he Trustee, 8ettlor's niece, NANC~Y
STARL~Y, is hereby appointed Successor Trustee hereunder. Upon the
5
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death, resi~nation, removal or incapacity o[ the ?~ustee and
~ccessor T~stee, a 'succeeso~ t~stee shall be a~in~ by
Settlor or, aft~ Settlor's death, by a MJority of the ~en[
~n~b~~ar~ea. ~y s~ces~r t~stee ~us a~tn~e~ shall
be a [tnan~ally sold ~d c~et~t co~ra~e t~stee. The
to all the ~tes and ~ers, including discre~iona~ ~ers,
herein qrante~ to ~he ~s=ee.
$.01. ~eneral ~rovision. Notwithstanding anything to the
contrary in th~s Trust, each disposition Settlor has made herein,
legal or equitable, to ~he extent it can be referred in its
postponement of becoming'a vested interest to a duration measured
by some life or lives in being at the time of Settlor's death, is
defi~itely to vest in interest, although not necessarily in
possession, not later than twenty-one (21) years after such lives
[and any period of gestation involved); or to the extent it cannot
be referred in any such ~ostponement to such lives, is to so vest
not later than twenty-one (2~) years from the time of S~ttlor's
death.
ARTICLE IX.
AND WEN~ES OF ADMINISTRATION
9.01. Pal~aent of Death Taxes and Other ~0 Settlement
ceostB. The Trustee shall ascertain from t_he legal representative
of Set,lot's estate whether the legal representative has sufficient
assets ~o pay the remaining legacy, succession, inheritance,
transfer, estate and other death taxes or duties levied or assessed
against the Settlor's estate {including all interest and
thereon), all of which taxes, interest and penalties are hereafter
referred Lo as the ~eath taxes, interest and penalties. If the
lega~ representative advises the Trustee that insuffic/ent funds
exist to Day all the death taxes, interest and pena[ties, the
Trustee shall then pay to the legal representative from thetrust
property, an amount equal to al! the death taxes, interest and
penalties in excess of the ,fun~s available to the legal
representative for these purposes, ~h/ch l~ayme~ts are to be mate
without
If the personal representative of Settlor's estate, in such
his soZe discretion, shall determine =hat appro~rlate asse~s of'
Settlor's estate are not available in suff~cien~ amount to pay
SeCclor's funeral expenses and (2) expenses of adm/nistering
$ecc[or,s estate, the Trustee shall, upon the request of the
personal representative, contribute from the principal of the ~rust
estate the amount of sHch deficiency; and in connection with any
~uch action the Trustee shall rely upon ~he written statement of
t~he personal representative as to the validity and correctness of
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the amounts of any such expenses, and shall furnish funds to the
personal representative so as to enable him to discharge the same,
or to discharge any Dart or all thereof himsel[ by making ~ayment
directly to the person entltled or claiming to be entitled to
receive payment thereof. No consi~eratton need be required by the
Trustee from the personal representative for any dlebursement made
by the Trustee pursuant here=o, nor shall there be a~¥ obligation
upon ~he personal representative to repay to ~he Trustee any. of the
funds disbursed by him hereunder, and all amounts di~burse~ by the
Trustee ~ursuant to =he authority hereby conferred upon him sba1[
be ~isbursed w~thout any right in or duEy upon the Trustee to seek
or ob=aln contribution or reimbursement from any person or property
on account of ~uch paymen=. ~he Trustee shall not be responsible
for the application o~ any funds delivered by h~m to the personal
re~)resentative ~ursuant to the authority herein granted, nor shall
the Tz~/etee be subject to liability to any beneficiary hereunder on
account of any payment made by him pursuant to the provisions
hereof.
IN WITNESS ~H~0F, Settlor and Trustee haws hereunto set
their hands and seals as of the day and year first written above.
CO~TH OF ?~I~LVANIA :
SS:
On th/s, /D-%~day of ~~a~-~_, 1997, before me, a
Notary Public,~e m34ersigne~ officer, ~rso~ally ap~mared ~]&~W
M. ~AHO, known tome (or satisfactorily proven) to be the person
whose name is subscribed to the within Trust Agrmement, and
acknowledged chat she executed the same for the purposes therein
contained.
I have set.Jt~ hand and offi~~%~..
- i Ja,,~t c. ~. ~a~~~'
68-1 235
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The foregoing Trust Agre~t w~s~deilvere~, an.~ ts h~y
accepted, at L~e, P~syl~ia. o~ ~~ ~~ 1997.
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COM~MO~TH OF PENNSYLVANIA :
COUNTY OF C~- ke~ { ~-. ,', j :: SS:
and having personal knowledge of the fogowing fiwt~ and cir--, depose a~! sv, ate that:
Date ~ Tim llJ~O'~l"; 30 of 11 P~
1. 1 axn the Trustee appoh~ted under a certain trust agreement executed by Susnn M.
Masaro on January 15, 1997. and entitled =The Susan ]VI. Masaro Family Irrevocable Trust".
have served as Trustee of said Trust continuously since the e~ecution ~h~reof.
3. As of the da~e hereot~ I had no actual knowledge of the termination, revocation or
modification of s~fid Tm~t.
COMMOlqWEAL~ OF PENHSYI.VAZIIA '
' 55:
coumY -
On t~s. ~e {~%d~7 of ~ ~.~,~d~, 20~, be~ me, a Not~ ~bli~. thc.
u~~ Offi~. p~nally ap~r~ AN~O~ ~ MAGARO, known to me(or
p~) to be the p~n who~ ~e is mb~ ~o the ~thin Affidn~, md ac~wi~g~ thai
he ex~I~ the ~me for t~ ~~ thcr~n
IN WITNESS WH~R~-OIt, I hereomo s~t my hand and official Seal.
Public
My Conmlission Expires:
; 71 7240611'8;
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Paga 9/'11.
DATED: ~L~~, I997
FaO~ SU~AN M. MAC~O, 9ETTLOH
TO ANTHONY R. MAGAR0, TRUSTH~
Property Description:
( 1 ) Real property located in East Pennsboro Township,
cAm~berland County, Pennsylvania, identified as Tax Parcel No. 9-13-
099 8- 004.
(2) Real property located in East Pennsboro Township,
Cumberland County, Pennsylvania, identified as Tax Parcel~lo. 9-14-
0834-223.
(3) Real property located in ~ast Psn~sboro ~amskip,
Cumberland County, Pennsylvania, identified as Tax ParcelNo. 9-14-
0834-224.
(4) Real property located in East Pennsboro Township,
Cumberland County, Pennsylvania, identified as Tax Parcel No. 9-15-
1288~046.
(5) Real property located in East Pennsboro Township,
Cumberland County, PennSylvania, identified as Tax ParcelNo. 9-15-
1288-047.
(6) Real property located in Silver Spring Township,
CumberIand County, Pennsylvania, identified as Tax Parcel No. 38-
04-0367-042B.
(7) Real property located in NewPort Borough, Perry County,
Pennsylvania, identified as Tax Parcel No. 190-046.04-303.000.
9
CO OFFICE OF AGING
; 7172406118;'' * Dec-31-02 12:14PM; P~c~.e ~t/",1
A_~cr r~cording, please reuan original Tru~ to:
Mark E. l-lalbruner, -Esquire
Gates & A.~sociatcs, P.C.
10{3 Mtunma Road, Suite 100
Lemoyne, PA 17043
684 ~
I Certify this to lac recordcd
In Cumberland County PA
Recorder of Deeds
238
IN THE MATTER OF THE PERSON
AND ESTATE OF:
SUSAN M. MAGARO,
AN ALLEGED INCAPACITATED
PERSON
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
PRELIMINARY DECREE
AND NOW, this ~0~ day of ~,ta~, 2003, upon consideration
of the
annexed Petition, it is hereby ORDERED AND DECREED that a Hearing on this matter
is set for the ~e_h
Courtroom No. ~
dayof,~)~,2003at J'.O0 P .M.O'clockin
· at the Cumberland County Courthouse, 1 Courthouse Square,
Carlisle, Pennsylvania.
incapacitated person.
~~ 5' is appointed to represent the allegedly
BY THF~I
IN THE MATTER OF THE :
PERSON AND ESTATE OF :
:
SUSAN M. MAGARO, :
AN ALLEGED INCAPACITATED :
PERSON :
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-03-084
ORDER OF COURT
AND NOW, this 5th day of February, 2003, following a
hearing, I find that Susan M. Magaro is an incapacitated
person, and Nancy Stahley is appointed emergency plenary
guardian of the person and the estate of Susan M. Magaro.
Anthony L. DeLuca, Esquire
For Area Agency on Aging
Lindsay Dare Baird, Esquire
For Susan M. Magaro
By the Court,
Edgar 'B. Bay~r~t
J o
prs
David Smith, Ph.D.
License
L~ for the Practice of Psychology in the State of Pennsylvania, License N. PS
~~t~Philosophy, Temple University, Psychology, awarded 1974.
Arts, Temple University, Psychology, awarded 1971.
~ of Arts, St. Vincent College, Psychology, awarded 1970.
PInldii Blonai Certifications
N~iliI~ tt(~rd of Certified Behavioral Analysts
7/90 L'~nt
President of Riverside Associates, P.C. Manage a Professional
Corporation providing comprehensive behavioral healthcare
including short-term, goal-oriented treatment for
behavioral/emotional problems to a variety of hard to treat clients.
4/~nt
Consultant to Human Services, Advise State and County officials
and human service agency executives on the design, management.
and evaluation of community services for people with disabilities.
Pri~ate Professional Practice. Independent practice of
psychology with an emphasis upon behavioral intervention
techniques. Clientele is predominately children and families.
12:19 7172386885 RIVERSIDES PAGE
1/7~6
Special Assistant to the Pennsylvania State Director [or Mental
Health. Responsibilities included refinancing community mental
heall~ services to maximize the use of medicaid funding:
increasing affordable housing opportunities for people with mental
illness; coordinating Pennsylvania's first federally mandaled Health
Services Plan; complying with the provisions of the Federal Nursing
Home Reform Act, of 1987 and implementing Pennsylvania's first
CASSP grant.
Director of Program and Policy Development, Pennsylvania
Office of Mental Retardation. Responsibilities included
administration of Institutional and Community budgets; maximizing
use of Federal funding; supervising the development and
implementation of regulations governing community mental
retardation programs.
Director of Department of Psychological Services, Harrisburg
State Hospital. Supervised 14 professional Psychologists and had
responsibility for the delivery of psychological services to over 600
residents of the state mental hospital.
Director of Mental Retardation Unit, Harrisburg State Hospital.
Responsible for all aspects of a residential program serving 14.5
clients and employing approximately 150 professional and
nonprofessional staff~
A~er~tant Professor of Psychology, King:s College. Taught
eleven semester hours per term. Also, performed research on
techniques associated with teaching children with mental
retardation and for controlling objectionable behavior·
AffNlttions
O
O
·
·
·
·
· ·.· ychological Association
.. for Retarded Citizens, Pennsylvania
{ ~n for Retarded Citizens, Dauphin County
~ .~tion for Behavioral Analysts
=~n_~n on Mental Retardation
.NIIIonal As~x~tlon for the Dually Diagnosed
_d03
l~:lg
717238~$85
RIVERSIDES
PAGE
04
Sp~l~l Assistant to the Pennsylvania State Director for Mental
Health. Responsibilities included refinancing community mental
health services to maximize the use of medicaid funding;
increasing affordable housing opportunities for people with mental
illness; coordinating Pennsylvania's first federally mandated Health
Services Plan; complying with the provisions of the Federal Nursing
Home Reform Act, of 1987 and implementing Pennsylvania's first
CASSP grant.
Director of Program and Policy Development, Pennsylvania
Office of Mental Retardation. Responsibilities included
administration of Institutional and Community budgets; maximizing
use of Federal funding; supervising the development and
implemental~on of regulations governing community mental
retardation programs.
Director of Department of Psychological Services, Harrisburg
State Hospital. Supervised 14 professional Psychologists and had
responsibility for the delivery of psychological services to over 600
residents of the state mental hospital.
Dtm, ctor of Mental Retardation Unit, Harrisburg State Hospital.
Responsible for all aspects of a residential program serving 145
clients and employing approximately 150 professional and
nonprofessional staff.
.a~iBtant Professor of Psychology, King's College. Taught
eleven semester hours per term. Also, performed research on
techniques associated with teaching children with mental
retardation and for controlling objectionable behavior.
AffNl~tlons
Psychological Association
i~'ation for Retarded Citizens, Pennsylvania
i ~tion for Retarded Citizens, Dauphin County
tion for Behavioral Analysts
Associal:ion off Mental Retardation
Association for the Dually Diagnosed
License Number
PS002423L
Expiralion Dart,
'1 t;30/2003
m
'"o
ent By: CUMB CO OFFICE OF AGING ; 7172406118; Jan-27-03 9:56AM; Page 2
Riverside Associates, P.C.
2818 Green Street, Harrisburg, PA 17110
(717) 2~8-6880
PSYCHOLOGICAL EVALUATION
DATE OF EVALUATION: Jalltlary 15, 2005
DATE OF REPORT: January 20, 2002
CLIENT PROFILE
Susan M. Magaro
January 12, 1912
Caucasian
Approximately 5' 5", 102 I1~.
Female
Rule out Dementia of the Alzheimer's Type
None
Cumberland County Office of AgirlfJ and Commurlftv Services
Priscilla Whitman. Protective Services Worlcer
Ow~ ho~Be, Enola PeJlnsyIvanla
REASON FOR REFERRAL
Purpose/Uethotl
IVlrs. Magaro was referred for a psychological evaluation oz~ January 6'f'. 2003 by
Cumberland County Office of Aging and Couunuuity Services Protective Services Worker,
Priscilla Whitman. Ms. Whitman expk~ine, d that the evaluation would be ustxl in petitioning
cmtrt tot guardim~ship. Sb~ asked that Mrs. Magaro be assessed for symptom~ of dementia and
a.ge,-relat~d cognidv-~ declinel
Au assessment interview w:~ conducted Onr January !3, 2003 in Mrs, Mag~tro'a home at
I Chestzr P,,aad, Enola. pa, 17025. ll~e interview involved Mrs. Magaro and he/' granddaughter.
Girm Livingston lage 22). Mrs. Liymgstou has known Mrs. Magaro all her lite. She rel~naed that.
she has been visiting her _.gTrarulmother almos~ every da3' since Octobea' 2002 and .prior to that, until
May 2002, had beem ~,,isiting l~er daily for a long period of time. Interviews and assessmen~
dtctivities were conducted between the hours of 10:00 am and 11:30 am,
ent By: CUrb CO OFFICE OF AGING ; 7172406118; Jan-27-03 g:57AM; Page 3/7
Information tbr this report was gleaned fi-om clinic~ and informant intervieves, direct
observation of Mrs. Magaro's behavior ami a brief survey or'her living enviromnent. Interviews
were semi-struc, mred and h~volved application of the M{ni Mental Status Examination,
adtt~axistration of the Scales of Independent Behavior-Rex:ised (gib-R) and a completion 'of a
checklist of symptoms associated with dementia m'~d age-related cognitive decline. Mrs. Magaro
and Mrs. Livingstone served as informants for completion or' the SIB-R m~ the dementia
check, li~t. Mrs. Magaro participated in all activities in~olve~l in administration of the Mi, nj Mental
Status Examination,
BACKGROUND/PERSONAL. HISTORY
Mrs. Magaro lives alone m her own two story home located at 1 Chester Road, Enola.,
Pennsylvania. By her account, she has lived at this address since approximately 1951, when she
moved there wifl~ herlmsband and two young children. Mrs. Magaro rePorted that her husband
died i~t 195'7. She did not remarry and has been living alone at this address far an undetermined
period of: t~me,
Though Mrs. Magaro appeared to be in relatively good heaith~ intbrinants report, ed several
recently diagnosed m~icat conditi,',ns. These iIlclude: a history of hypertension, peripheral
vascular disease, rnalnutritiorr, atto dehydration. Mrs. Magaro was talcing nv prescribed
medication at the th.ne of this evaluation.
Mrs. Magaro reported that she was born in Perry County and later moved to .Cumberland
County a_,; an ~,~cl,h. She reported completing the g'~ .grade in school and electing to di.~,,ontinue her
education after thc 8* grade due to lack of transportation la~ the 9'~ grade class. Mrs. Magaro
reported enjoying her SO,doling and recalled tidal She did well in all subjects.
According to her report, Mrs. Magaro was employed throughm]t most of her adult lite as a
seamsu'ess in a pajama factory in Mechanicsburg and later as a State mnployee supervising ~
parki.ng lot in Harrisburg. Mrs. Magaro cotfld not recali her age at the time of hew rnarriage~
though she frequently talked about lt~ deceased husband Anthony Mag~u'o. Mrs. Livingstone
reported that.Mrs. Magaro has been retired as long as she can remember and fl~at, in recent years..
has left her home on very few occ,xsion~ and then only when accompanied by someone else. Mrs.
Livingstone reported that her lta~her, Mrs. Magaro's only surviving child(aged approximately 53)
has been Mrs. Magaro's guarctian for several years and has lateen responsibility fo)' managing her
tinanees, maintaining her home: shopping for her, and looking in on he~. Mrs. Livingstone
reported lzowever, that Mr. Mag~o Js no longer able to perform these support functions. Both
Mrs. Livingstone and Mrs. Magaro reported that Mrs. Magaro receives sore= support from
neighbor's that Mrs. Livingstone report, ed are now elderly. Mrs. Magaro said that neighbors
seldom visit her ax~y longer. Mrs. Magaro also has periodic visits from a worlcer a:;sigm-~ to her
by the (-'tm~bexPand Count3' Office of Aging and Communi .W Services.
ent By: CUMB CO OFFICE OF AGING ; 7172406118; Jan-27-03 9:57AM; Page 4/7
CMNICAL INTERVIEW/BI~HAVIORAL OBSERVATIONS
Me~al Status ~xamination.
Mrs. Magaro is a slight woman with blue eyes and straight gray hair (pirm~ up on her
head) who appears hex stated age. Reporm indicate that she has lost 24 pounds during the pa,ut two
years. She wears glasses and is extremely hard of hearittg. Mrs. Mag~o walks without assbtance
but complaim of frequent "dizzy" spells. On the day of the interview she wore a dress with a
sweater, white athletic socks and sneakers. Her clothing was .dirty from long wear without
washing. Mrs. Magaro herself appeared as though she hadn't bathed in .~me time. She rcpoixed
that she seldom washes hex hair ',tad that ~e has difficulty getting in and out of the bathtub on her
ow~ so washes at the sink instead, ller fingernails and hands were dirty, th(rash there wax no
noticeable body odor.
Prior to my arrival, M~s. Magaro had been told that she was to he visited by a doctor on
this thy. When I arrived, she greeted mc -and invited me m sit directly next to her to facilitate her
hearing. Mrs. Magaro was Polite m~d cooperative, Her behavior was socially appt'opriate and eye
contact was establL~;hed, mid maid)rained throughou! the interview. Rapport was established and
maintained relatively easily; though Mrs. Magaro'~ heating sometimes made ir difficult to h, eract
effectively, which required my interacting wi~ her grmddaughter tbr assi.~tance in answering.
Mrs. Magaro wa,$ oricnte,-1 to place, person, and the present situatiop. Her orientation to
time was poor. She could not accurately name rite season, date, clay, or month despite the fact
the previous day: lammry 12i, 2003 had bec~ her birthday.
Mrs. Magaro's made an effort tO maintain attention, but it was nevertheless inconsistent.
She occasionally seemed to "drift off" and at other limes, perseverated on questions unrelated to
the intcrvicw (e.g. whether or not her htlaba.m:l m-as still living),
Mr.~. Magm'o's immedi~,t~ memory w~ very good as evidenced by lief ability m repeat
three trained objects immediately. Her short-term mentory howe's'er was extremely poor when
asked to repeat thc names of the same objecLs five minute~ later, she was umable £o name even one_
Mrs. Magaro's lolxg-l.erm memory was also poor. She was unable to provide de,ails of prior
employment ired had di£ficulty remembering whether or m~t her husband had died.
Mrs. Magaro's mcmd ,.,'as relatively normal and appropriate to the situation, ller affec~
wa~ congruent with mood. During the interview Mrs. Magm'o evidenced some s~gns of paranoid
thinking to the extent that she repeate~y report~, her fears that the railroad ma5' bt: plarming to
buy her house ~nd tha~ someone had stolen (or. wotdd steal) her siJ. verware_ Aside i?OlXl I:hi~, Mrs.
Magaro e¥idcmced no signs of depression, psychotic di.~ordc-r, suicidal, or homicictal ideal.ion.
Mrs. Livm .gstouc clid report, however, that Mrs. Magaro cri~s uearly daily and exprcs'scs extreme
fear of b..-~ing alone m'~eral times a week.
ent By: CUMB CO OFFICE OF AGING ; 7172406118; Jan-27-03 9:58AM; Page 5/7
BEHAVIOR ASSE~SMEI~T
The SII~-R was completed during the clinical i~tervicw and scored later. The .qIB-R ia a
comprehensive measure of adaptive and problem behaviors. It is designed to measure thnctional
independence and adaplivc functioning ar home and in others settings_ $cor~ allow users LO
compare one ingi.vidual [o others of the same age (Mrs. Magaro's scores were compared to a
sr~istical sample of hldividuals 80 years of age and older) and m identify specific support needs.
It provides extensive information for assessing adaptive strengths and service needs_ A table of
scores sa~mmarizing the outcome of this administration is .attached. Overall Mrs_ Magaro's
functi(mal indelxaxlence is very. limited, less than 99.9% of the ret~rence group. SIB-R results
sugges! that Mrs. Magaro is able to do tasks those over 80 years of age can perform, only ? % of
the time. Her greatest su'ength is in the area of' motor ski!Is where she scored at the 20'~
percentile. Mrs. Magaro's ~ocial and ccmununJcation skills are also very pmited (.4~ percentile).
Her perr, onal living skills including, ~atmg, toileting, dressing, self-care, and domestic skills are
very limited to negligible (at the. 1'~ percentile). Tiffs iow rating is based on the facts that she docs
not rcmennber to or consi~'tently prepare meals for herself, does not appropriately toilet herself.
does notch-ess appropriately, change into clean clo~ing, care for clothing adequately, and that she
doe~ not perform other self-care fi~ncxions independently. Finally, Mr.-. Magaro's community
living skills including her ability to manage money, tell time and imeract with the community (e. g.
use the telephone book, cfc.} arc very limited to negligible (1~ perce~rtile). Mrs. Magaro's
maladaptive behaviors which include regmlar falls, crying without reason several t/utes each week,
social isolation, withdrawal, mid t~equem resistance or refusal to pertbrm socially apprcgriate and
necessary_ activities are considered to be marginally serious. These £mdings suggest that. lVlrs.
Magaro needs nmch more supl~n than others her age, primarily because of limited adaptive
behavior. The outcome suggesLs a need t'or outside help to protcmt her health and $afel3,.
Mrs. Magaro ~xluires support and sttpervision with most activities of daily living. A
st~d ch~kli~ of sympto~ associa~ wifix dementia was applied ba~ed upon mformatkm
provided by Mrs. Magaro ~d Mrs. Livingstone ~d observafio~ of Mrs. Magaro's behavior.
Survey of her preset pe~om~ce suggests Bmr Mrs, Magaro shows earl)' signs et' l)~lenfia,
which wOUM 5~ tO exce~ probl~5 associat~ wi~ age-reiamd co~fitive ~ecline in s~e-ag~
~rs. Mrs. Magaro, for ins~ce, contuses ni~t a~ day and exhibits an extremely awhyt~'~ic
gleep/w~e cycle. Her m~o%, is genially p~r. She lhrg~s pm~ay ~lrough f~ili~ romines
such as eat~g, toilefing, and ~R~g ~e table. She ios~ or mi~laces o~jecaz, forgels wor~ mid
common obj~tg~ and ~}rgets names of p~ople whom she knows (e.g. her gvanddaughter who she
s~s everyday). Mrs. Magaro also cxhibicq u~h~ac~i'i~ric irritabilRy ~d i~ easily ~sct. She
sex, ks reassurance that careg/vers ~e nearby and seems apprehensive evea if ie~ alone ~. a room.
She e~fibits a loss of interest in foraterly hvored objc:clS add a(:rivitic~ ~d p~ticiI)ares in no
apparent i~iediate activities m occupy h~sclf. She secure rctucmn.t to leave, the house or to
engage in previously pret~red ~on~eous activiti~. Mrs. Mag~o is reported to ~ve difficulty
~'id~ dcp~ pt~ccprion a~ stmble$ ~r los=g he: balance increasingly more ~equently irmluding
approximate monthly fallz: on ~e st~s from ~c P: to 2~ fioc,r of her home.
ent By: CUMB CO OFFICE OF AGING
; 7172406118;
Jan-27-03 9:58AM;
Page 6/7
DtACI~IOSTIC r-oPJtJULATIOft
Mrs. Magaro present{, a.s a socially isolated 91-yeax.-old won[an with diminishcxl cognitive
and adaptive skills. Though nox~e were observed directly, reports s'uggext that Mrs. Magaro also
experJ, ences numerous symptoms (c.g. frequent crying, fearfulness, loss of appetite, disrupted
sleep, etc.), which rrray be associated with depressed ntood. Direct observation ofMrs. Magaxo's
behavior, informant reports, and administration of sm'vey instruments document that Mrs. Magaro
currently exhibits a moderate memory impairment characterized by diminished ability to carry out
motor activities, despite intact motor functions. Failure to recognize and identify familiar objects
ami disturbance.~ in her ability to plan, organize, sequence and abstract, ideas are all indicative of
early stage dementia. Together these deficits cau.qe significant impairment in Mrs~ Magaxo's social
functioning and represent a significant decline h'om previous levels of fimctioning. A repor£
provided by her grazMdaugh~ augge$1.s that these impairment.s have h-ad a-gradual onset and. are
progressive.
In summary, Mr.~. Magaro:s diagnostic profile includes the tbllowing:
AXilS l:
AXIS Il:
AXIS IlI:
AXIS VI:
AXIS V:
290.13 Dententia of the Aizheimer's type with depressed mood
V71.09 No Diagnosis
Hard of hearing, malnutrition, dehydration, hypertension, peripheral v~cular
disease
Severe, social isolation with regard to primary support group
Mrs_ Magaro's currcl~t Global Assessment of Functioning score is estimated to be
approxin~ttely 22, indicating a need for ahnost constant supervision due to gross
impairment in reality testing, comntuuication, cognition, affect, and personal
hygiea~e
DISCU~SlON
In stmnmu~- Mrs. Magaro exhibits ntm~crous c -hax~tcterLstic~ of.an incapacitated pc-rson.
She has significant current and prog, yessive, cognitive and adaptive skill impairmeu,~s, M.~s,
Magaro i~ not well or[creed u) time at~! has difficulty relating to immediate practical nee:~s such a,x
the need to eat, bathe, and dress appropriately for weather conditions. Mrs. Magaro's incapacity
in this regard is sevel-e. Without adequate supervision, Mrs, Magaro'$ cognitive and behavioral
deficits represent ta~gible fl~reats to her own well-being.
M~. Magaro's emorio~aal state is apparentJy unstable. Reports indicate ti)ar she
exi)eriences renu' md exhibits some signs or' pel3eC.utory thinking. 'Ilae'sc have bc~cn evidenced bi~
untimely visits (at midnight, etc.) to neighbor'; hom~ oMrmg reported fiLq Of crying .and
fearfulness and through repeated ~eports o~: [:ears th~', her hou.xe will be taken or that her
e~lt By: CUMB CO OFFICE OF AGING ; 7172406118; Jan-27-03 9:58AM; Page 7/7
belongings ~vill be stolen. .Though Mrs. Magaro appeared to bc h~althy, she ha5 sc'vc~-al
previou.~iy diagnosed medical conditior~ and had not seem a medical doctor in over two years ar
the time or' my interview. Regular falls in her house pose a seriotis threat to her continued well-
being and her lack of awareness 'and inattemiveness to nutrition .suggest that, without supervision,
Mrs. Mag-aro's health .will deteriorate. Reported weight loss underscores t3Js potential.
Mrs. Magaro evidences sigmticant deficits in all areas of adaptive behavior inchxding ~(~cial
interaction, language comprehension, language ex'pression, caring, toileting, dressing, selt~care,
household skills, time awareness, money handling, and safety awareness. These deficits arc
greater than 99 % of persons over 80 years of age. Results of this evaluation suggest that Mrs,
Magaro is an incapacitaled person who, without direct and cortstant supervision 24 hours a day, is
unable to perform mo,~ activities of daily living and is ar significant risk ot: harm to her.
Magaro requires the amoum .and type of supervision currently available m a aursh~g home ot
similarly supervised setting. Given the naazre of Mrs. Magaro's disorder and currea]l age, it is
likely that these incapacities will become incr~tsingly more serious as time p~sses though
supportexl envixommmt and increased social interaction may impede thc speeaf or' deterioration.
There is no likelihood that. these cognitive and adaptive behavior deficie~tcies wil.l dmfiaish or
improve,
Psy¢llOlOgi~c
Mrs. Magaro
Prls.--llla Whi~nalt (Datlphkt coun~*y office oF Agln~ aniJ communiCy ~ervice$~
Riverside A~cF,,ates Cll~ i:lle
SIDffE 11113
GIANT
ENULA, PA 17025
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STORE #113 ENOLA, PA 17025
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L i f'e t t I.'le2 BI]NI.ISCftR[I 'Say i
I'm 9lad ~utl 5hr' Yuur Casl, ie,
BEINUSCARD-THE KEY TI)
LOW PRICES AND MDREI
U~:~il i.,5 u,, II,u IJ',ter,,el "BONUSCARD-THE KEY TO OPEN 24 HOURS
uuu. ~], a,,t pa. eof, LOW PRICES AND MOREl . EVERY DAY
GIANT
S'I[IRE 1111:5 EN[ILfl, Pt1 17025
lllflNl( YI]IJ 45002569574
UF
10 / 1 -I / 02
IIIIR HIll< 1/~ GAl. IJ NP
IIIIR f.1]lt< 1/? GIlL ~ NP
9"fIPI]I. E PIE
000S4089 FRESH SRUINGS
gl~l Eli'S J(:[- IL)8
~Fl(;lt'B JC.E
BEICIt'5 JOE
WFi CH'5 JC~
IdELCII'5 DRl( 10~
DEl CII'B ,)CE I0~
~HI.CIt'5 Ji;E I0~
PO~ILRfll)I S[NGt. E
DHNNI]N Y[]GUR[
O0(}3?IIB BHNJlB BOY
14EI. CII'5 JCF: IOZ
5t:II~I:PPES IL. lA
000359H9 BI]NUB 8IJY SAVINGS
O00~BgA~ BONOS BUY SAVINGS
WI':I CII'S JCE
WtlEfilIF:S CEREOL
~tt[:I/I]ES CEREftL
fAX .Z6 BAL
gREDI 1' CARl}
REF II 01~)7~1
10/Ifl/02 '1.1:20 OIlS (}5 01[)9 105
CltANGE .00
IIIIIILNIJHIJER JIF llE:f4,~ 50111 = lB
YIIUR 5tlV~NGS IN ltlI5 ORDER
I]ONIISCARO SAVINGS
2.18
SI'ORE Ill 13 ENI]L~, PA 17025
ever'~ fi~.e Sou ~)e]p uif/, ....
e..}~r]euce PJean~: c~ji (-),., ~.
food ~eict')), Sfo, e N~n~)9~/,r 90 rO12
11'0't/02
FLIRKEY H/'I Z.q9 F
IdttEBT];ES'~ERE'Ai._ d 3. fib E
SCHIdEPPES2L fR 1 .S9 B -
OUR NI-LR :2 l;flL. U NP 1,38 F
N*** TAX
THANK YTJG 4550000~400
UF 'cm,~,,,z:t-~l/ti B. 84
310 EIIST PENN [}RIVE fl 0113
ENOLR. PA 17025
CRED[I CARD ~J~ENT
Ex~ 0509 C,rd
P~nt Amou, I
REF fl 023198
II/O~t/OZ 12:2G 0113 06 01;5~t J85
CHANGE .00
I'l]fRL NUMBER DF Z[E~S GULP '=
11/04/02 12:26 PM 0113 0° 01;54 lBS
Visit us on the Inter'r~et
www. BJ~r,Jpa. Eom
Li['eti~e BONu~cRRD Savings 6,?BI.gO
Earned lhis gisi~ 0
Redee,.ed This Yisil 0
Exlr~ Reward Paints R~a,tab. 0
0 pbrf~t-~-'~e~:e Reelected (
p,.in~5 expire m, November. 30, 20~ __
STORE #113
GIANT
ENOLfl. Pti 17025
THANK YOU 48001Z34567
Nu ~oel is In m',sur'e uour' 5at'isF~etion
everu ti,~e yeti shop uJfh us. ~f' there
is anyfl-iin9 ~ e:an do fa improve your'
exper'je~jce PJeabe Loll (7i7) 909-7012.
Todd ~eidll, STore Hanover.
11/05/02
GOLD MINi CUPCR 2.99 F
UIJR ~ILI< 1/2 GAL B NP 1.38 F
~I-IEAf~ES CEREAL B ;~.49 F
FIN PIlBD%NG ~PR .96 F
SCHWEPPES ZLIR 1.39 B
PB~ERADE SI NGI..E
00045079 BDNUS BUY SAgZNG8
~FLCH'S JCE lOZ .6~ F
~ELCH'S I]RK lOZ .~7 B
~EICH'S JCE IOZ .63 F
~EI_CH'S JCE 10~ .6; B
~ELCH'S BRk lOZ .47 B
BELCH'S JCE IOZ .63
FINASi LIP BALM
00055062 BONUS BUY SAVINGS .14-T
FINAS[ SIJGIt~ 1.65 F
B'II'ALIANO BREAD ~ I.B9 F
690 PREPSICED BIBgOUNT ,19-F
***~ TAX .~S GAL 19.61
UF CREDZT CARD 19.61
GIANT FOOl] STORES U 0113
310 EAST PENN BR~UE
ENOLA, PA 17025
CREDIT CARfl PAYflENT
Exp 0509 C~rd XXXXXXXXXXXX]510
REF # 096220
11/05/02 13:34 0113 10 OOGl 157
CItANGE .00
IOTRL NUHBER OF ITEMS SOLD = 15
YOUR 5flYINGS IN IHI5 ORDER
BONUGCARD SflUINGS .53
TDTflL SAVINGS .53
11/05/02 1:~4 PH 0113 I0 0061 157
U~sit us on filu Inf~rnet
uuu.gim~loa.E~
LJ GIANT
STOI?E #11,1 ENOLA, PA 17025
experience please call ('?17) 909-7012.
11118/02
D' I IRLiRNI] DREHD
D'I[FlLIttNEI BREAD
OUR MILE 1/2 Gill W NP
OUR MILt( 1/2 GAl. W NP
FIN 1155 175[:'[
1URkEY HAM
FIN lO,ELS tRilL
FIN IUWELS 1ROL
PfIWER[tDE 320Z
WELCH'S JCE IOZ
WELCtI' 5 JCE
SENSR fiONAk SLID
POWERRI]E 320Z
CItNADA DRY 2 [.'IR
WELCIt'S'JCE 10~
WEI_CH'S JUE lO~
G[il. ll MINI OlJPCli
WHEHI1ES CEREAL W
WHEFllIES CEREAL W
lflSl'YKflkE
I(RRF1 C, tlEESE
TIIANK YOU
O004lBB9 80HIJB BUY B~UIHG
000~5~04 BONUS BUY SAVING
~ B Z/1.O0
00037]01 BDNUB BUY sRuiNG
2 B .19
690 PREPRICED BIBCA[INT
690 PREPRICED DISCOUNT
..~. 1AX .44 BAL
VF CREDI[ CARD
1 BgF
1 DgF
I 38 F
1 30 F
1 O5 1
2 49 F
?5 [
75 r
I 19 B
.63 F
.73 F
.7't B
1.19 B
1.'t9 El
.63 B
63 B
2.99 F
3.49 F
,99 F
2.94 F
4000~186118
.50-'B
,15-B
· 50-[
.IB-F
.IO-F
31
I;[flNl FBI]l) STORES ~ 0113
310 EIl~] PENN DRIVE
ENU[ fl, Pti l~025
UREDIT CARD PI1YMENI
Exp 0S09 Card XXXXXXXXXXXXit510
P~umenl tlmount $
KEF 11 0145[~4
ll/18/OZ 15:47 0113 06 0138 3306
GIANT '
STORE Ill] '. ENOLFl, PA 17025
THANK YOU 4000:118611B
a. xper'ien[e please t:aJ]
}odd Weir:hi, Stor'e H~nager'.
UF
12/Ofi/OZ
[IIIR MILl( I/2 GilL W NP
DilN ISIt tlAM
t<RflF I' CtlEESE
WItEA'IIES CEREAL W ~
TAX .00 BIlL
CREDIT CARD
I 41 i
2'39 i
~ 49 F
11 2B
11 2B
GIANI EO[]D SIORES ~ 0113
310 Ei:IS1 PENN DRIVE
ENOLH, PI:t 170Z5
CREO[I CARD PflYMENE
Exr, 0509 Cacd g~XXXXXXXXXS510
Pa~ent Hmount $
REF ~ 040420
12/06/02 10:23 0113 05 0048 llfi
**************************************
CHANGE .00
IOI'HI.NUMBER (IF itEMS SOLD : 4
12/06/02 10:23 ttM 011I 05 0048 116
1) isit us on the .l:r, ler·rml
wuw.gianJpa.c~m
LiFellme tIONIISCRt~D SaVilliJ5
5.66
I'm glad you 5hopped here today.
Your Cashier .... JFlNIE
~BONUSCARO-IHE KEY TO
LOW PRICE5 AND MUREI
OPEN 24 HOUR5
EVERY DAY
STORE 1113 ENOLA, PA 17025
THANK YOU 40003106110
M~i 90~]] i5 JO ensur-e gOLlY safis{'a[:Jlan
ever,~ lime BL]U simp with us. If' fl]ere
i5 an~JhJm~5 [ fall do fl] JmProv~ ~trtur'
eXp~r'ience PJ~csB c~ll (?17) 909-10i2.
Todd ~eirhl, 5tar.~ Hm'~r'.
12/10/02
OUR MILK 1/2 GAL W NP 1.41 F
Ij'IlHL[fiND BREAD , 1.89 F
D'IIALIFlNB BREAD ~, 1.89 E
ENSIJRE PLIJS 6Pi( 9.[14 F
GINGER fiLE 1.lB B
UflNIStt CAN 3.49 F
GINGER AlE
1.18 ~
000~588] D'IIALI8 BOQ 8QG 1.89-F
TAX 15 BAL 19.14
UF CREDIT CAR~ 19.14
GlflNI' FOOD S[ORES
310 EASt PENN DRIVE
ENBLA, PH 17025
CREB]I CARD PAYMENT
Exp OSO9 Card XXXXXXXXXXXX3510
REF 1I 01903336
12/10/02 14:13 0113 07 00333 I1~
CHANGE
lOTFlL NUMBER OF lIENS S[]I~ ~ 7 .00
YOUR SAUINGS IN THIS ORDER
BONUSCARO SAUING~
TOTAL SAVINGS I.B9
12/10/02 2:133 PM 011~ 07 003~ 114l'Bg
Visit u5 on the inter-net www. 9i~mlfpa Eom
BONIISCflRIJ Saving5 lhis Visit 1.89
Lifetime BONUS(:R~D Savings 8.54
I'~ glad uou shopped Ger~
GIANT
STIlf(E #113 ENIJLA, PA 17025
THANt{ YOU 480031B6118
1 Z ./1 3/0 Z
UF
ENSURE PLUS GPI{
FiNA51 SUGAR
00037449 BONUS BUY SAVINGS
WUERI [ES (';EREj"IL W
[IUR MILl< 1/2 GAL W NP
SENSI-iI[DNR[ SODA
000~01 ~I]NiJ~ BUY
SE NSA I'lflNflL SflDiI
000~4~01 BONMS BOY
5ENSd'I[I]NAL SUIIA
00034~01 BONUS BUY
PO~ERfiDE ~Z[IZ
5NfiCI{ CAt(ES
O00~OZB5 BUNDS BUY
~*** rAH .14 KAL
COED[1 CARD
9.Gq F
165F
77.-F
3 '-t9 E
ql F
09-B
O9--B
1 19 ~
1.09 f
.ZO-F
18.84
1G,84
UIiINI FI]Illl SI[IRES fl 0113
310 EASI PENN DR[gE
F Hill. fi, PR l?OZS
t:REI][I L:RI~LI PAYHENI
E~'p 0402 Card XXXXXXXXXXXX~030
I?11 fl OqSO0~
12/1:~/02 IS:~O 0113 11 0042 157
CHANGE .00
]UI[II NIJHBFR OF [IEH5 SOLD = 9
YIJLItt SAVINGS IN TttlS ORDER
gONUSCARD SAVINGS
IOlflL SAVINGS
12/Ig/02 1:38 PM 01lO 11 0042 157
I ,23
1,23
Uisil us un [h~ Juler'net
kl lul Id . 9 i ~['l I p~. EOlq
STDRE I113
GIANT
ENBLA, PA 17025
THANI( YOU 4110031861 lo
My 90ill i5 t0 erlsur'e UOLtr
ever'u time Uuu shop with us. ]TF fh~r'u
exp~rien[:e PIPase [~1] ('?1'?~ 909-7012:
todd ~eicht, Store ~na~ar'.
12/1~/02
UilR NILi(. 1/2 GOL
I1UR ~I_R 1/2 G~L ~ NP 1.~1 F
COOKED HAH ~ 4.q9 F
000~9~1~ 8ONU~ ~UY SR~NGB .50-F
D' J'lAL IflNg BREAD
00041699 BDNU5 BUY 5AVI'NG5 .90-'F
. LlrfLE UEBBIE ~ 1.19 E
00040342 BBNU~ BUY ~AVINGS .20-F
FRISKIES 3.1SLB , 3.31 f
00035658 BONUS BUY SAVINGS .15~T
kRiiFl SINGLES * ].~1 F
000466~9 BONUG BUY SAVINGS .BZ-F
3~.34 FRiSi<I[ C,iI 5.5 1.02 l
FRU[I~ORI(fi .99
~* 1AX .31 GAL 17.26
~li~AllE5 CEREAL ~ ~.~g F
WEI. uit'S JCE 102
WELCH'S
WELP. H'~ JPF 10~ .6'~ F
WELCH'S' DRI~ lO~' .-47 ~ .
· m"" TAX .41 GAL 2~.05
VF CREDIT CARD ~.
G[flNI FOOD S~ORES ~ 0113
~IO ERS1 PENN
ENOLR, PR 17025
CREg[T CR~[J PAYHEN1
Exp O50g Card XXXXXXXXXXXX35 I0
Paum~nt A~uunt $ ****"23.05
RE[: fl 0153'/5
12/18/02 12:43 0113 ll O01fi
CItANGE .00
II}IRE NUMBER DF iTEMS SOLD = 16
YOUR 5AUING5 1N THIS ORDER
DDNUSOARD SAVINGS
T[ITAI qnurH~=
STORE 11113
GIANT
ENULA, PA 17025
THANK YOU 480031861
Hud ~oa] i5 to em,sure uuur 5afisf'act]on
ever'u time uno ~hap with us. If ther'e
J5 allythil-19 [ can d~] fo improve your
experie.ce Please call (717:) 909-7012.
Todd ~eicht,
1Z/ZO/OZ
ENSURE PLUS GPK lO.lO F
I**~ TAX .00 BAL 10.1~
CAsH 10.25
OHARGE .09
TUIAL NUMBER DF IIEMS SOLD = 1
12/20/02 2:2~ PM 0113 05 0299 182
Uisil us on the Internet
www, 9i ~n~pa, Eom
LiFetime BONUSCflRD Saving~ 12.~q
]]'iq 9lad Uou shopped here fadag.
Your Cashier --- DAN
BONUSCARD-TtlE KEY ID OPEN 24 ttOURS ':
LO~ PRICEB AND NOREI EVER? DAY ~
2.57
KMART STORE 4479
5050 JONESTOWN ROAD
HARRISBURG. PA. 17112
(7171652-4770
YOU HAVE T DAYS TO BUY INSURANCE FOR
YOUR ELECTRICAL OR BATTERY PURCHASE
CRSHIER: PRECIOUS
~ENERAL HERCNRND~S~E
73468921424 PLUSH
07095076052 1QT SAUCEPAN A
5,99
17.99
**~* TAX 1.44 BAL 25,42
XXXXXXXXXXXX3510 EXP 0905
VISA/VS APPROVAL 412834
VF VISR/VS 25.42
CHANGE .00
YOUR TO~AL SAVINGS:
2.00
TOTAL NUMBER OF ITEMS : 2
I IIIIIIi lll ll llll
CQE YLE LON giT 95V EOB
12/24/02 7:03 PM 4479 10 1226 0168
Merchandise included in toda!~'s
transaction mag be refur, ned or
exch~nscd before 03/24/03
this receipt.
The complete return & exchange PolJcu
is available at the Service I)esW,
GIANT
S/firE I113 EMI]LA, PA 17025
48003186111)
MU goal is to ensure UOur satisfaction
exPer'Jen[m o1:.~ ~. ,u IRPr0V~ ,
12/27/02
OUt'~ H~LK 1/2 GRL Id NP 1.41 F
IAST¥~i~KE DONUTS w 2 59 F
690 PREPRICE~ 8ISCOUNT "
~"~" )'AX .26-F
UF C~EOIT C~O0 BAL 3,74
3. ~4
GIRN[ FO[II) SIORES
ENO/R, P-A 17025
CREOII' t:RFCD
Pfi~HENI
Exp Oq02 Card X'XXXXXXXXXXXflO~O
RET ~ 051565
12/27/02 1~1:2! 011~ 09 0098 3307
CHANGE
lIJlflL NIIH~ER OF [[EMS SOLD ~ 2 ,OD
YOUR SflUING5 I'N THIS
8flNUSCflR8 nuru~.
[ .
8TilL SflUINGS .26
12/2H02 2:2I p~ 0]13 Og 0098 330'/.26
Visit .s on the .[nternet
www.~ianlpa,com
BONUSCflRD Savings Ibis Ui~i t .Z6
Lifetime fll]NUSCflRD Savin~s l~.fiO
' ]"~ glad uaw shopped
~our C ' here fodag.
ashier DAVE
STORE #113
ENOL~, PA 17025
THANK YOU
48003186118
My goal is to ensure your satlSeaczfon
every time you shop wlth us. I¢ there
ls anything Z can d~ zo Improve your
experi~ence Please: call {717) 90977012
TOdd Weicht, Store Manager
12/24/02
LIPTON TEA. 1000 ~ 2.99 F
00045288 BONUS BUY SAVINGS 1.O0-F
~* TAX .00 BAL
CASH 1.99
CASH ~,00
CHANGE 1.00
TOTAL NUHBER OF I/EMS SOLD =
YOUR SAVINGS ZN THIS ORDER
BONUSCARD SAVINGS
TOTA~ SAVINGS l.O0
1.00
12/24/02 4:29 PH 0113 83 0222 872263
Visit us on the Internez
ww~.g]anzpa.co~
BONUSCARD Savings Th~s Vis/t 1.00
Lifetime BONUSOARD Savings 13 34
Z'a glad You shopped here
Your Cashier -- U-SCAN
BONUSCARD-THE KEY TO OPEN 24 HOURS
LOW PRICES AND MORE! EVERY DAY
GIRNT
5TDRE #113 ENDLR, PA 17025
THflNI( YDU
~B003186118
ever'H T~.mo ~ou 5lloP u~th us. IF there
~5 aF~l'hlr/9 I cai dg 'fO ll~prov~ ugur'
experlencv please ca~[ (717) 909-'7012.
Tadd ~i[hr 5tur'~ Manaeer,
01/05/03
GINGER HL.E 1 18 B
GINGER ALE 1.1~ g
ENSURE PLUS 6PK 10.1b F
ENSI.IRE Pi d5 6PK 10. 16 F
NrIEHI~E5 CEREfiL ~ ~ 7,.q¥ F
~*** TAX .15 BIlL ~fl.32
UF CREDIT CARD 26.~2
GIgNI FDI']D HI(IRES ~ 0113
3~0 EFtST PENN DRIUE
ENBLR, PH 1PO25
fiREDZI (]RRB 'PHMHENT
Exp 0,509 Card XXXXXXXXXXXX~5 It)
P~menl Hmuu~ t $ ~x,26.!2
REF ~ 05]0q0
1/05/03 1~ 18 0115 05 0211 t61
CHANGE ,00
iCl'AL_ NUMBER OF IIEM5 SOLD ~ 5
1/05/03 1 18 PM 011~ 05 0211 lfll
U15IT u5 £1il time ~nt~rna|
uuw giar'ltpa.aom
2005 klgNUS(.:flRD 5avtn95
,00
I'm 91aa uou 5hopped here iuda,t.
Ymur gaeh~er -- ALEX
BDNUGCflRD-THE KEY TO OPEN 24 ttDURS
LOW PRICES AND MOREl EUERY DAY
GIRNT
STORE #11'3 ENOLA, PA 17025
THANK YOU 4900~1861ia
011O6103
MC
VF
OUR MIL. t< 1/2 CRt. W NP I 40 F
OUR HIiLt< 1/2 GAL W NP 1.40 F
FINflST SP[IONS .59 '[
FINflST SUGA~ 1.79 F
TAX .04 BAL 5.22
S~A~ED C.DUP8~:~ 2. O0-
TAX '- .04 BAL 3.22
CREDIT OARD ~.22
GiANf FOOb SIBRES 1~ 011~
~'10 ERST PENN DRIVE
ENOLA, PH 1702S
CR~.[,' £ l URR[) PRYMENI
Exp 0402 Card XXXXXXXXXXXXGO'~O
REF ~ 059476
1/06/03 1~:35 Oll5 05 01% 11~
CHflNBE .00
r[I'tAL NIlM~ER Of: ]:lENS SOLD ~ 4
YOUR SAVINGS IN THIS ORDER
COUPON SAVINGS 2.00
TOTAL SAVINGS 2.00
1106103 4:3~ PH'OtI3 05 0193 113
.00
i'm glad ~ou 5hopped her'~ [odau.
Your Ca,bier -- CHRY
BDNUSCARD-THE KEY TD OPEN 24 HOUR5
LOW PR'ICES AND MORE! EVERY DAY
GIANT
STORE #113 ENQLA, PA 17025
THANK YOU 49003186118
ever~ ~me ~ou ~hop w~th u~, If Shere
is an~$hing ~ can do fo i~prove ~our
experience ~lea~e call (717)
~dd Weich~, S~ore M~nager~
01/09/03
EN'¥ENMRNN SNACK * 3.39 F.
690 PREPRICE~ DISCOUNT ,3~-F
SENSRflONRL SODA ~ 42 B
000411~1 BONUS BUY SAVINGS .OS-B
SENSATIONAL SODA ~ .42 B
00041161 BONUS BUY SAVINGS .05-B
WHERTtES CEREAL W * 3.49 F
~#~ TAX
UF CREDIT CARD 7,35
GIANT FOO~ STORES ~ 0113
~lO ERST PENN DRIVE
ENOLR, PR 17025
Exp 0S09 Card ×XX××××XXXX×5510
REF ~ 000218
1109/03 16:24 0~13 10 oogB 192
CHANGE .00
TQlRL NUMBER QF ~TEMS SOLD ~
YOUR SAVINGS IN THIS ORDER
BDNUBOARD SAVINGS
TOTAL SAVINGS
1/09/05 4:24 PM 0113 10 0096
Y~sit us on the Iniernef
www.giart~p~.com
BONUSCRRD Savings lhi5 Visit ,4'
2005 BONUSCRRD Saving5
*************************************
I'm glad uou shop~ed here
Your Cmsh~er -- MATT
BONUSORRO-THE KEY TO OPEN 24 HOURS
LOW PRICES AND NQRE! EUERY DAY
CLUB HANA6ER ROBERT FOHBY
C 717 ) 558 - 4200
HARRISBURG, PA
01/13/03 16:21 2591 8175 014
V MEMBER 101-10680863156
THANK YOu,
1188
NAOMI LIVINGSTON
635725 JUICE 24PK 9.12 N
176233 APPLESAUCE 5.68 N
652240 FRUIT N GELS 6,17 N
19983 FRUIT BOWLS 5.98 N
338721 ENSURE PLUSC 32.48 N
TOTAL 59.43
SAMS P CREDIT 59.43
ACCOUNT ~ 10680863156
APPROVAL ~ 000387
CHANGE DUE 0.00
# I TEHS SOLD 5
TC) 0393 2409 2109 3385 5640
SAM'S CLUB Travel 1-800-955-SRHS
O1/13/03 16: 21: 34
MEMBER COPY
GIANT
STORE #113 ENOLA, PA 17025
THANK YOU 4BOO31B6.1ID
M~ 9cai is fo ensure uour satisfaction
everu time uou shop with us, If there
is anufhJn9 I can do fo improve your
experience please call (717) 909-7012.
Todd Weichf, Sfor-e Manager,
01/24/03
OUR MILK 1/2 GAL W NP 1,~0 F
OUR MILK 1/2 GAL W NP 1.qO F
WHEATIES CE]REAL W S,q9 F
SENSATIONAL ~QDR ~ .q2 B
':00041098 BONUS BUY 5RUINGB ,OB-B
SENSATIONAL SODA , .42 B
00041098 BONUS BUY SRUING~ .09-B
COOKED HAM 3,49 F
TRSTYKRKE DONUTS * 2,59 F
690 PREPRICED DISCOUNT .26-F
~*** TAX .04 GAL 12,82
UF CREDIT CARD
****************************************
GIANT FOOD STORES ~ 0i13
310 EABT PENN DRIUE
ENDLA, PR 17025
CREDIT CARD PAYMENT
Exp 0509 Card XX×XX:XXX~,XXX3ilO
PaymenT'Amount $ ****'12.B2
REF ~ 068774
1124103 15:45 0113 10 0093 131
**************************************
CHANGE .00
TOTAL NUMBER OF ITEMS SOLD = 7
YOUR SAVINGS IN THIS ORDER
BONUSOARD SAVINGS ,4~
TOTAL 5AUING5 .43
1/24/03 3;45 PM 0113 10 0093 131
Visit us on the Internef www. Bianfpa.~o~
********** SAVINGS SUMMARY ***********
BONUSCRRD Savings This Visif .4~
2003 80NUSCRRD Savings .BY
I'm ~lad uou 5hopped here fodau.
Your Cashier -- GLADYF
BONUSCARD-THE NEY TO OPEN 24
LOW PRICED AND MOREl EVERY
IN THE MATTER OF THE PERSON AND :
ESTATE OF: :
:
SUSAN M. MAGARO, :
AN ALLEGED INCAPACITATED PERSON:
:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COLrNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-03-084
PETITION TO EXTEND EMERGENCY PLENARY GUARDIANSHIP
OF THE PERSON AND ESTATE
AND NOW COMES THE PETITIONER, the Area Agency on Aging in and for
Cumberland County, Pennsylvania, who represents and avers as follows:
1.
The Petitioner is the Area Agency on Aging, in and for Cumberland County, with
its office located at 16 West High Street, Carlisle, Cumberland County, Pennsylvania.
2.
The alleged incapacitated person is Susan M. Magaro, age 91, widow, who, since
the Hearing for appointment of Emergency Plenary Guardians of the Person and Estate
on February 5, 2003, has been residing at Perry Village Nursing Home in New
Bloomfield, Perry County, Pennsylvania but who previously had resided for many years
at 1 Chester Road, Enola, East Pennsboro Township, Cumberland County, Pennsylvania.
3.
On or about January 28, 2003, Petitioner filed a Petition for Appointment of
Emergency Plenary Guardians of the Person and Estate of Susan M. Magaro, an alleged
incapacitated person.
4.
On February 5, 2003, a Hearing was held on the Petition resulting in an Order
being entered wherein Nancy Stahley, niece of Susan M. Magaro, was appointed
Emergency Plenary Guardian of the Person and Estate of Susan M. Magaro, which Order
was to be in effect for seventy-two (72) hours.
5.
The seventy-two (72) hour period has elapsed.
6.
Petitioner believes and, therefore, avers that the emergency continues because her
condition remains the same.
7.
Petitioner believes and, therefore, avers that the Emergency Order dated February
5, 2003, a copy of which is attached hereto, marked as Exhibit "A", and incorporated
herein by reference, should be extended for twenty (20) days from the expiration of the
initial Emergency Order.
8.
Lindsay Dare Baird, Esquire, counsel for Susan M. Magaro, the alleged
incapacitated person, does not object to the requested extension and Paul Orr, Esquire,
counsel for Anthony R. Magaro, son of Susan M. Magaro, at the conclusion of the
Emergency Heating did not object to the requested extension.
WHEREFORE, Petitioner prays that this Honorable Court:
1. Extend the appointment of Nancy Stahley as Emergency Plenary Guardian
of the Person and Estate of Susan M. Magaro, an alleged incapacitated person, for twenty
(20) days from the expiration of the initial Emergency Order, at which time a full
Guardianship Hearing will be held; and
2. Issue a role upon Susan M. Magaro, the alleged incapacitated person,
with notice thereof to be given to her next-of-kin, and to such other persons as this Court
may direct, to show cause why she should not be adjudged an incapacitated person and
Nancy Stahley, niece of Susan M. Magaro, be appointed Permanent Plenary Guardian of
her Person and Estate.
Respectfully Submitted, _
Anthony L. DeLtlca, Esquire
113 Front Street
P.O. Box 358
Boiling Springs, PA 17007
(717) 258-6844
VERIFICATION
I hereby verify that the facts and information set forth in the foregoing Petition to
Extend Emergency Guardianship of the Person and Estate of Susan M. Magaro are tree
and correct to the best of my knowledge, information, and belief. I understand that any
false statements contained herein are subject to the penalties of 18 Pa. C.S. Section 4904,
relating to unswom falsification to authorities.
Dated:
Priscilla Whitman
iN THE MATTER OF THE
PERSON AND ESTATE OF
SUSAN M. MAGARO,
AN ALLEGED INCAPACITATED
PERSON
IN THE COURT OF COIVfHON PLEAS OF
CUliBERLAND COUNTY, PENNSYLVANIA
ORP?uXNS' COURT.DiVISION
NO 21-03-084
ORDER OF COURT
A~N~ NOW, this 5th day of February, 2003, following a
hearing, i find that Susan M. Hagaro is an incapacitated
person, and Nancy Stahley is appointed emergency plenary
guardian of the person a~d the estate of Susan M. Magaro.
Anthony L. DeLuca, Esquire
For Area Agency on Aging
Lindsay Dare Baird, Esquire
For Susan M. Hagaro
By the Court,
~Edgar B Bay±~,~
prs
17_i
13
EXHIBIT "A"
A TRUE OO~¥ FROM RECORD
In Testimony wherof, I hereunto
set my hand and the seal
of said Court at Carlisle, PA
day of ~ ~ 20 O~
06,z,-I
Clerk of the Orphans Cou~
Cumberland County
IN THE COURT'~OF'~'COMMON:~PLEAS
CUMBERLAND COUNTY, PENNSYLVANI
ORPHANS' COURT DIVISION
NO. 21-03-084
IN THE MATTER OF THE PERSON
AND ESTATE OF:
SUSAN M. MAGARO
AN ALLEGED INCAPACITATED
PERSON
PETITION TO EXTEND EMERGENCY
PLENARY GUARDIANSHIP OF THE
PERSON AND ESTATE AND ORDER
ANTHONY L. DELUCA
ATTORNEY AT LAW
113 FRONT STREET
P.O. BOX 358
BOILING SPRINGS, PA 17007
IN THE MATTER OF THE PERSON AND · IN THE COURT OF COMMON PLEAS OF FEEl 10 ~11§3
ESTATE OF: · CUMBERLAND COUNTY, PENNSYLVANI~:~{ ~ .. ~
SUSAN M. MAGARO, :
AN ALLEGED INCAPACITATED PERSON: ORPHANS' COURT DIVISION
· NO. 21-03-084
ORDER
AND NOW, this I I ~ day of February, 2003, upon consideration of the
attached Petition, it is hereby ORDERED AND DECREED that ·
1. The Appointment of Nancy Stahley, niece of Susan M. Magaro, as Emergency
Plenary Guardian of the Person and Estate of Susan M. Magaro is extended for a period
of twenty (20) days; and
2. A rule is issued upon Susan M. Magaro to show cause why she should not be
adjudged an incapacitated person and Permanent Plenary Guardians of her person and
estate be appointed. A hearing on this matter shall be held in Courtroom No.
of the Cumberland County Courthouse, on al , 2003, at ~'. ~
o'clock ~ . M..
listed-~the ?etitl6n mr ~ppol/itmgntef Emer-enc-'~, .~ Plcnar~- Guardirms ef the Person..ai~/y
by ........... : ....'- ...... 1 .... 4 ~e..+;n~4 x:.ail.
('F-
Edgar B. Bayle~q,~L~
IN THE MATTER OF THE PERSON AND : IN THE COURT OF COMMON PLEAS OF
ESTATE OF: : CUMBERLAND COUNTY, PENNSYLVANIA
:
SUSAN M. MAGARO, :
AN ALLEGED INCAPACITATED PERSON: ORPHANS' COURT DIVISION : NO. 21-03-084
PETITION FOR APPOINTMENT OF PERMANENT PLENARY GUARDIANS
OF THE PERSON AND ESTATE
AND NOW COMES THE PETITIONER, the Area Agency on Aging in and for
Cumberland County, Pennsylvania, who represents and avers as follows:
1.
The Petitioner is the Area Agency on Aging, in and for Cumberland County, with
its office located at 16 West High Street, Carlisle, Cumberland County, Pennsylvania.
2.
The alleged incapacitated person is Susan M. Magaro, age 91, widow, who, since
the Hearing for appointment of Emergency Plenary Guardians of the Person and Estate
on February 5, 2003, has been residing at Perry Village Nursing Home in New
Bloomfield, Perry County, Pennsylvania but who previously had resided for many years
at 1 Chester Road, Enola, East Pennsboro Township, Cumberland County, Pennsylvania.
3.
On or about January 28, 2003, Petitioner filed a Petition for Appointment of
Emergency Plenary Guardians of the Person and Estate of Susan M. Magaro, an alleged
incapacitated person. A copy of said Petition is attached hereto, marked as Exhibit "A"
and incorporated herein by reference.
4.
On February 5, 2003, an Emergency Hearing was held on the Petition and, at the
conclusion of said Hearing, the Court found that Susan M. Magaro is an incapacitated
person and appointed Nancy Stahley, niece of Susan M. Magaro, Emergency Plenary
Guardian of the Person and Estate of Susan M. Magaro.
5.
Nancy Stahley, niece of Susan M. Magaro, is willing to accept the appointment of
Permanent Plenary Guardian of the Person and Estate of Susan M. Magaro.
WHEREFORE, Petitioner prays that this Honorable Court appoint Nancy Stahley,
niece of Susan M. Magaro, Permanent Plenary Guardian of the Person and Estate of
Susan M. Magaro.
Respectfully submitted,
Anthony L. DeLuca, Esquire
113 Front Street
P.O. Box 358
Boiling Springs, PA 17007
(717) 258-6844
VERIFICATION
I hereby verify that the facts and information set forth in the foregoing Petition for
Appointment of Permanent Plenary Guardian of the Person and Estate of Susan M.
Magaro are tree and correct to the best of my knowledge, information, and belief. I
understand that any false statements contained herein are subject to the penalties of 18
Pa. C.S. Section 4904, relating to unswom falsification to authorities.
Dated: ~[_lJ~/Zlzl. l_~, ]O: ~tgo,.~
/
Priscilla Whitman
12'4 THE M_ATTER OF THE PERSON
AND ESTATE OF:
SUSAN M. MAGARO,
AN ALLEGED INCAPACITATED
PERSON
JAN
' IN THE COURT OF COMMON PLEAS OF
· CUMBERLAND COUNTY, PENNSY-LVANLA
ORPHANS' COURT DIVISION
28
PRELIMINARY DECREE
AND NOW, this day of ,2003, upon consideration of the
annexed Petition, it is hereby ORDERED AND DECREED that a Hearing on this matter
is set for the day of ,2003 at __. M. O'clock in
Courtroom No. __ at the Cumberland County Courthouse, 1 Courthouse Square,
Carlisle, Pennsylvania.
is appointed to represent the allegedly
incapacitated person·
BY THE COURT,
EXHIBIT "A"
IN THE MATTER OF THE PERSON
AND ESTATE OF:
SUSAN M. MAGARO,
AN ALLEGED INCAPACITATED
PERSON
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DMSION
NO.
PETITION FOR APPOINTMENT OF EMERGENCY PLENARY GUARDLANS
OF THE PERSON AND ESTATE
AND NOW COMES THE PETITIONER, the Area Agency on A~ng in and for
Cumberland County, Pennsylvania who represents and avers as follows:
1.
The Petitioner is the Area Agency on Aging, in and for Cumberland County, with
an office located at 16 West High Street, Carlisle, Cumberland County, Pennsylvania.
2.
The alleged incapacitated person is Susan M. Magaro, widow, age 91, who
resides by herself at 1 Chester Road, Enota, East Permsboro Township, Cumberland
County, Pennsylvania and has resided there for a number of year.
o
The only known relatives of the alleged incapacitated person are:
A. Anthony R. Magaro - son
106 Pine Hill Road
Camp Hill, Pennsylvania
B. Gina A. Livingston - Granddaughter
C/O Dauphin County Victim Witness Assistance Program
Dauphin County Courthouse
Front and Market Streets
Harrisburg, P~nnsylvania 17101
C. Irene Meadowcroft - Niece
9 Salt Road
Enola, Pennsylvania
Nancy Stahley- Niece
29 Barnett Street
P.O. Box 215:
New Bloomfield, PA 17068
Helen Clouse - Sister
31 Barnett Street
P.O. Box 215
New Bloomfield, PA 17068
Susan M. Magaro has, for at least three (3) months, been incapable of managing
and caring for herself and her financial affairs.
5.
Susan M. Magaro exhibits symptoms of mental incapacity, including but not
limited to dementia.
Susan M. Magaro's mental incapacity prevents her from managing and caring for
the affairs of her person and estate.
The Petitioner, through its authorized representative, has conducted an
investigation of this matter and has determined that, on January 15, 1997, the Susan M.
Magaro Family Irrevocable Trust was executed by her wherein she appointed Anthony R.
Magaro, her son, as Trustee of the trust. A copy of the Susan M. Magaro Family
Irrevocable Trust is attached hereto, marked as Exhibit "A", and incorporated herein by
reference.
8.
Further investigation by Petitioner has revealed the following:
a. That Susan M. Magaro sits in her house in the dark with windows covered
by newspapers;
b. That she is unable to cook for herself;
c. That ongoing attempts to provide nutrition under care management have
been unsuccessful;
d. That a neighbor gave her a frozen meal to warm up which she returned
still frozen, unable to prepare it;
e. That spoiled food has been found in the refrigerator and she does not
know how long she had the food; and
f. Food has been purchased for Susan M. Magaro by staff from the Area
Agency on A~ng, neighbors, and Gina A. Livingston, a ganddaughter.
9.
While food has been made available to Susan M. Magaro, observation has been
made that little food has been consumed and she has been seen flagging down a passing
motorist after she was told by an individual that he could not go to the store for her at that
time. The unknown motorist subsequently returned with milk for her.
10.
During the past two (2) years, Susan M. Magaro has made numerous telephone
calls to the East Pennsboro Township Police Department concerned about the following:
a. That she is fi-ightened because she believes that men were going to stop; :
pick her up and take her away to Texas;
b. That she is agraid to be there alone;
c. That someone has entered her house and has taken such things as
silverware, scissors or flashlights; and
d. That she requests police to watch her house or drive by her street.
11.
In September, 2002 Petitioner's author/zed representative met with
Anthony Magaro at his mother's home to discuss services that would be available to her.
This meeting was unsuccessful and he was angry that a neighbor was providing his
mother with frozen meals from the Office of Aging and that it should stop because he did
not trust the food that was provided.
12.
During that meeting in September, 2002, Anthony Magaro also stated that another
neighbor was nosy and should not interfere with his mother even though that neighbor
was helping to buy milk and food for his mother.
13.
On or about December 20, 2002, Gina A. Livingston, granddaughter of Susan M.
Magaro contacted Petitioner with concerns regarding her grandmother because her father,
Anthony Magaro, was arrested and in jail because he could not make bail. The said
Anthony Magaro is still in jail.
14.
The granddaughter, Gina A. Livingston, stated on or about December 20, 2002
that her father, Anthony Magaro, had not been providing any care to his mother and she
was now concerned how her grandmother's bills were being paid and that the assistance
her father had been providing to his mother had declined over the past few years.
15.
On or about December 23, 2002, Priscilla Whitman, Protective Service Case
Manager for Petitioner, visited the residence of Susan M. Magaro and made the following
observations:
ao
So
ho
Her clothing was very dirty;
Her body was dirty;
The house was dark;
She cried out in pain when sitting down in a chair after answering the
door;
She asked Ms. Whitman on four (4) occasions who she was and the reason
for her visit;
She asked if her spouse was living and believed that he was living in
Wormleysburg with another woman;
She did not know how to contact her son and did not have his telephone
number; and
She did not know that Christmas was two (2) days a~vay.
16.
On January 2, 2003, Priscilla Whitman visited the house of Susan M. Magaro and,
at that time, observed that she was still dirty, had no recollection of who Ms. Whitman
was, and did not know the day, month or year.
17.
When asked on January 2, 2003 whether her son had visited her over the holidays,
she said that he did but could not say when.
On January 17, 2003, Petitioner was notified that Susan M. Magaro. had called
another party, was very ups~ because she was dizzy and needed blood pressure
medicine. Arrangements were made for her to see Dr. Lynn Comehus.
19.
A physical examination conducted by Dr. Lynn Cornelius revealed the following:
a. Malnutrition;
b. Abnormal weight loss;
c. Dementia, multi-infarct;
d. Alzheimer's, delirium possible;
e. Peripheral vascular disease;
f. High blood pressure;
g. Inability to attend to daily living needs;
h. Poor hygiene;
i. Mycosis; and
j. Debility.
20.
Susan M. Magaro has had a psychological evaluation conducted by Riverside
Associates, which evaluation reveals the following diagnoses:
a. Dementia of the Alzheimer's type with depressed mood;
b. Severe, social isolation with regard to primary support group; and
c. Mrs. Magaro's current Global Assessment of Functioning score is
estimated to be approximately 22, indicating a need for almost constant
supervision due to gross impairment in reality testing, communication,
cognition, effect, and personal hygiene.
2t.
Under the terms of the Susan M. Magaro Family Irrevocable Trust, she
irrevocably transferred assets listed on Schedule "A" which assets are referred to
hereinabove in Exhibit "A".
22.
Petitioner does not know the status of said Trust.
23.
The Petitioner believes that Susan M. Magaro has monthly income from Social
Security and a pension from the Commonwealth of Pennsylvania which are deposited
into a bank account for her but that she has no control over the money.
24.
Petitioner believes and, therefore, avers that allowing Susan M. Magaro to
continue living in her home and wandering would place her in imminent danger of death
or serious bodily harm.
25.
Petitioner believes and, therefore, avers that Susan M. Magaro has not been
properly cared for by her son, AnthonY, Magaro, and that she should be placed in a
nursing home facility.
26.
Less restrictive alternatives are not available because there is no one able to care _
for her.
27.
Nancy Stahley, niece of Susan Magaro, is willing to accept the appointment of
Emergency Plenary Guardian of the Person and Estate of Susan M. Magaro.
28.
No other Court has ever assumed jur/sdiction in any proceeding to determine the
incapacity of Susan M. Magaro.
29.
The failure to appoint Nancy Stahley, niece of Susan M. Magaro, as Emergency
Plenary Guardian of the Person and Estate of Susan M. Magaro will result in irreparable
harm to the person and estate of Susan M. Magaro.
WHEREFORE, Petitioner prays that this Honorable Court appoint Nancy Stahley,
niece of Susan M. Magaro, as Emergency Plenary Guardian of the Person and Estate of
Susan M. Magaro.
Respectfully Submitted,
'Anthony L. I2e_,~uca, Esquire
113 Front Street
P.O. Box 358
Boiling Springs, PA 17007
(717) 258-6844
VERIFICATION
I hereby verify that the facts and information set forth in the foregoing Petition for
Appointment of Emergency Plenary Guardian of the Person and Estate of Susan M.
Magaro are true and correct to the best of my knowledge, information, and belief. I
understand that any false statements contained herein are subject to the penalties of 18
Pa. C.S. Section 4904, relating to unsworn falsification to author/ties.
Priscilla Whitman
18;
Dec-31 -02 12:11PM;
Page I
rz~'r~ ~OM? A~R~~ is executed in triplicate om thin ~'~
day offS, 1S97, by ~d betwe~ ~S~ M. ~, now Of 1
~es ter Road/ East Pen~ro T~s~D, ~erland
P~ylv~ia (herein called "Settlor-), and ~ ~. ~0, now
of 106 Pine ~11 Road, East P~sboro T~hi~, ~erland County,
Pe~syl~a~a (herein called "T~st~e-).
ARTICLB I. TRUST ESTATR
1.01. Initial Principal. Settlor, desiring to establish
an irrevocable trust, does hereby irrevocably transfer, assign and
deliver to the Trustee, and his successors and assigns, the assets
listed on Schedule "A" attached hereto and made a Dart hereof. Aa
further evidence of such assignment, Settlor has executed or will
execute or cause to be executed such other instz%unents as may be
required for the purpose of completing the assignment or transfer
of title to such property to the Trustee. The Trustee accepts such
transfer and assignment to himself as Trustee, and the Trustee
undertakes to hold, manage, invest and reinvest the assets of this
Trust and to distribute the income and principal of the Trust in
accordance with the provisions of this Agreement.
1.02. Additfon _~ l Principal. Se t tlor and any other
person(s), with the consent of the Trustee, shall have the right at
any time to make additions to the corpus of t~his Trust or any share
thereof hereby established. Ail such additions shall be held,
governed and distributed by the Trustee in accordance with the
terms and conditions of this Agreement.
AKTICL~ II. II~REVOCABILI~Y OF TRU~
2.01. ~xrev~mbilit¥. Settlor has been advised of the
consequences of an irrevocable trust and hereby declares that this
Trust shall be irrevocable and shall not be altered, amended,
revok~ or term/hated by Settlor or any other person(s}.
A~TI CLE III. TRUST
3.01. Trust~Princ~pa/. The entire corpus of this Trust,
incluchtng the assets initially transferred to this Trust,
subsequent additions to th/s Trust and the proceeds of any sale,
exchange or investment'of such Trus~ assets, shall be used for the
~urposes herein contained.
3.02. Distributions During Settlor,s L~feti~.' During
Se~tlor's lifetime, th9 Trustee shal~ d/strlbute all of t_h~ net
income of. the Trustt~, or for the benefit of, Settlor. The
Trustee shall make no distributions of prlncipal to, or for the
benefit of, Settlor.
ent By:, CUUB CO OFFTCE OF AGING ; 7172406118; Dec-31-02 12:11PU; Page 2
3.03. .~enerml Power of ADDoin~,t. Settlor's child,
ANT~0NY ~. MAGAR0, is her~y grant~
s~e or all of ~e princi~l of t~s T~t to hi~lf, his ee~ate,
~s cr~ors or the cre~itor~ of his estate, ~n ~ch ~ro~rtions
an~ u~n ~ te~ (in t~st, ~trtght gifts or in any o~er
~er) as he de~ a~vis~le. This ~w~ sh~Z ~t be ~ercis~le
~der ~s will. If Se~tlor's ~lld fails, ei~ in w~e or in
~art, to ~ercise ~e g~eral ~w~ of aD~in~nt herein granted,
~hen ~he ~a~tnted 9rinci~l shall ~ntinue ~ t~st and shall be
~nister~ ac~rding to the te~ of
3.0~. T~rminattcu~ and Oistrlbutio-. The Trust shall
terminate upon Settlor's death. Upon telTai-ation, the remaining
trust estate shall be distributed in fee single to S~ttlor.s son,
ANTHONY R. MAGA~O, or his surviving issue, per stirpe~.
ARTICLB IV. POW~R~ OF TRU~T~
4.01. Genera~l P~wer_s. In a~dition to such other Dowers
and duties as may have been granted elsewhere in this Tr~st or by
law, but subject to any limitations contained elsewhere in this
Trust, the Trustee shall have the following powers and duties:
(A) In the management, care and disposition of this Trust,
the Trustee shall ha~e the power to do all things and to execute
such deeds, instruments and other documents as may be dee~ned
necessaI7 and pro,er, including the following powers, all of which
may be exercised without order of or report to any court:
(1) To sell. exchange or otherwise dispose of any
~roperty, real, personal or mixed, wheresoever Ideated,
at any time held or acquired hereunder, at public or
private sale, for cash or on terms as may be deter~dned ~
by the Trustee, without advertisement, including the ~.
right to lease for any term~otwithstand/ng the periodof ~
the Trust, and tog rant options, including an option for ~
a period beyond the duration of the Trust. c~
(2) To invest all monies in such stocks bonds :D
securities, investment companies or trust shares,
mortgages, no~es, choses in action, real estate, co
imDrovements thereon, and other property as the Trustee co
may deem best, without regard to any law now or hereafter c~
in. force limiting investments of fiduciaries.
(3) To retain for lnvestment any property deposited
with the Trustee hereunder.
(4) To vote in person or by proxy any corporate
Stock or other security and to agree to or take any other
action ~n regard to any reorganization, merger,
consolidation, liqeidation, bankruptcy or other procedure
2
68-1
~nt By:, CUMB CO OFFICE OF AGING ; 7172406118; Dec-31-02 12:11PM; Page 3
or proceedings affecting any stock, bond, note or other
security held by this Trust.
(5) To use lawyers, real estate brokers,
accountants and any other agents if such employment is
deemed necessary or desirable, and to pay 'reasonable
compensation for their services.
{6) TO compromise, settle or adjust any claim or
demand by or against the Trust and to agree to any
rescission or modification of any contract or agreement
affecting ~he Trust.
(?} To renew any indebtedness, as well as to borrow
money, and to secure r. he same by~ortgaging; pledging or
conveying any property of the Trust, including thepower
to borrow from the Trustee (in the Trustee's ind/vidual
capacity) at a reasonable rate of interest.
(8) To retain and carry on any business in which
the Trust may acquire any interest, to acquire additional
interests in any such business, to agree to the
liquidation in kind of any corporation in which the Trust
may have any interest and to carry on the business
thereof, to join with other owners in adopting a~y form
of management for any business or property in which the
Trust may have an interest, to become or remain a
partner, general or limited, in regard to any such
business or property and to hold the stock or other
securities as an investment, and to employ agents and
confer on them authority to manage and operate the
business, property or corporation without liability for
the acts of any such agent for any loss, liability or
indebtedness of such business if the management is
selected or retained with reasonable care.
(9) TO register any stock, bond or other security
in the name of a nom/nee without the add/tion of words
indicating that such security is held in a fiduciary
capacity, but accurate records shall be maintained
showing that the stock, bond or o~her security is a trust
asset, 'and the Trustee shall be resl>onsible for the acts
of the nominee.
[B) Whenever the Trustee is directed to distribute any trust
principal in fee sim~le to a person who is then un4er twenty-one
{21) years of age, the Trustee shall be authorized co hold such
pro~-rty in trust for such personuntil he becomes twenty-one
years of age, and l~ the meantime the Trustee shall use such part
of the inc~- and principal of the tr~st as the Trustee ~ay deem
necessary to provide for the proper support and education of such
De,son in ~he standard ~f living to which he has become accustomed.
681 2.31
e, nt, By; CUMB CO OFFICE OF AGING ; 7172406118; Dec-31-02 12:12PM; Page 4/11
If such Person ~hould die before becoming twenty-one (21) years of
age, the property then remaining ~.n trust shall be distribute~ to
=he Personal representative of such person's estate.
(C] In making distributions from the Trust to or for the
benefit of any m/nor or other person under a legal disability, the
Trustee need not require the appointment of a guardian, but shall
be authorized to pay or deliver the distribution to the custodian
of such person. =o pay or deliver the distribution to such person
without the intervention of a guardian, to pay or deliver the
distribution to the legal guardian of such person if a guardian has
already been appointed, or ~o use the distribution for the benefit
of such person.
(D) In the distribution of the Trust and' any division into
separate trusts and shares, the Trus~eeshall be authorized to make
the distribution and division in money or in kind or in both,
regardless of the basis for Income tax purposes of any property
d/strtbuted or divided in kind, and the distribution and division
made and the values establishedbythe ?rustee sha/lbebind/ngand
conclusive on all persons taking hereunder. The Trustee may in
makiz~] such distribution or division allot undivided interests in
the same property to several trusts or shares.
(N) The Trl/stee shall have discretion to determine whether
items should be charged or credited to income or principal or
allocated between income and Drfncipal as the Trustee may
ec~uitableax~d fair under all the circumstances, including the power
to amortize or fail to amortize any part or all of any.premium or
discount, to treat any part or all of the profit resulting from the
maturity or sale of any asset, whether purchased at a premiu~ or at
a discount, as income or principal or apportion the same between
income and principal, to apportion the sales price of any asset
between income and principal, to treat any dividend or other
dfstribution on any investment as income or principal or to
apportion the sazne between income or principal, to charge any
expense against income or principal or apportion the same, and to
provide or fail to provide a reasonable reserve against
depreciation or obsolescence on any asset subject to depreciation
or obsolescence, all as the Trustee may reasonably deem equitable
mhd Just under all of the circumstances.
5.01. ~ne~.~ Pro~s~o~. No beneficiary shall have the
power to anticipate, encumber or transfer his interest in the trust
estate in any manner other than by the valid exercise of a power of
appointment. No part of the trust estate shall be liable for or
charged w~th any debts, contracts, liabilities or torts of a
beneficiary or subject to seizure or other process by any creditor
of a beneficiary.
4
684 232
ent By: CUMB CO OFF[CE OF AGZNG ; 7172406118; Dec-31-02 12:12PM; Pa,~e 5/11
ARTICLE VI. CONSTRUCTION 0P T~UST
6.02. Cho~ce'of I~w. This Trust 8hall be admiuistered and
interpreted in accordance with the ~aws of the Co~mo~l~ of
Pennsylvania.
6.02. Code. Unless otherwise stated,, all references in
this Trust to section and chapter numbers are to those of the
Internal Kevenue Code of 1986, as amended, or corresponding
provisions of any sub6equent federal tax laws applicable to this
Trus t.
6.03. Other. Unless the context otherwise requires,
the use of one or more genders in ~he text includes all other
genders, amd the use of either the singular or the plural in the
te~t includes both the singular and the plural.
6.04. ~ionf. The captions set forth in thisAgreement
at the beginnimg of the various divisions hereof are for
convenience of reference only and shall not be deemed to define or
lim/t the provisions hereof or to affect in any way their
construction and application.
6.05. ~itus o£ Tr~st. The Trust shall have its legal
situs in Cumberland County, Pennsylvania.
ARTICLE VII.
COI(P~ATION OF T~U~TEE AND
APPOINTMENT OF SUCCESSOR TRUSTEE
7.01. C~s~.sat~o~. The Trustee shall receive as his
com~ensation for the services performed hereunder that sum of
money, based on an hourly charge or percentage rate, which the
Trustee normally and customarily charges for perform/ng sim/lar
services during the time in which he performs these services.
7.02. Re~oval or Hes~qnation of Truste~. Settlor may
remove the Trustee at alDy t~ne or t/~es, with or without cause,
u~on thirty (30} days writteml notice given to the Trustee. After
the Settlor,s death, a majority of the current income beneficiaries
may remove the Trustee at any time or t~mes, with or wtthou= cause,
upon thirty (30) days written notice given to the Trustee. The
Truste~ma¥ resign at any time upon thirty (30) days wrlttennotice
gtvel% to Settlor or, after Settlor's death, upon thirty (30) days
writtennottce given to the current incom~beneficiaries. Upon the
removal or resignation of the Trustee, a successor trustee shali, be
appointed tn accordance w/th the terms set forth tn Paragraph ? 03~
below. '
7.03. APpoinUment o~ Sg~Celsor Trusteg. Upon the death,
resignation or incapacity of the Trustee, Settlor's niece, NANCX
STAHL~Y, is hereby apl~c;/nted Successor Trustee hereunder. Upon the
5
· x~ 884 ~ 233
~nt By:, CUrB CO OFFICE OF AGING
; 7172406118; Dec-31-02 12:13PM; Page 6/11
d~, resl~tion, r~l or inca~city of the T~stee and
~ccessor T~stee, a successor t~stee shall be a~int~ by
Settlor or, after Settlor's death, by a ~Jority of the ~ent
in~e b~ef~ar~es. ~y successor t~stee ~us aD~tn~ed s~ll
be a f~ncially sold and c~et~t co~ra%e t~stee. The
~cceseor T~stee and any fur~ Suc=essor t~stee s~ll succeed
to all the ~uttes and ~rs, including discretio~ ~ers,
herein granted to the T~s~ee.
8.01. ~eneral Provision. Notwithstanding anything to
contrary in th/s Trust, each dis~osition Settlor has ~aade herein,
legal or equitable, to the extent it can be referred in its
Postponement of becoming a vested interest to a duration measured
by some life or lives in being at the time of Settlor's death, is
definitely to vest in interest, although not necessarily in
possession, not later than twenty-one (21) years after such lives
(and any period of gestation involved): or to the extent it cannot
be refex;ed in any such PostPonement to such lives, is to so vest
not later than twenty-one (21) years frc~n the time of Settlor's
death.
ARTICL~ IX.
PAYMENT OF TAX~2, ~
AND F~.PEN~ES OF ADMINISTRATION
9.01. Pal~en~ of neath Taxes an~ Other .~,s. ta~$ settl~
c~oste. The T~stee shall ascertain fr~ ~e l~al repres~tative
of Settlor's estate whether the legal representative has sufficient
assets to Day the r~ining legacy, succession, i~eritance,
tr~sfer, estate ~d o~er dea~ t~e~ or duties levi~ or assessed
against the Se=tlor's estate (including all interest ~d ~enalties
thereon), all of which t~es, interest and pe~lties are her~fter
referred ~o as the death taxes, interest ~d ~nalties. If the
l~al ~pres~tative a~ses ~e T~tee ~t i~suffic~t f~ds
~ist to ~y all the death taxes, interest and D~alties, the
T~stee s~ll ~ DaY to ~e l~al re~resentatf~ fr~ the t~st
pr~erty, an a~unt ~al to all the death t~es, interest ~d
penalties in execs of the fuds available to the legal
r~res~zattve for these D~ses, which ~nts are to ~ ~de
wi thout aD~rtio~t.
If the personal re~resentatiwe of Settlor's estate, in such
his solo discretion, shall determine that appropriate assets of
Settlor's estate are not a~allable in sufflci~ut amount to pay (1)
Settlor' s funeral expenses and (2) expenses of admi~isteri"_g
Settlor,s estate, the Trustee shall, u~on the request of the
personal representative, contribute from the principal of the trust
estate the amount of such deficiency; and in connect/on with any
such action the Trustee shall rely upon the written statement of
the personal represen~ative as to the validity and correctness of
684 .34
.:nt B~: CbMB CO'OFFIC~ OF AGING
7172406118;
Dec-31-02 12:13PM; ,Page 7/11
the a~unts of any such e~ses, ~ s~11 furnish f~ds Co the
Der~onal reDresentative so as to enable h~ to ~ischarge the
0r to ~i~arge ~y ~rt or all ther~f h~e[[ by ~g Da~n[
directly to the person entitled or elating to be enEi[led
receive pa~ent there,- No =onsi~erat~on ne~ be r~tre~ by
T~Btee fr~ =~e personal representative for ~y dleburs~t
by the T~scee pursuant hereco, nor shall there be a~y obligation
upon ~he ~r~onal reDres~tative ho repay ~o =he T~stee any o~ the
funds ~ieburse~ by h~ hereunder, an~ all ~un=s ~isburse~ by
T~s~ee ~rs~t ~o =he authority h~y conferred u~n h~m
be 6isburse~ w~thouC any right in or ~Ey u~n ~e T~Stee to seek
or ob~aln ~ntributlon or re~urs~u fr~ any person or
on account of such pa~=. The T~Stee shall not be res~nsible
Eot ~e applicac~on o~ any f~de ~elivered by him to t~e personal
r~reeenta=ive pursuit uo the au~hor~=Y here~ grants0, nor shall
[he T~etee be s~ject =o liability to any bemef~cia~ hereunder on
accost o~ any pa~ent ~e by him pursuant to the provisions
hereof.
~ ~~S ~F, Se=tlor and T~s~ee have hereto set
their hands an~ seal~ as of the day and year first ~itten above.
(BAAL)
COMMONWEALTH OF pENNSYLVANIA :
~ ~h~S, ~ /~day of ~, 1997, before me, a
contained -
1. .:'."' ~'
sel: hand and o. fi¢ia
235
ent 9y~ CUMB CO OFFICE OF AGING
; 7172406118; Dec-31-02 12:13PM; , Page 8/11
e~t By:'CUUB CO OFFICE OF AGING
;
7172400118;
Dec-31-02 12:13PU; Page 9/11
DATED:~I997
Fa0~ ~N M. MAGA~O, 8ETTLOH
TO ANTHONY R. MAGAR0, TRUSTHE
D~'~ {~1/2~000 T~ 10r~19 ~ of 11 Pgs
ilo: 2000-OOO~ CE~ ~ ~J'! ~ .12~
Property Description:
(1) Real property located in East Pennsboro Township,
CA~mberland County, Pennsylvania, identified as Tax Parcel No. 9-13-
0998-004.
(2) Real property located in East Pennsboro Township,
Cumberland County, Pennsylvania, identified as Tax Parcel No. 9-14-
0834-223.
(3) Real property located in East Pemn-boro Township,
Cumberland County, Pemnsylvania, identified as Tax ParcelNo- 9-14-
0834-224.
(4) Real property located in East Pennsboro Township,
Cumberland County, Pennsylvania, identified as Tax Parcel No. 9-15-
1288-046.
(5) Real property located in East Pennsboro Township,
ChL~berla/~dCounty, Pennsylvania, £d~ntified as Tax ParcelNo. 9-15-
1288-047.
(6) Real property located in Silver Spring Township,
Cumberland County, Pennsylvania, identified as Tax Parcel No. 38-
04-0367-042B.
(7) Real Droperty located in New~ort Borough, Perry County,
Pennsylvania, identified as Tax Parcel No. 190-046.04-303.000.
en~.B.y.: '~UMB,CO OFFICE OF AGING
7172406118; Dec-31-02 12:14PM; . .Page 10/11
A FFfDAVIT
^~o~en. M~¢~O
COMMO~TH OF PENNSYLVANIA '
· SS:
country oF C,~ ~ ~ ~ I~.~, ~__ -
und~s~ offi~, p~sonally ap~r~ AN~O~ ~ MAGARO, known to me (or
pr~) to be t~ p~n who~ n~e ia mb~ to the ~thin Affida~, ~d ac~ow{~8~ thai
he ~t~ the ~me for the p~o~ thef~n
IN WITN~ WHEREOF, I her~mo act my hand and off. iai S~l.
~bHc
My ~~on E~res:
~0~ 68-t ~,~
ent'By: CUMB CO ~FFICE OF AGING ; 7172406118; Dec-31-02 12:14PM; . ~a~e 11/11
Alter recording, pica.se renan original 'rrusi to:
Mark E. Halbrtmer, ..Esquire
Gatc-s & Associates, P.C,
1013 Murnma Road, Suite 100
Lemoyne, PA 17043
684 ~l:f
I Certify this to be recorded
In Cumberland County PA
238
IN THE COURT OF COMMON PLEAS
~UMBERLAND COUNTY, PENNSYLVANI
DRPHANS' COURT DIVISION
NO. 21-03-084
IN THE MATTER OF THE PERSON
~ND ESTATE OF:
SUSAN M. MAGARO,
AN ALLEGED INCAPACITATED
PERSON
PETITION FOR APPOINTMENT OF
PERMANENT PLENARY GUARDIANS
OF THE PERSON AND ESTATE AND
CITATION
ANTHONY L. DELUCA
A'I-I'ORNEY AT LAW
113 FRONT STREET
P.O. BOX 358
BOILING SPRINGS, PA 17007
IN THE MATTER OF THE PERSON AND : IN THE COURT OF COMMON PLEAS OF
ESTATE OF: : CUMBERLAND COUNTY, PENNSYLVANIA
SUSAN M. MAGARO, :
AN ALLEGED INCAPACITATED PERSON: ORPHANS' COURT DIVISION : NO. 21-03-084
:
CITATION TO THE ALLEGED INCAPACITATED PERSON
To: SUSAN M. MAGARO:
We command you to appear at a hearing in the Orphans' Court of
Cumberland County, to be held in Courtroom No. 2 of the Cumberland County
Courthouse, on c~l, ~t/205 , at ~ :~., o'clock A.M..,_ to show cause why
you should not be adjudged an incapacitated person and a Permanent Plenary Guardian
appointed for your person and estate.
BY THE ~//
//
Edgar ~.~a~ley, .. "~""~ { J.
IN THE MATTER OF THE :
PERSON AND ESTATE OF :
:
SUSAN M. MAGARO, :
AN ALLEGED INCAPACITATED :
PERSON :
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-03-084
ORDER OF COURT
AND NOW, this 21st day of February, 2003, this matter
having come before the Court on a petition of the Office of
Aging, and the Court having previously appointed Nancy Stahley
emergency plenary guardian of the person and the estate of
Susan M. Magaro, it is now ordered that Nancy Stahley is
appointed permanent plenary guardian of the person and the
estate of Susan M. Magaro. Guardian should serve without bond.
Anthony L. DeLuca, Esquire
For Area Agency on Aging
Lindsay Dare Baird, Esquire
For Susan M. Magaro
prs
(.-' /?///
Edgar B~ Bay~ey, u.
IN RE: SUSAN M. MAGARO
AN ALLEGED INCAPACITATED PERSON
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-2003-0084
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 rights will be affected, including our right to manage
money and property and to make decisions. A copy of the petition which has been filed by AREA
AGENCY OF AGING is attached.
You are hereby ordered to appear at a hearing to be held in Court Room No. 2, Cumberland
County Courthouse, Carlisle, Pennsylvania, on FEBRUARY 21 ., 2003, at 8:45 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 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 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 gift 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 heating (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.
Clerk, Orphans' Court Division
Cumberland County, Carlisle, pA
My Commission Expires 1 st Monday,
January, 2006
SHERIFF'S RETURN - REGULAR
CASE NO: 2003-00084 0
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
CUMBERLAND CO OFFICE OF AGING
VS
MAGARO SUSAN M
BRIAN BARRICK , Sheriff or Deputy Sheriff of
Cumberland County, Pennsylvania, who being duly sworn according to law,
says, the within DECREE was served upon
MAGARO SUSAN M the
DEFENDANT
at 1 CHESTER ROAD
ENOLA, PA 17025
SUSAN MAGARO
, at 1548:00 HOURS, on the 31st day of January
by handing to
, 2003
a true and attested copy of DECREE together with
PETITION FOR APPOINTMENT OF EMERGENCY PLENARY
GUARDIANS OF PERSON AND ESTATE
and at the same time directing Her attention to the contents thereof.
Sheriff's Costs:
Docketing
Service
Affidavit
Surcharge
18 00
10 35
00
10 00
00
38 35
Sworn and Su~bed to before
me this ~Z7 ~'' day of
F~,~. /~ [~) ~ A.D.
Clerk ~ Orhan~urt <~ L~-~L.-.
So Answers:
R. Thomas Kline
02/03/2003 ~
ANTHONY DEI,UCA/~
Deputy Sheriff
02/20/03 THU 15:57 FAX 717258390 ANTHONY L DELUCA ESQ ~001
IN THE MATTER OF THE PERSON
AND ESTATE OF:
SUSAN M. MAGARO,
AN ALLEGED INCAPACITATED
PERSON
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. 21-03-084
AFFIDAVIT
The undersigned, Paul B. Orr, Esquire, attorney for Anthony R. Magaro
represents as follows:
That he has received and has accepted service of the Petition for
Appointment of Permanent Plenary Guardians of the Person and Estate of
Susan M. Magaro on behalf of Anthony R. Magaro;
That Anthony R. Magaro waives the twenty (20) day Notice of Hearing
required to be given to the next of kin;
That Anthony R. Magaro consents to the appointment of Nancy Stahley,
niece of Susan M. Magaro, as Permanent Plenary Guardians of the Person
and Estate of Susan M. Magaro; and
Date:
Appointment by way of filing
That Anthony R. Magaro may, in th ~fl~ure, seek reconsij~ion of this
a ti o .? norr u .
Paul - - '
50 E. High Street
Carlisle, Pa. 17013
(717) 258-8558
ID# 71786
AUTHORITY TO PAY COURT APPOINTED COUNSEL HAR 0 4 2003
I_ COURT - - ·-2. VOUCHER
ID District Justice ID Common pleas ID A~pellate E] Other -'N-0 - ;'6 8 9
-3. FOR (D.J., _C.P., APPELLATE) . ' 4. AT (CITY/STATE) -
- 5_. BUDGET CODE
S. IN _THE G~'E::~/~t~/~. ,'~-~'&,~ ~ ~S~ 7. CHARG~OFFENSE (PURDON CITATION) 8. U Pb'l'l~ OF~4SE .
vs ~. ~J~/~ O FELONY ~ MISDEM~NOR
9. PROCEEDINGS (Describe briefly) ~ 11. PERSON REPRESENTED 12. CIVIL DOCKET NO. .
I ~ Defendant-Adult ~' ~
40 A~eflee 13. CRIMINAL DOCKET NO.
5 ~ H~beas Petitioner
6 ~ Material W~lness
T ~ Parolee Charged Wilh Violation
10. PERSON REPRESENTED (Full Name) 8 Q Probationer Charged Wdh Violation 14. APPEALS DOCKET NO.
g ~ Olhe~
I 6. NAME OF A~ORNEY/PAYEE AND
~ ~ ~ LindsayDareB;ird
' / ~1 L[ 37 South Hanover Street
NAME OF COMMON ~LEA~ J'UDG~ASSI~NED TO CASE c. .......; ~:,..PA_. ~'"C~'~, / ~ ~-~o07
17. TELEPHONE No, ~ 18. SOOAL SECURITY NO OR E IN NO
CLAIM FOR SERVICES OR EXPENSES
19. ., , SERVICE HOURS DATES AMOUNTS CLAIMED
a. Arraignment and/or Plea Multiply rate ~r hour times
b. Prelimina~ Healing hours to obtain "In Coup" com-
~ Motione and Requests~ ~ ~nsation. Enter total below.
~ e. Sentence Hsarlng, ~/~ ,
O }. Trial
g. Re~ocation Hearings
h. Juvenile Hearinga
i.j. Appealsolher (Speci~ on additional mheets)C°u~/ ~/~ 19~ TOTAL IN COURT COMP.
/--
=' /12.
TOTAL HOURS = ~' b~ ~ER H~R
20. a. Intemiews and conferences Multiply rate' per hour times total
b. Obtaining and reviewing r~ords hours. Enter total "Out of Coup"
~ ~ c. Legal research and brief writing com~nsation below.
~ ~ d. Invesdgad~ ~d other work (S~i~ ~ addi~n~ ~eem) 20~ TOTAL OUT OF COURT
COMP.
TOTAL HOURS = X ~ PER H~R = $
21. ._,, I~MIZATION OF REIMBURSABLE EXPENSES AMi PER I~M
Mileage $.25 ~r mile x
O 21~ TOTAL ITEMIZED EXP.
=$
22. CERTIFICATION OF A~ORNEY/PAYEE ~/ 23. GRAND TOTAL C~IMED
Has compensation ancot reimbu~ment for wo~ In this ~e pmvlous~ ~en applied fo~ ~ YES~NO = S //~- 5~
Ifyes. were you paid? ~ YES ~NO Ifye~bywhomwereyou~i~ Howmuch?.
Has the person represented paid any money to you. or to y~r knowl~e anyone else. In connection with the maker for 24. DEDUCT. PRIOR PYMTS.
which you were aopointed to provide representation? ~ YES ~NO 4 If~vefletails on additional sheets = $
I ~wear .or affirm lhe truth or co,~ne~ ._-/~ ~ ~~' 3' 2'
o~ me adore statements S~ure of A~om~Payee Date 25. N~ AMOUNT C~IMED
Copy I - Mail to Court Administrator at completion of service
2A
0810
I
PLEASE ADDRESS ANY CORRESPONDENCE REGARD NG
THIS VOUCHER OR TRANSACTION TO THE OFFICE OF THE
CONTROLLER CUMBERLAND COUNTY COURT HOUSE
CARLISLE, PA:IT013. ,
COUNTY OF CUMBERLAND
GENERAL ACCOUNT
CARLISLE, PENNSYLVANIA
No,
REMI'FI"ANCE ADVICE- .~.'t-I~".'ACI~[~ S~'~'~I~I ,CH ,[~(' IN FULL SETTLEMENT OF ITEMS SHOWN HERE~Nt
IF NOT CORRECT, PLEASE RETURN WITH EXPLANATION.
0395875
BEFORE DEPOSITING
I
VOUCHER #
VENDOR #
NAME
DEBIT VCH ADDRESS
CREDIT VCH
CHECK REQUEST/ VOUCHER FORM
CONTRACT # l
Lindsay Dare Baird
37 South Hanover Street
Carlisle, PA 17013
INV # 006892
PAGE 1 OF 1
DESCRIPTION #
ACCT #1
V&F ACCT #2
~ ACCT #3
ACCT ~
AccT #5
Final Check?
ACCT #6
DIST C ~
PRIOR
YEAR?
YES
INV DATE 3/17/03
/ 21-03-084 Orph~
01-236-641-050
ACCT #7
PAY DATE ~
(Limit: 14 spaces)
AMT1 $112.50
AMT2
AMT3
AMT4
AMT5
AMT6
AMT7
TOTAL AMT
$112.50
APPROVAL SIGNATURE:
NOTE: SHADED Areas for A/P Use Only
3/17/O3