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03-30-11
iy~~ ~~ IN THE COURT OF COMMON PLEAS OF ' "~~ ~' CUMBERLAND COUNTY, PENNSYLVANIA ~ ~ ~ o dy cn ~ ~ ~`= In Re: Estate of Grace A. Branthafer ORPHANS' COURT ~'~SION`•° A C) . NO. 21-11-0205 PETITION FOR APPROVAL OF SETTLEMENT AND DISTRIBUTION OF SETTLEMENT PROCEEDS PURSUANT TO 20 Pa.C.S.A. &3323(a) AND ORPHAN'S COURT RULE 3 AND NOW, this ~~day of 2011, comes Petitioner, Ronald J. Batzel, Executor of the Estate of Grace A. Branthafer, by and through his attorneys, Salzmann Hughes, P.C., and hereby respectfully petitions this Honorable Court to approve the settlement and distribution set forth herein and, in support thereof, avers as follows: 1. Grace A. Branthafer, died on April 2, 2010 as a result of injuries sustained from a motor vehicle accident. A copy of the Death Certificate is attached hereto and incorporated herein as Exhibit A. 2. The above motor vehicle accident occurred on April 2, 2010, while the decedent was a passenger in a vehicle being driven operated by Jeffery Gaver. The police report of the accident is attached hereto and incorporated herein as Exhibit B. 3. The Register of Wills of Cumberland County, Pennsylvania issued Letters of Administration C.T.A. on March 22, 2011 to Ronald J. Batzel. A copy of the Short Certificate is attached hereto and incorporated herein as Exhibit C. ~~ rr; C7 ~, z c ."` t--, -ci t ~ ., :., ~~ _~1 .~-, _- ;=~ ~~ a -'r 4. Grace A. Branthafer's Last Will and Testament listed her children Cindy Poole, Gary Lee Batzel, Sr., Thomas R. Batzel Ronald J. Batzel and Mary Anne Godshall (incorrectly spelled Gutshall in the Will) as the residuary beneficiaries thereof. (Last Will and Testament attached hereto and incorporated herein as Exhibit D). 5. Mary Anne Godshall died on February 29, 2008 survived by a daughter, Kitina A. Nester. 6. As a result of the accident in question and the death of Grace A. Branthafer, Petitioner made a claim against the operator of the vehicle involved in the accident, Jeffery Gayer, who at the time of the accident, was insured under a liability policy issued by Nationwide Insurance (hereinafter "Nationwide"). 7. Mr. Gaver's Nationwide insurance policy has liability limits of $50,000.00, which Nationwide has tendered in full. See Declaration Page for Mr. Gaver's insurance policy and letter of February 2, 2011 from Nationwide attached hereto and incorporated herein respectively as Exhibits E and F. 8. Grace A. Branthafer did not have her own automobile insurance, therefore, no claim was made for underinsured coverage. 9. Nationwide has required Court approval for the distribution of the settlement proceeds. No Court action or other proceeding has been instituted, since this claim was amicably resolved without the necessity of such action. 10. Counsel respectfully requests approval of attorneys' fees in the amount of 33% of the recovery of Petitioner, totaling $16,500.00. Said amount being consistent with the fee agreement and representing a reasonable fee for the services performed. WHEREFORE, Petitioner requests that he be permitted to enter into the settlement recited above, and that the Court enter an Order of Distribution as follows: 1. The sum of $50,000.00 shall be paid to the ESTATE OF GRACE A. BRANTHAFER, Deceased, in the survival action claim brought as a result of the death of Grace A. Branthafer. 2. From the settlement amount, the sum of $16,500.00 shall be paid to Salzmann Hughes, P.C., for attorney fees. SALZMANN HUGHES, P.C. By a~ + Susann B. Mo son, squire Supreme Court ID #77041 354 Alexander Spring Road, Suite 1 Carlisle, PA 17013 (717) 249-6333 Date: lI / Attorney for Petitioners VERIFICATION The foregoing document is based upon information that has been gathered by my counsel and myself in the preparation of this action. I have read the statements made in this document and they are true and correct to the best of my knowledge, information and belief. I understand that false statements herein made are subject to the penalties of 18 Pa.C.S.A. § 4904, relating to unsworn falsification to authorities. RONALD J. ZE Date: ~,J ~ ~ ~' IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA In Re: Estate of Grace A. Branthafer ORPHANS' COURT DIVISION NO. 21-11-0205 CERTIFICATE OF SERVICE I, the undersigned, hereby certify that on this ,~TMday of March 2011, a copy of the Petition for Approval of Settlement and Distribution of Settlement Proceeds was served by First Class Mail upon the following: Cindy Poole 63 Amsley Drive Chambersburg, PA 17202 Gary Lee Batzel, Sr. 26B North Spring Street Shippensburg, PA 17257 Ronald J. Batzel 7821 Stump Run Road Fayetteville, PA 17222 Thomas R. Batzel 14019 Route 322 Brookville, PA 15825 Kitina A. Nester 620 East Broad Street, Apt. 1 Quakertown, PA 18951 Susann B. M 'son squire Salzmann Hughes, .C. Supreme Court LD. # 77041 354 Alexander Spring Road, Suite 1 Carlisle, PA 17015 (717) 249-6333 Attorney for Petitioner VI~ARiVi1~6G: Bt is illegal to dupl'll;ate this ropy by photostat or photograph. ?i:c. for this ce.rtif~c-ate, ~fi.OU P 1~2~7295 Certific:~rion Number^ This is to certify that the information here given i; correctly copied from an original Certificate of Dean duly filed with me as Local Registrar. The origins t certificate will be forwarded to the State Vita Records Uffic;e for pe ant filing. ~ 6S/ /o ai Registt~ar Date Issued rnostN eEV 7t!l006 TYPE ~~ #32-232 ~~ j ffi COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT Of HEALTH • VITAL RECORDS CORONER'S CERTIFICATE OF DEATH (3ea k1ae11CNone end sYetnelea on reversal t. Mlardfhr6d F.r.aML. rr.aAd 2Sr a>krrewN7Nrea tGerdorbldarti ~cfgA Grace A Branthafer Female 209 - 20 - 5342 Aril 2, 2010 aApr hadeW~dryY lMgwl lOMM1 aer, dera 7. rerder PrrdpdA 89 vR wr. °" "°` r"` November 25,1920 Noep°t °"" Three Springs PA ^ O , „~ s+rouewn ^na ^ wa. ^>arerr a.m.e7dow~ eG ero, .o.ro,~ edrarir..parrr.~Vwanewanerl a Yrpsq,trel,.re ~ ~ N' Dlrr to Cumberland Shippensburg ~~ t•>wa.~•t 79 West King Street uaoan.narosaudU white H.Or.aefl User d.eadw a0dd i.D,ndWN 121ne WCreae MrrM to OebOeA'FacYln en4mrPMUA ~114e1119rre terlr4 rlw'NNra to W,rYq Spwrr tNai.,pM, wYr•.Y„ iareaxar anara.rwrwrh usM~Wioirr7 rsar~wrro-ta- t+r«s«t wmYa.owaa.et+~D.dii Canner ~ Anouse Foods ^~, gg,,, 5 year widowed tao,rrr,wtw>,aeuuP-«<r7rren.rd~.r7rer) oorrire pA 0itl0m°0" 216 East Orange Street tm^a,e.,rruaeb "°'r^~°°° 1ietlr e"'r' 7.a Shippensburg, PA 71257 Cumberland ' t7noo~ny na~ ~arrraa Shippenabur ~ g QVr~ 14FHah NrritM Srre W.re~d ~ to Yrlrfr Nrr(Ret afe>t, n,p,namr) Frank B. Booher Mary Ann Hann pea Yee.rrer rhea tnoe r vea taaramty,ry~a,r.taaaaarr...r+r.~4~d Tommy Batzal 74019 Route 322,•Brookville, PA 15825 Ett MMW dOrpaMOe ® DOaaTr Y10. aredapoeeon PtrM~drX 7r'} ^ euw ^ wno+rreas~a. 21n fMtorddyrlh~N.rdua~ritarargxrAw4rcd l1t LULnltaYlrw~rrr.tbecOq 770165 rwta«„ ib.«orrrwawwa ^pw•tgerabc l7MretdEmerrrlbionN (~tb^w 4-5-70' Hollinger Crematory Mt. Holly Springs, PA Ts< lkwwfrnwe rapraidd et0.FbrriAaeu 7~.tbnarneaerdidq - - ' .r. FD-012984-L Foge].sanger-Bricker Funeral Home inc., 3hippensburg, PA 17257 GagAr. MaeteteW/dw or/rYq A.lofraadA'~dts ewaacr.,eraayewad,rrdm.a. {9dereirotllq Pffi Nrrerkrtia 7.70.D,r si7ae Maald%!r~ ggeu r m rvdr rer a arm. m wyrredd.rh WrMiaW MrapwabP.eon N.TirdDrb Aprx. =f.ArPon.cM 0e.0YrnO.Ay;MN ffinr dwedrreall,ecll:,riwrCoeirtna Nrrroeerthre..kn«dnar7 ""0"p°"0101Y4 11:00 A. µ April 2, 2010 j8*• ^r• Rm27.Mt 6eafe ~lhdJrm-er..,ryd,,.w maylofwr-M 6~icMlru eh~irh~00N~OR~iaee~r wrbaerrr~e.eemp, i (h1Nb Mrh M!~ rer 81.epTr.en lertaWErbOrW7 migblMareh-gawy..srPret ^ 1Y, ^-i.edv wyms7.nrc«w4kMIr6ilbeWeAedo•inter•wlopy.lMcA'ewwwa.ronLa. , D w ^ urnow m ~w r '~ ~a . r : .. Coapression Asphvxi.a ~ Ou-blursrrrgtanr •Ik , ^ bprprr derD~)rl n Motor Vehicle Craeh ^ Pn~nren,derN ' ~iiL~ii~°~ c~4eE aeale<a,mbp.mordk ~ ^rdp.pwawp.~~exn~xaq, ~` r ~ ; rata a • or r Zara. oore.rwin dl: ~ wnap.areprtpar D Yate.~ d ~ ~ ' D era.r~prredaerterpryw eOa. Wrrheayry am.rr..+rxaJ~v et, NanNtdMla 9a.Dwdr{wP~.4xtarl ~a.0am6etbwlgaerrae a to passenger n ~~d~x~ w~a.KF.aoa P«r~aer ~ b dca~a.d oa ii~ ^~ D+*weaa April 2,2010 that left roadwa struck buildin Street pna ~' ra Dwa ^w. ~!"wrr O-°~re aanr.du-•u pra. 73i1«7dMMC! >Rl.~ttwpraarM7A~a•ar! M-~dM•,a~derwarra aw.a ~r...w ^P•br+r W.King 5 Shippensburg ^>~°' ^arerrawewre 11:00 Au ^"" ~° ^oa.r PA ~ .. , eh.CrWrttlitlar7 oaN ~ xs.sgra+wtr . ChM orr~W4'~rrdMroa~eedarawMoanaecpy~Irypnr aan.wuara.oem~Yloa ar.27i t-ea Ngdagpw.reN earaaranrerbe•rra(~re nawwrrraa._________-_ _ ^ ~ d (>~ _SSOroner • A-r.~a.~aeaeaaehberh~F+S~rapaneaorgeraad A-~44dbesxwadra.ttaa.eda.nr yre.,ar°1~ee,br~'wMdi(~ ao~wrr arlee______~_._________ ^ l9t lbiner Nr6u eEd Dra Slpod'taatli~YFled) • aaawE~rr>.raa. ontrrrrd.drwa..rr«a..i~waf rwa.e,er,.new,.,are,rawangq.naaraw...r.a.~ April 5, 2010 , x~o ~ ° '~ ~'~" `d~o~ ~i~r~r m•ei~'r`~a""re°~° I oZ I/ I oZ i~ ~l tatraFrePtae~aaY.7rA c c ei c. e, on 6375 Basehore Rd., Suite ~1 r O B Mechanicsbur Pa. 17050 (/' t>iwat~onvmrra. a 5!~~3?9 a PETITIONER'S ~ EXHIBIT a ~_ 05-18-'10 11;20 FPOM-Shippensburg Police 717-532-2313 ' Print CAS X10152568 ti t t I i f i i COMAflOIUW~t~LTla OF pEWF11SYLNA-NfA ~OLiC~ CRiASFI ~IEPOItYi~1G FOd:ftfl [ase Closed Reportable Crash A{4'SD0 1 r't Voe Rs Ain ~ Yes t") No T-323 P0002/0007 F-104 Fage 1 or' 7 iu~uii~iidmi ~.... ~ ~ wo,s,m Inddent Numhar - - Pollee A eery Patr s~-2ola16s3 21aa9 ~ ~j a A engl Name Precinct In~ wn G~ •p h - 04 02 ~ 2010 B b urg oroug Shippcns Dls all Time [ Arrival Time (mS} Investlgatar 9adge Number 1 I06 1108 ROBBRT M. VAN SCYQC 0600 Revis~y®r Bar~dryrye AJum~+her royal Date ,(M+M~•WYY) ~ Ll 3 ~7 ~ [ou Coun Namc ENunici all Munldpallty Name ~ "! weak 21 t~mberlsnd 409 hipplutsbtyrg Borough O Sun O Thu O ~ w Fd ~~ ~h Time No of Units P e in urod Kllled~ wif> oo Crash Date (MM~a ~• 02 - 2010 1105 ~ l" I 1 2 complete O Tue O Sat Form F (~ Wed O Unk Workzone~~ sZy) O. Yes ~ ~ B~tl us O Ves • No R~~t~ one ©Yts i No t P@NHb07O Yes ~ No rnfersecfron Tvee O 4 Way Intersettinn O 'Y' intertecBolt O brie er5 ~~ O Off Ramp O Railroad Crossing ~, 1 w I , * Midblack ~ •T- kltersettion O Round Ahout O On Ramp O trossover O other , 3om Bouts Numhar segment ( tlona9 Travel Lanes Speed Limit (~ North Howse f~rmber (~f appEc~k) 0011 O 02 25 g O scum 76 O East For t~id~bbck uasiks o~ty. use Street Name 5trest Endng tMsber and make wre ~ West P~ '~ ~~~ ST 'O Unknown a r'"e is O ~ Tate Q 'INrn ~ ~j ~ ~ ~, f~ Roa~ O o ~Stree~t 0 R ode O U~knarrn Borita Number Se mant (Optiona4 Travel lanes Speed limit Q North ~~ ~ ~ 8 O South f Street Ending ~ O East r ~ street Name I Owen ` o O unknown Sislt~ O Interstate Q Tumoll~ t) O ~mplke Q H1gAway ~ R~n~ a w St ~t ~ ~e O unknown (Not Turnpike) (Eas _ __ IMersacdng Rt Num Or MJIe Peat Qr Segment Marker ~~ • ^ ~ ~ Fact lea St Ending 3 Nun pr O East a Wise ~ ~ ©west Or Miles ~ ~fa ~Itton ~AYBTTE ~ ~ ~ . ~ eonr ~ fatal ~~rks N Intersectng Rt Num Or Mile Post Or Segment Maeloer ~ C O ~~ Distance From Gash 3 This Optwn ~ ~~ ~ . ^ Street Name St Ending ~ Inte sectin ~ O O South Q SCMe -o Landmark 1 f~ ~~ dQ~pe Fa S g r r Effit O W t landmark 1 artd ~ ~ ~ es Landmark Z1 ~ agrees minutes Seconds Degrees Mtnutos Seconds latitude: 40 02 : ss ,coo Longitude: -- 77 31 ;0. DOo . a ~ 1~~rnRnn- eevtre .... _ O Yield Sign O Police Of11ar or FW9man ~ Not Appiirabk O Traffic 5ignai ©CvolsR Crresing ©OU+er lyprt TCD ttcn iYa~crbnhw pence Functioning Emerg ~ No Controls O Improperly O Siyraiat~~ ' O ~~ Traffic O Stop Sign O Cros~sinq Controls O Unknown O ~~9 {~ ~~~FUnction e-g (~ Unknown Lam Qf 'Nbt /Mppb"cibhe ;slap rest of the ltrrle Cfostue secdoN ~ O North O East O North and South O AE S E (N W) f~ Not Applicable Q PartiaEy ~ Fully O Unknown , ' , t O south O West ~ East end West e > Q yes ~ No O < 30 Min. O 3060 Min. O t-3 hrs ~ 3~6 hrs ~ t3A hrs O > 9 hours O unk+wvm Dst+!lRyd Unknown O ~ . wRM a na~sao t+ustl piWNNndY CAIPY a PETITIONER'S ~ EXHIBIT http:Nwww.dotb.state.pa.us/crsapp/Pri ~ ~ 0330622010041x10263$26... 4/14/2410 05-18-'10 11:20 FROM-Shippensburg Police 717-532-2313 T-323 P000310007 F-104 Print CRS W0152568 Page 2 of 7 d~~ ~T ~~ ~~~ RB1dd NI il~~~~~CII~I~IIUI~ Crash Number Pages AA 500 2 P0r'~ "~ °n~' _ -~~-~ ~~' W0152568' ~ Motor Veh'uJe in O Hit & Rim Vehicle ~ Illegally Packed O LegaNy Perked ONon -Motorized ('Wndrerclal Vehhit T mm TransPh~ Q YM ~ Nu r0 ~~-"' ©PedesUian O PreWheetdiav,setc ~ O Pre~vibious Crash O Train O phantom vehicle {If Ye; Complete for'M Ci 3~ of •a..~N,ra~• nr •Pedesidan on Skates in wheerchalr. etc'. Compfefe. Fwm M SeeNon ZS _ - Unit Na First Nama MI Dato of 8tr~iMM~PD-YYYY) 01 JEFFREY' ~ Ol ~ 1961 Last Name Tsle hone Number Delete? Q GAVBR Address ! ! Stato ~ 1:7257 214 E QRANC3E ST APT A SHIPPBNSBURG PA Oliver Lleensa Number 5 Ctas PA 24330313 ~ Po060YLtrsr9s Suseeited 4 DrNer or PedasNla Ph f Condhhfn ~ ~ ~ O illegal Drugs O Medicattors ~ ('~ ~~ laegal Drug Q ~ rre Medication O Fap9 O O almlra O Akx,hd and Drugs O Unknown..,__. _._. 0_-Dunk&~.. d -r"d-r-._.._.. . ~ !WEeP ~ UnkrwMm Aiaohal rest 1rYne PrimaryYelrlde[ode V1Mathur Chargedt ~ Test Not (iyen Q Breath O Other Q T cif ~ RECT~LBSS DRIVING Q Yes ~ No O eiood ©Lkine ed Afeoho! Test Results Q Test Refused Q Una DnArer wasonse t=Driver Ope<aced 3=Drirer Fled Sane Vehicle 4~fit and Run ~ Test Giveh, ~ ~ UAknown 9 1~ , COrlWrnirrated Results a ,,, 2=N0 Dr6rer 00=.Not Applicable 02r~rivate Vehicle Not 04~tate Police Ydiiek 07ohlw-idpal Police Yeh O~Federal Gov Veh -Oth 98 02 01=Prhete Vehicle Ovvnedi teased by odvet OwnedA.Nled by Oriwr 03~tented Vehicle 05=PENNDOT Vr!htde Of:=Other Munidpal 06~Other State Grn- Veh Government Vehke er - 99~+Unknovm Same as ,.............._..._ Driver OGARY Y, ~'TZfiI., SR _ Add+ess ! CKY /State ! ZI Rf3 PA 17257 ; Vehcle Make Ma__ ke [ode JeeplWill sIK~ 216 B ORANGE ST S~IIFPENSSYJ Medal Year Vchieb Model tee 1J4FJ38L,~1.)<,282099 1990 CHERf)~BE Lte Plata Rag. State t?st. speed t!d?hie lowed Towed HBJS012 PA 999 • Yes O No STQUFFEIZ'S AUI'0 insurance Company Poltq Na lnswan -~ _~ O Yes r ~ O ~ known -- 1 Towing Pass. Veh grMohilelMaduiar Hame 7=SP.rllhTrailer Tig Np (Tag Year Tap SY '"-'~ n aFTowing rrudt s-Camper 8~lher ~ Nq,yf a Una~p. g LJ 3 Yawing tJYliry 7roil er 6-FuA Trailer 9=Unknown - - L..~-J W of (~ Wehlcf~„^Prysidon 01 *R9ovemen! 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Com hie Fwm a~ Seetlon 28 Cammen7al yehkle O Yes ~ fVo Qf Yes, CamPfefe Form Cl Unit Nb Flrst Name 02 TORN MI Date of filth (MM-Ol}YYYYI R~ 11 15 1978 East Name 701o hone Nunsber ©? FRFY Address / !State ~ 17201 780 Lri~IA DR CHAMBERSBURG PA Drhrer ltwnse Number State dash . ~ ~ 25339035 ~ Ah»heNDrvat SruOaCtad brNer er AedesMaer Ihvslal taandidon ~ ~ Q illegal Drugs Q Medication i ~~~tN O ldeaal Drug O Fatigue O Medication Q Alcohol O Alcohol and Drugs Q Unkruwm 0 lotad~eon O U~,s~e O Asleep Q Unknown Alcohol Test T~ O pyjmary behlde [ode Ylofadoe Cry~~M? ~ Test Not Gwen O Breath O ebod (~ urine Other O Te t Gi`~"" {f NOAI$ - - O Yes O No ven s AMDlt01 Tact Resrrlb Q Test Refused [~ Resu Test Given, ®. ~ O [anWminated Results Dr~_ PJatonCa 1=DMer Gpereted 3~rwer Fled Scene Vehkle 4=Flit and Run ~ 2:No Driver 9=Unknpwp Ownar/D6Vir ODdJot Applicable 01=Prindta Yehide Owned/ leased by Driver 02=Private Vahide Not OwnadrLwsod by Driver 03=Rerded Vehicle 04~tate Pdice Vehicle 07=MunidpN Poia Veh 05=PFNNDOT VeMcle 09=Othat Mlaridpa! 06=Other state Gov Vah Government Velticle 09aKederal Gar Veh 98sOlhet 99dJnknown same as "" grhnr Q DEBORA~i I. FREY Address I / Stems 121p VH~a ~- -1 Mi 55 780 LYl~TDIA DR CHAMBBRSBURG PA 17202 ~ tyodei Year VehTde Model (~ ~~ VIN I{M1iDN45D63U475313 2003 license P'iaM Reg. State Est. Spaod VaMtla Towwd Towed B FBB5215 PA 999 • Yes O No STOCyFpER'S ACJTO lnsuranca Company Polioy No STAT$ FARM O No O k n Y 133 3594 A29-38 ~ ~ es Ty a 1=Towing Pass. Vah 4=MohilelHbdular Home 7~emi-Tra'ler Tag 7a~ TAI ~t l No,.Of ~ , r ^ z=TOw1ng Truck S-Camper E=Other I - 3.Towing Utidty Trader 6_full Trailer 9~nkrawn. u e Units: m ~ (~ •Vehld~/ias/tlon Ol • avemant Ol pye la Y Sneda! lkaoe u y~~ eoior Vihlth TtNta OS~arge Truck 6~W xOdJmryde, 9icyde, T~ 00 tz=Camme-dal a e 9~ 0~ja Ol 01=AutomobAe 0 02=Motorgcle D76Van 2t~TherPedakyde l B H OO~lot Aaa~abte 01=Fire C rri 13^Taxi !1'~oM OtmbNo Og=brown 03~Bus 10i5novrrrrobde 04a5mall Truck 1 harm >yquip orse a u 21= 23~Hase i4 FGdw' 02eAmbulance ~.,p~cy at~Ttattor Trailer 22 Twin Traier 02+:Red t0~range pf •a2 ; Comph!M Form T2{art~udwn Equip TV 24~Train 25=Tloliey 08„Dt~ t~,ry~nry 23 Triple Trailer 03=YLRdIe 11- 04=Gr4eA 12s~e ) 13=A ~ SeLiloA 26 1&=0iher Typa Spac Vah 98+.Other ~ pNtA Vahide 1 T °~Pd Transport 31=sAodified Veh 99=UnknOvim 05=eisck 99dlnknown 19=tfik. Type Spac vah F ,,,s ~rt 2~ 99=Unknaxn !nltlai bn t Daet~f~ Grad nt 3aDownhit RaAd AUcrnment 00=Npn-Collision 14~1ndercarrFage OG d Urut T 15 tt~loAa 2~FUnctlonal ~ t=Minor 3bD'rsabl'erg ~ 1 t=level 4=Bottom of FM Top of Hill t=StraigM 1 2~urVed pw2 = O1-12=Cbd< Points 9=Unktiown Z=~ 9=Unknown 9=t&rkrrown 13aToD g9=4Jn1(nown _ - ~nM s M.~oo irk PENNDOT CCtPY http://avww.dot6.state.pa.us/crsapp/pzintlmages/XmlFiles/20100330522010041410263 $26... 4/14/2010 05-18-'10 11:21 FPOM-Shippensburg Police 717-532-2313 print C12S W0152568 J cbtw~to~vu~nl~aa oa r~~ivsv~v~iA pOltC@ CRASH REPOR41N1~S iFORM Page~~ AA 500 S ~ "~ °n~ _ I ' I T-323 P0005/0007 F-104 rage'+ of ~ ~I~~Il~lelll~I~~ Crash Number W0152568 /~ t ~ of .. PasserggerK~kcupa~nt E one . J /Not Applicable ~i o+.NOt AppIKa41e Z=Passenger Ot~river -All Vehides 01~houlder Belt Used 1=~ ailed d ' cte 7=Pedestrian 02_Front Seat Middle Position 02~.ap trek Used 2=7otal~ E 8~3ther 03~ront SEat Right Side 03d.ap And Shoulder Belt Used 3=ParGa ly ~jeded 9=Unkrwwn 04=5eaond flow • Left 5'uk Ot 04=Child Safety Seat Used 9rUnkrrown MotortYd2 pasSEnngger 05=AAOt Helmt!t Used I>S~eson flow -Middle Position tlfr8't~de~-met 4~ed H 06=Second Row • Right Side 1o~Sa B Used Improperly ~d / Not AppCicabte ~~~~ 01.third Row Or Greater - 11=C Salary Seat Used Improperly 1_Tftrovgh ~ p~ Open'mg B left Silk 12=Helfiet Used Improperly 2=Thro h 51dsyy~ndow M=Mate Unk ug t>B~thlyd Row Or Greater - 90~Restrakn Used, Type nown 3~Tftro gh Vfndshield U bUnkt-oNm Middle Positon 99=Unlutow'm 4=TFuough Back Doe 09=Third Row Or Greater • 5-through Sack Door ale Qpen~+g Right Side ~~ f~Ttrcaugh Roof ope,~r! 5wrroof! kcab F 00- one se /Not Applcable f T bl T D u e ruc e o vtO 10_Sfeeper Section O Comertl t l~~ 11-In OOtthheOr Endas ~ OS•-Front Afr Bag ~ oyed (for Tlus Sea$ 7~m~h Roof ing (Convertible . led Passes er Or Car Area 02=5ido AN' Bag , (For TEus Seat? Tpp Up) ed De Gt e !ur r ty o3 oth Z fi gs~k~ pp p y p = e t 2=In 0 n Area 3=Nlade~e ~ (Back t)f Pidorp, EtcJ 04-MrdGple A'u Bags Deployed tb d n e Eye Protec 19=TraBing Unlt 05=MCtoKy ~~qr ~,N,y 1A~tid tkt Vehido Exterior 06,Bicydbt Weanng ER-awlKneelPads ~ 15=Bus~assenger 10eA'v Bag Not Dopkyad. Switch On ~ or:NO~t'f Applicable ~ If ~~ 9Betxher 11- Bag Not Deployed, Switch O 1vNOt t~etrrotad g~ If 99=unknown 12 flag Not be bYed• 2~fxtdcated By Mechanical Means Unt Swifdr 3#reed SY Non - Mechanical Mears fr~l 13+dAH Bag Removed To Crash) g„Dther ig=UnknoNm if AH Bag Deployed 9-Unknown 99~Unkitavm IIM5 /-genry: ~ t•r•Tt AIVIBUI,ANCB S Medkel Faddty: CHAMBRSBURG HOSPYTAL Uait No Person No Delate7 Dab ~ fIlath ~D-WYY) ~ A B C DBE ~ P ~G (H~ ~! 'J 01 01 O 01 - ~ - 1961 ~ ~ ~ Ol L_ J 00 ~.J l :._.I lTJ Nauss ! Address / PhonO EMS Transport ~ soma as GpV~ JBF'FR13Y B 21a B ORANGB ST APT A SFIIFFBNSBURG FA 1 Q YAS • No Opere~ Usk No ~ Delsts7 D~ of ~h (~ ~~ ^ ^ ~ Q~ OI 02 Q 11 25 1920 2 F 1 03 03 00 1 0 2 Name 1 Address / One EMS Transport GRACE A. BRANTHAFBR 216 B. GRANGfi STREET SH1pPBNSB'C7YtG FA p Yes • No ~ OA~ r Uhit No Parson No Delete? Da Birt M-DD- A B D F G 02 01 d 11 - 15 - 197$ I~a4~ Ol 03 10 1~0~3^ Nams / Addraas / PFrvsro EhAS Transport 0 same u g~X, JQHN R 7$0 L><1~CDTA DR CH.AMBERSBYJRCI PA 17201 f» Yes O ~ Operator Unit No Fsr~n NO Da~a7 Dr'""~~~ _ aaac~oo oao ~~ ~~ NamO I Addrea !Phone EMS Transport Same as O Yes l~ No Operator unit No FOrssll Na DalstaT Dats of Bitch (MM•DD-YYtfY) A B C p E F G ~~''H Inn Name / Addross I tvlto-x EMS Transport Q Sime as ~ Yes fa NO tperator Unit ~ ~~ ~ DaleteT ~~ of Birth (MM•DD•YYYrrY) A B C D E F H I Flame 1 Address / Phono EMS Transport Same as d Yes ~ No Operator faew, a~eoa d~f PENNDUT(+UPT http://`avww.dot6.state,pa.us/crsapplPrintImages/XmlFiles/20100330622010041410263826... x/14/2010 05-18-'10 11:22 FB(lM-Shippensburg Police 717-532-2313 T-323 P000610007 F-104 rdgG ~ ui ~ pint CRS ~V'0152568 co~~lpNWt~,iLYw o~ ji+~NP6~YLV0+~d)d~ POLICE: CR/A54t jrTtrPORTiNG 0:011Rfl Paga~~ AA 500 4 1~ta vre ony • ~ _~ Craft f7es~r1~?~n ~ 0=NOrFConiston Y+Head On 1=Rest End ~ (Baddng~~ I~tfon to Roe ~ 1`On TYavel LBnea 3=ttsdian ~~ s -- ir3ltouldar 4~ROadslde .. rs.a . 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Quirk, 30 Whitetail Drive, Carlisle, Pa. 17015 Carol A. Disiasa, 285 Newvilie Road, Shippensburg, Pa. 17257 Vehicle 2 had stopped or was nearly stopped for traffic that had slapped for a red traffc signal at the intersection of West King Street and Fayette Street. Vehide 2 was struck in the roar by vehicle 1 and then vehicle 1 veered off onto the sidewalk where it confirmed Weston the sidewalk for a distance until it struck the corner of the building at 79 West King Street causing• the structure to caBapse crushing vehide 1 and killing the two ocx:upants. Investigation and interviewing witnesses Isad tD the possibility that a medical condition exist~ecd at the lima of the accident. Cumberland County Coronor on scene assisting with the investigation. pops ~ ~usao hRrns} PaNNDOT RQPY http://www.dot6.state.pa.us/ersapp/~,'rint~magesf~ml~iles1201 Q03306220100414102638~6... 4/14/201 D 05-18-'10 11:25 FROM-Shippensburg Police 717-532-2313 T-324 P0002/0002 F-105 Print C1t~S W0152~6$ Yage ~/ ar ~/ ~~ ~ ~I I1~~~IIIIIII~II~~~ crash Mursstrer N if~~(R ~I'A ( Page aw O W015256$ ~ retkruro~r AA 500 F ~ O ~ d ati - -- C olr n don Surtara Q grids ar elodt Q DErt edat lwtsdkrlo O MlRtary Q Qther Federal Sires Q Conaete O Stag, Gravel or [~ Other ~ poi itt'mn 0 Indian Reservation Q other t~ Blarktap 'ti°1e O Unknown 0 Natbnel park O ~ I~ nNersriy O Urduiown Plessn oomptete unit Information tlnr e~aels unit Involved in a faQa! sash. Do no _ t repeat the lnforrriadnn In the fields above on muitipte pales. , unk Ne Ol ed kn ac Pofn I• O Non.Coll~lon Qii 12 010 Oio a2Q ReserlAlans idot a Pennsylvania RasL! Q CwnpRedYVRts Qoriver Q Top Q 0 030 RosWalonsNat Unknown ~ 0 Cornplience h ~a 0 ~ ~ ~ Ra Oundercarrlage 0 0 Q , -uo W mp11 O O Towed UMt 0 ~ Es yn O © ~nsylvdnla O O le rFndo O m O Unknown 0 prl„er r r li ed W!~ ~ 0A Requlnd • Non Unknovrn O 0 A"°!da'K° Ma"e"'rer Compilanoe Compliance ~ None Required ~ , O No Avoidance ~ ManerrYer Q BEvideiree Dyer O ManeuAV~dence es ~ Compliance Unknown tlarver Uzarrse ~ l~ ~ O ~ ~q O Brakin Skid staoring - E~Videnca 0 I^Canc[usive ~ Marko ltirldent O or Dryer Stalled ulre d O ~I~ m t ~nsylvania Q ~ Y~ thence O D~ h e . ar SRrok ©Unlmown Q MDr verb O ~de~ r i r ti d k f O o rerna er>:e Nat or 0 Unknown ~ q~ t derRlde dlntor ~ No ~ Underdde Oruat Tbs[Z~ O ocher © Blood , i No Underrkle or Q Compartment O yeldde~ Other oweride lntruibn Unknown If lest ~ None p urMe O Chen p~~, Underridq unknown M Tnst - so tifw O In°d rpnerd O ~~ n UAknown O oven wee or D D n = Nd Test 4hKr1 S = AM hetsrminez i w tfo Drug Reported 6 w P[F ~~n9r Ilse O l,ighu Flashing d p~ ltgh6 and Siren 2 sa Marijuana a sa Other (~ ^ J 3 = Cato g = unknovm Tear L Not In ¢menfN+eY ~ Use Q Siren Sounding Q Unknown ,_ 4 = tlpia~s ~,~ u^tt No ~~ Pr/ndak t~eacr Pofis Q Q Non{olksion ~ 1 ii a Q ~ - J O 0 2 s Restr~elo^s N~ a PannsylvsNa ~ CompliedVYnh ODdver O Top O 0rj Q Q NaRestriNo ~ O~ d yy~ CJ U~pl°~'ce O UndercaMa9e 0 0 04 0 Q uC ~IEanu Q7owed UnR py 0¢ 05Q © ~ Pennrylvania ~ ~p ~ O Nowt e Q Unknown i r ~~~~~ Vlfltt+ en O O ~ n~ e Awldanao.Awer =s C m l ce t;om O None Required Roqu(red - O O NdAaneuver nce O EYide a other O MarcreruveAVOWanu ~ tbmpllance Unknow^ Eraking Skid Stewing - Evlderrce i t d ~ wred far U Not Re k if CDL ~ ve © nton rn O Madts Evident or brNer Stated g or s ~ O Ydtide Ciao O Cpl Required No Yard Ucense Not a PertnsyNania d far ~~ Q D~ Brakln Na Skid ~gp Steedn9 and Braking Q unkrwvm Q Ma rhrer ©Evldena or Stared [] Nwt Licensed Valid tkence for ~ t]us ©Unknown UnderliP~sndlotor U d id Oar Drud Trlst ?~Oe Q eload O arr ma^t O ~~ea other n ~ Mo underride or © Override ~ None [~ Urine Q Gwek sown H lest Underride, Unknown ff Underrtde aruo Tam ~ ~ ~ ~~ r] , O Comparrment O ComPartmerd O l~rderride ar Inutrsran I^trrxlon Unknow^ werdde lJJ h i etam 0 a No Test Ghhar 5 = Aprp nes D 1= No Dreg Reported 6 =PCP Both lights and ee flso 0 Ughts !'lashing O Sin Z a Meri~usna ! = t~lhar 9 R~rk~ Test e ~ Uk in Emergency ©S1ron Sounding ©unknown q = Opiat s ~a PEi~iN~ 7 COPY http;//www.dot6.state.pa.us/ersapp/Printlmages/~mlFiltJs/20100330622010041414263826... 4/14/2010 COMMONWEALTH OF PENNSYLVA^~~~ COUNTY OF CUMBERLAND SHORT CERTIFICATE I, GLENDA EARNER STRASBAUGH Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 22nd day of March, Two Thousand and Eleven, Letters of ADMINISTRATION C. T.A. in common form were granted by the Register of said County, on the estate of GRACEA BRANTHAFER late of SH/PPENSBURG BOROUGH rFir:r, M;dd~, casr~ in said county, deceased, to RONALD J BATZEL (First, Middle, Lasf/ and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 22nd day of March Two Thousand and Eleven. File No. 2011-00205 PA Fi 1 e No . 21- 11- 0205 Date of Death 4/02/2010 S . S . # 209-20-5342 egis er s A ~ I A /~ a PETITIONER'S W EXHIBIT J W J J Q NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL LAST WILL AND TESTAMENT I, GRACE A. BRANTI-iAFER, of 216 East Orange Street, Borough of Shippensburg, Cumberland County, Pennsylvania, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my legally enforceable debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give and bequeath those certain items of furnishings, household appliances, a doll collection (each doll containing a number from 1 - 89 thereon) and other items of personal property that I may own on my passing to those persons named on a certain six-page listing of personal property dated Apri128, 2000, and signed by me, which is to be found with or attached to this my Last Will and Testament. THIRD. I give and bequeath any doll given to me which is not mentioned in paragraph two of this my Last Will and Testament to the person who gave me any such doll or dolls. FOURTH. I direct that any dolls that I may have purchased which are not mentioned in paragraph two of this my Last Will and Testament become a part of the rest and residue of my estate and disposed of in accordance with the provisions of paragraph fifth of this my Last Will and Testament. FIF'I'Fi. I give, devise and bequeath all the rest and residue of my estate, real, personal and mixed, whatsoever and wheresoever situate to my children and grandchildren, namely; CINDY POOLE, GARY LEE BATZEL, SR., THOMAS R. BATZEL, RONALD J. BATZEL, and MARY ANNE GUTSHALL, on a per stirpes distn'bution basis. My hereinafter named Co-Executors shall determine in their sole and absohrte discretion whether to distribute items which comprise the rest and residue of my estate in kind or to liquidate all or a part of the rest and residue of my estate through private or public sale or sales. It is my specific intent and direction that any items which make up the rest and residue of my estate which are to be sold not be sold to auctioneers, dealers or other persons who will re-sell or who are h7cely to re-sell said items for profit. SIXTH. In the event that any beneficiary of this my Last Will and Testament is under the age of eighteen (18) years, I then give and bequeath said beneficiary's share to and appoint as Guardian of any property which passes under this Will or otherwise my son, THOMAS R. BATZEL, of Box 341, R D. 1, Brookville, Pennsylvania 15825, AS . , ~ /~n~,,~~ (SEAL) PETITIONER'S EXHIBIT a MARK, WE!GI.E ANO PERKINS - ATTORNEY - 126 EAST KING STREET - SHIPPENSBURG. PA 77257-1397 GUARDIAN, NEVERTHELESS, to invest and re-invest the same until the said beneficiary reaches the age of eighteen (18) years, with the following powers in addition to those presently given by law: A. The power to expend the income towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; B. The power to expend the principal, within the discretion of the said Trustee, if the income is insufficient, towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; C. The power to sell any and all real estate, within the discretion of the said Guardian; D. The power and obligation to distribute the balance of principal and interest, if any remaining, when the said beneficiary reaches the age of eighteen (18) years, without the necessity of a formal adjudication of the Guardian's Account in the Court of Common Pleas of Cumberland County, upon the receipt of a good and valid release; E. The principal of the Guardianship and the income therefrom shall be free from the debts, liabilities, and engagements of-those beneficially interested therein, and shall not be subject to assignment by him or her, nor to attachment or execution under any legal, equitable or other process for the enforcement of judgments or claims of any sort against them, either individually or collectively; and F. In the event the above-mentioned person is unable. to accept the position of Guardian , I then name, constitute and appoint my grandson, GARY LEE BATZEL, JR., of 1717 Orchard Road, Chambersburg, Pennsylvania, as Guardian, with the same powers hereinbefore stated. SEVENTH. I nominate, constitute and appoint my grandson, GARY LEE BATZEL, JR., of 1717 Orchard Road, Chambersburg, Pennsylvania, and my grandson, TIMOTHY L. M. BATZEL, of 97 Parsonage Street, Newville, Pennsylvania 17241, or the survivor thereof, to be the Co-Executors of this my Last Will and Testament. MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 EIGHTH.. I hereby direct that all federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of administration of my estate and that such be paid out of the rest and residue of my estate. NINTH. I direct that my personal representatives shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, GRACE A BRANTHAFER, have hereunto set my hand and seal to this my Last Will an ~, j~tament, written three pages, the first two pages signed for identification only, this L~~~"J day of , 2000. ~ ~ (SEAL) ~~ ~ '~ MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 726 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 This instrument was by the Testatrix, on the date hereof, signed, published and declared by her to be her Last Will and Testament, in our presence, who at her request and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND _ ~ ` ; SS. I, GRACE A. BRANTHAFER, the person whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledg before me by GRACE A. E ,the Testatrix, his Z Q~ay of 2000. NOTARIAL Jerry A_ Weigle, ~ Ipensburg, PA Cui MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 1 725 7-1 397 COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND We, ~ ~ r ~ ~ Fi - ~trm~ and ~:... C~ L-t ~.-~ the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw GRACE A. BRANTHAFER, the Testatrix, sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix, signed the will as witnesses; and that to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn or affi d to and sub,cribed be~iafe~ie by~ T ~ this' I~ ~~ay of C~~~(,t)C~ (~ , 2000. NOTARIAL SEAL Jerry A. Weigle, Notary Public Shippensburg, PA Cumberland Co MARK. WEIGLE ANB PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 LIST OF PERSONAL PROPERTY BEQUEST REFERRED TO IN MY LAST WILL AND TESTAMENT DATED APRIL 28, 2000 1. To my son, RONALD J. BATZEL: Doll #6 -Prairie doll with black hair, dressed in plaid & flowers Doll #41 -Doll with blonde hair dressed in light pink pantsuit Small china closet 2. To my daughter, MARY ANNE GUTSHALL: Doll #18 -Doll with blonde hair dressed in red Christmas dress with ruffles on sleeves and skirt with a veil Doll #29 -Doll with short brown hair dressed in red velvet with white fur Doll #36 -Doll with blonde hair dressed in blue and green velvet with flower apron Five-shelf bookcase in living room Microwave stand 3. To my son, GARY LEE BATZEL, SR.: Doll #23 -Twin dolls dressed in green & red plaid -one tooth - on a stand Doll #23 -Eagle in a case Booher wedding picture Sewing machine with stool Stereo Knickknack stand with four shelves Entertainment center Talking stuffed Santa Claus 4. To my grandson, GARY L. BATZEL, JR: Doll #2 -Rose colored doll -looks like Fawn with a hair bow Doll #30 -Tall doll with blonde hair -rust light color -with umbrella at her side Doll #46 -Tall skinny clown with red pantsuit with feathers around neck Doll #51 -Gift gallery fantastic (hanging) All Avon except dolls in living room Ceramic cats in spare room Grace and Jim's wedding picture -10 x 13 in size Small curio cabinet ~- ~~~~ ~ (SEAL) 5. To my great granddaughter, JESSICA A. BATZEL: Doll #26 -Doll with blonde hair dressed in old-fashioned royal blue with glasses Doll #58 -Musical doll with blonde hair dressed in red velvet (sitting/gift gallery) Doll #75 -Small bride doll in bell case Tiger picture in spare room 6. To my great granddaughter, FAWN E. BATZEL: Doll #33 -Pink and green clown Doll #53 -Doll with brunette hair holding umbrella up - nightlight Doll #64 -Indian doll with white dress Framed picture of kittens (11 x 13 in size) 7. To my great grandson, SEAN T. BATZEL: Doll #40 -Victorian gardner doll named Beth dressed in red satin Doll #62 -Doll with short blonde curly hair dressed with a hat with a rose on top (laughing) School desk Small rocking chair Desk with drawers Computer chair Iron claddsadle horse & wagon Five-drawer dresser in hall All toys including stuffed toys . One of the painted kitten pictures in spare room One of the German Shepard pictures in spare room Toddler bed 8. To my great grandson, COLTON R. BATZEL: Doll #47 -Native American doll with blonde hair dressed in gray fur with jewels Doll #71- Poncathos doll dressed in brown outfit Doll #83 -Doll with blonde hair with pink ribbon in her hair dressed in pink dress with flowers One of the German Shepherd pictures in spare room One of the painted kitten pictures in spare room ¢~ - '~~ (SEAL) 9. To my son, THOMAS R. BATZEL: Doll #27 -Doll with black hair dressed in a red dress with white apron and red Hat Blue recliner Hutch cupboard Large ceramic Mr. and Mrs. Santa Claus Ceramic Dutch boy and girl (little knickknacks) 10. To my granddaughter, THERESA BATZEL: Doll #4 -Doll with blonde hair dressed in plaid dress with red trim and white lace with a hat Doll #49 -Doll with blonde hair dressed in blue velvet with white fur/gold trim Doll #68 -Japanese doll ' 11. To my granddaughter, PATSI J. MCLINEY: Doll # 16 -Doll with brown hair dressed in blue party dress with puffy sleeves Doll #52 -Flexible porcelain pierrot doll Doll #72 -Old fashioned prairie doll with red hair 12. To my granddaughter, MISSY BATZEL: Doll #10 - Doll with blonde hair dressed in a dress with holly on it with a red velvet hat Doll #50 -Doll with short blonde hair dressed with a fancy ruffle with matching hat Doll #70 -Clown doll dressed in red and blue 13. To my daughter, CINDY POOLE: Doll #19 -Angel doll with brown and gold wings Doll #20 -Small musical doll on high chair dressed in green & white Doll #38 -Doll with blonde hair and a gray, green, purple & blue stripped back pack Shell hanging ornament Muffin ceramics for jelly Grandfather's Clock Table & Chairs ~~,.sL (~. ~ (SEAL) 14. To my grandson, RONALD A. POOLE: Doll #1 -Angelina doll with black hair dressed in red Christmas dress with white fur and bells Doll #48 - Doll with long blonde hair dressed in simple flower dress Doll #69 -Clown doll dressed in purple and yellow 15. To my great grandson, JAMES D. POOLE: Doll #25 -Doll with brown hair dressed in a purple ballerina outfit with a flower headband Doll #55 -Santa Claus doll with presents Doll #74 -Doll with dark hair dressed in a white dress with rule on top 16. To my great granddaughter, KAYLEE R. POOLE: Doll #39 -Doll with black hair dressed in a light blue polka. dot outfit with lace and dark satin Doll #61-Prairie doll with blonde hair dressed in blue and white Doll #79 - Doll with dark hair dressed in pink dress with bow in front wearing glasses with flowers 17. To my grandson, CHRISTOPHER J. C. BATZEL: Doll #3 -Doll with blonde hair with white fur & mitt -burgundy shawl Doll #5 -Doll bride with brown hair named Fran Doll #9 -Doll with red hair dressed in Angelina green velvet with white ruffle Doll #17 - Doll with brown hair dressed in red dress with white front & hat of a teardrop Doll #34 -Doll with blonde hair dressed in peach outfit with fluffy hat Doll #37 -German doll Blue & white glaze two-handle vase with flowers on it 18. To my great granddaughter, KAYLA BATZEL: Doll #32 -Purple clown doll Doll #60 -Angel doll with blonde hair with wings, halo and star wand Doll #77 -Doll with blonde hair dressed in mauve outfit with flowers ~ ~~j~,~. (SEAL) 19. To my great granddaughter, SARAH BATZEL: Doll #43 - Doll with blonde hair dressed in mint green party dress Doll #65 -Doll with brown hair dressed in pale pink dress Doll #81 -Doll with dark hair dressed in a layered dress with a straw hat 20. To my grandson, TIMOTHY L. M. BATZEL: Doll #8 -Doll with brown hair dressed in pink silk party dress with pearl buttons Doll #11-Black dolls dressed in blue dress with straw hat and spring flowers Doll #12 -Doll with blonde hair dressed in pink dress with straw hat and spring Flowers Doll #13 -Doll with blonde hair dressed in cowgirl suit with red hat Doll #14 -Christmas doll with dirty blonde hair dressed in green/rose dress with a burgundy hat Doll #15 -Black skater doll with~burgundy hat Doll #21-Boxed musical doll with blonde hair with red ribbon and pig tails Doll #54 -Skater doll with brown hair, dressed in blue velvet Doll #85 -Black doll with china tea set Doll #86 -Doll with blonde hair with spring tea set Five-piece bedroom suite (bed, dresser with mirror, 2 chest of drawers, night stand) 21. To my great grandson, Timothy L• M. Batzel, II: Doll #28 -Twin dolls dressed in blue plaid and black velvet Doll #59 -Doll with red hair dressed in green velvet with plaid and a hat Doll #76 -Doll with strawberry blonde hair dressed in a spring dress 22. To my great grandson, TAYLOR D. BATZEL: Doll #42 -Crawling doll with red hair dressed in red velvet with hearts Doll #63 -Doll with blonde hair dressed in pink dress with lace Doll #80 -Ballerina doll with silver tutu 23. To my granddaughter, GRACE L. POOLE: Doll #31 -Victorian plastic doll dressed in red dress and high society hat Doll #35 -Doll with black hair dressed in pink frilly dress with lace ruffle veil down the front Doll #57 -Doll with brown hair dressed in pink satin dress with hair bow ~(, (SEAL) 24. To my great granddaughter, DESTINY D. POOLE: Doll #44 -Doll with blonde hair dressed in peach outfit with straw hat Doll #66 -Doll with red hair dressed in pink dress with flowers in her hair Doll #82 -Doll with dark hair dressed in red velvet dress with a bow and lace across the front 25. To my granddaughter, TABITHA K. POOLE: Doll #22 -Twin dolls dressed in pink velvet with a small rocker Doll #73 -Doll with blonde hair dressed in red velvet dress with lace trim with a straw hat Doll #78 -Doll with blonde hair and pale fact dressed in a rust/brown dress 26. To my great grandson, BRYCE D. NEIVES: Doll #7 -Ballerina doll with brown hair dressed in a pink dress Doll #45 -Doll with red hair dressed in blue & purple and a hat with a feather Doll #67 -Bride doll with black hair 27. To my granddaughter, CRISTIlJIA L. REXROTH: Doll #56 -Doll with blonde hair with blue fur shawl 28. To WILLIAM J. WOLFS (friend of the family): Doll #84 - Doll with blonde hair dressed in red velvet & white with key in her left Hand with white fur head wrap & bow ~~~~ ~ /~~ (SEAL) 610 234 2929 Property 01:45:56 p.m. 03-21-2011 2 /2 Nationwide' On Your Side For coverage definitions and descriptions, visit Nationwidecom Insured Driver(s) Name Date of Birth Manta! Status Shirley C Gaver 03/OS/57 Widowed Insured Vehicle(s) and Schedule of Coverages Nationwi~ Auto Policy Policy Period: Apr 14, 2010 -Jun 2, 2010 Policy Number. 5837C 688228 Prey~red an April 16, 2010 Page 2 of 4 Your Policy Declarations 2001 Dodge Neon Se/ VIN 1B3A54&CB1D109907 Coverages Comprehensive and S 1500 iN Customization Collision and $1,500 IN Customization Property Damage Lfability Bodily Injury Liability Uninsured Motorists-Bodily Injury Underinsured MotoristsrBodily Injury Limits of Liability Actual Cash Yalue Less $ 250 Actual Cash Vatue Less S 500 $ 50,000 Each Occurrence $ 50,000 Each Person $ 100,000 EacllOccurrence (Non-Stacked) $ 15,0 Each Person S 30,000 Each Occurrence (Non-Stacked} $ 15,000 Each Person $ 30,000 Each Occurrence Premium $ 59.00 $ 1 a2.ao $ 64.70 $ 51.20 5 3.30 First Party Benefits Option 1-Medical Benefit Option 2-income Loss Benefit Option 4-Funeral Benefit Limited Tort $ 5,000 $ 10.000 Total S 1,000 Monthly $ 2,500 $ 8.50 $ 34.30 $ 8.30 $ 0.40 Total for this Vehicle $ 412.50 Policy lave! Schedule o! Coverages Coverages Limits of LiabiBty Premium Roadside Assistance Pius-Covers Disablement S 10.00 UpTo 100 MilesJ$100 Lockout/ $ 500 Trip Interruption Endorsement 3436 Accident Forgiveness feature Intl -Currently Eligible To Use Total for PoEcy Coverages S 10.00 Polity Form and Endorsements V-0376 Nationwide Auto Policy V-3272 Limited Tort Option Election (Pennsylvania) V-3329 Amendatory Endorsement V-3393 Guaranteed Automobile Insurance Coverage (Pennsylvania) V-3436 Roadside Assistance Deductible a PETITIONER'S W EXHIBIT J H Continued on the next page Natiomvide Insurann All'wd Inwrance NatbmNide Agribudn Titan Insurance ess On Your Side' Victoria Insurance One Nationwide Gateway 'Dept 5867 "Des Moines, IA 50391-587 February 2, 2011 SALZMANN HUGHES 354 ALEXANDER SPRING RD STE 1 CARLISLE, PA 17013 OUR INSURED : Shirley C & Jeffery Gaver OUR CLAIM NUMBER : 58 37 C 688228 04022010 01 YOUR CLIENT :The Estate of Grace Branthafer DATE OF LOSS : 04-02-2010 Dear Ms. Hughes: Please accept this correspondence as a formal tender of our insured's $50,000 per person policy limit contingent upon receipt of a copy of the death certificate for Grace Branthafer. Please forward a copy of the death certificate to my attention at your earliest convenience. This settlement will of course need to be court approved prior to the issuance of the settlement proceeds. Please contact me to discuss if you have any questions or concerns. Sincerely . R/Vtwi rik D rows Claims Department Nationwide Mutual Insurance Company (610)234-2719 a PETITIONER'S W EXHIBIT J F H ~ ~~ Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such a person to criminal and civil penalties.