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HomeMy WebLinkAbout03-0413IN RE: EMMA C. WENTZEL an incapacitated person On the Petition of E. K. Weitzel : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, : PENNSYLVANIA : ORPHANS' COURT DIVISION : : NO. PETITION FOR APPOINTMENT OF GUARDIAN OF THE PERSON AND ESTATE OF AN AIJ,EGED INCAPACITATED PERSON TO THE HONORABLE PRESIDENT JUDGE OF SAID COURT: NOW COMES, Petitioner, E. K. Weitzel, by and through her attorney, Marielle F. Hazen, Esquire and files the within Petition for the Appointment of Guardian of the Person and Estate of an Alleged Incapacitated Person, and in support hereof, avers as follows: 1. EMMA C. WENTZEL, the alleged incapacitated person, currently resides at 242 West Pomfret Street, Carlisle, Pennsylvania 17013. She is ninety-one (91) years old, her date of birth being February 19, 1912. 2. EMMA C. WENTZEL was married to Frank Toth in 1952. They have been separated for many years. 3. EMMA C. WENTZEL is not a patient in a mental hospital. 4. The Petitioner is E. K. Weitzel, of 445 West Penn Street, Carlisle, Pennsylvania 17013. E. K. Weitzel is EMMA C. WENTZEL's only child. 5. The names and addresses of those persons who would be the intestate heirs (or next of kin) of EMMA C. WENTZEL are as follows: Frank Toth (husband), 1 East Bird Street, Shippensburg, Pennsylvania 17257; and E. K. Weitzel, 445 West Penn Street, Carlisle, Pennsylvania 17013 (daughter and Petitioner). 6. The names and addresses of the person or institutions providing residential services to EMMA C. WENTZEL are as follows: NONE 7. The names and addresses of other service providers are as follows: None. Her primary physician is: Rodney K. Hough, M.D. Rodney K. Hough, M.D. & Associates 49 Brookwood Avenue Carlisle, PA 17013 (717) 243-8000 8. EMMA C. WENTZEL was not a member of the Armed Services of the United States, nor is she receiving benefits from the United States Veterans Administration. 9. The Petitioner asks that she, E. K. Weitzel, be appointed as limited Guardian of the estate of EMMA C. WENTZEL. The proposed guardian is the daughter and only child of EMMA C. WENTZEL. 10. The proposed guardian has no interests that are adverse to the interests of EMMA C. WENTZEL. 11. Petitioner believes, and therefore avers, that no Court has ever assumed jurisdiction in a proceeding to determine whether EMMA C. WENTZEL is incapacitated. 12. Petitioner believes, and therefore avers, that EMMA C. WENTZEL has not previously had a guardian appointed, nor is a guardianship heating pending in any other jurisdiction. 13. The reasons why this guardianship are being sought are as follows: EMMA C. WENTZEL is unable to manage her financial affairs in a way that safeguards her physical safety due to manic depression, possible obsessive compulsive disorder, and dementia. 14. EMMA C. WENTZEL's residence, which is owned by her, was condemed in August 2001 and she was evicted from the premises due to the fact that the condition of the residence presented a significant health risk. There was no working plumbing on the premises. 15. When EMMA C. WENTZEL was evicted from her residence by the Borough of Carlisle, the Borough spent Twelve Thousand Dollars ($12,000.00) restoring the property to safe living conditions. 16. The Borough of Carlisle has repeatedly requested payment by EMMA C. WENTZEL for the clean up and repairs of the property. EMMA C. WENTZEL has refused to pay for the clean up and repairs. 17. Due to failure to pay for the repairs, the Borough plans to foreclose on the property June 11, 2003 if payment is not received. 18. EMMA C. WENTZEL refuses to make payment of the debt, which is now in excess of sixteen thousand dollars ($16,000.00) due to interest that has accrued. 19. EMMA C. WENTZEL has ample funds to pay for the repairs to the property. 20. EMMA C. WENTZEL's attorney, George Douglas, Esquire, is in possession of a Sixty-eight Thousand Dollar ($68,000.00) check made payable to EMMA C. WENTZEL and her husband as a result of the condemnation of another property owned by them. 21. Attorney George Douglas has strongly recommended to EMMA C. WENTZEL that she allow the.funds held by him to be used to pay off the debts. EMMA C. WENTZEL has refused. 22. If the debt is not paid, EMMA C. WENTZEL will have nowhere to live after the sale of her home on June 11, 2003. Petitioner believes and therefore avers that EMMA C. WENTZEL lacks the capacity to understand and appreciate the consequences of her actions. The physical welfare of EMMA C. WENTZEL is significantly at risk if the debt against the residence is not paid prior to the sale. 23. The following steps have been taken, in order to find less restrictive alternative to the appointment of a guardian: EMMA C. WENTZEL refuses to execute a power of attorney. She further refuses to comply with directions from Petitioner and/or EMMA C. WENTZEL's attorney. No less restrictive alternatives are available to adequately protect the physical and financial well- being of EMMA C. WENTZEL. 24. The Petitioner requests that the guardian be granted limited powers to act for EMMA C. WENTZEL in the following specific areas: the authority to endorse on behalf of EMMA C. WENTZEL, the check in Attorney George Douglas' possession and to receive EMMA C. WENTZEL's half of these funds which amounts to approximately Thirty-four Thousand Dollars ($34,000.00). Petitioner requests the authority to utilize these funds to pay offthe lien against the property and to pay off the £mes against EMMA C. WENTZEL that she has incurred due to the condition of the property. 25. The proposed guardian has the following qualifications: The proposed guardian is the daughter and only child of EMMA C. WENTZEL. The proposed guardian loves and cares for her mother, and wants to ensure that EMMA C. WENTZEL will continue to have a place to live. 26. The gross value of the Estate of EMMA C. WENTZEL is unknown, but estimated to be approximately One Hundred Fifty Thousand Dollars ($150,000.00). EMMA C. WENTZEL receives funds from a Trust; however, her net income from all sources is unknown. Petitioner respectfully requests that the Court, under Section 5511 of the Probate, Estates and Fiduciaries Code, issue a Citation to EMMA C. WENTZEL, EMMA C. WENTZEL's next of kin, and to such other persons as the Court directs, to show cause why EMMA C. WENTZEL should not be adjudged to be an incapacitated person and limited guardian of her estate be appointed. Respectfully submitted, Date: · ~ l~ie~lle~. Hazed'h, Esquire Attorney for Petitioner Attorney ID No. 68003 2000 Linglestown Road, Suite 303 Harrisburg, Pennsylvania 17110 (717)540-4332 COMMONWEALTH OF PENNSYLVANIA · · SS: COUNTY OF CUMBERLAND · On this, the /~)day of //}~/~E~-~-,2003, before me, the undersigned officer, personally appeared E. K. Weitzel who, being duly sworn according to law, does depose and say that the facts set forth in the foregoing Petition are true and correct to the best of her knowledge, information and belief. IN WITNESS WHEREOF, I hereunder set my hand and official seal. E. K. Weitzel ~/ SWORN to and subscribed before me this ]4~blic NOTARIAL SEAL J£S$1CA A. HOLLAND, NOTARY PUBLIC CITY OF HARRISBURG, DAUPHIN COUNTY MY COMMISSION EXPIRES MARCH 4r 2006 VERIFICATION I verify that the statements made in this Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904, relating to unswom falsification to authorities. IN RE: EMMA C. WENTZEL an incapacitated person : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, : PENNSYLVANIA : ORPHANS' COURT DIVISION : : NO. Weitzel. CONSENT TO APPOINTMENT AS GUARDIAN The name of the proposed guardian of the person of EMMA C. WENTZEL is E. K. Weitzel. The name of the proposed guardian of the estate of EMMA C. WENTZEL is E. K. 3. The proposed guardian speaks, reads and writes the English langu_age. person. The proposed guardian does not have an interest adverse to the alleged incapacitated 5. The proposed guardian is not a fiduciary, or officer or employee of a corporate fiduciary of an estate in which the alleged incapacitated person has an interest; and is not the surety, or officer or employee of a corporate surety of such fiduciary. Dated: E. K. Weitzel ~) IN RE: EMMA C. WENTZEL an incapacitated person On the Petition of E. K. Weitzel · IN THE COURT OF COMMON PLEAS · OF CUMBERLAND COUNTY, · PENNSYLVANIA · ORPHANS' COURT DIVISION · $o. 3' PRELIMINARY ORDER OF COURT AND NOW, this tc/t~ day of ~9~0t-¥ ,2003, the foregoing Petition having been presented in open Court, upon consideration thereof and on motion of Marielle F. Hazen, Esquire, Counsel for the Petitioner, it is ORDERED and DECREED that a Citation be awarded, directed to EMMA C. WENTZEL to show cause why she should not be adjudged an incapacitated person and a plenary guardian of her estate and person be appointed, returnable ~ c~ , 2003 at o_ o'clock,RM., prevailing time, ~ The time and place of hearing on the petition for appointment of a guardian of the estate and person of the alleged incapacitated person are fixed for ~ 6~ 2003, at a'?-LqCgo'clockJ~.M., prevailing time, in the Orphans' Court Division, CUMBERLAND County Courthouse, Carlisle, Pennsylvania. At least twenty days, written notice of the hearing shall be given to EMMA C. WENTZEL, the alleged incapacitated person, by serving her personally with the Citation and this Order of Court and a copy of the foregoing petition together with an explanation of the content and terms of the petition; and at least ~ days' written notice of the petition and hearing shall also be given to the next of kin and to the following parties in interest: Frank Toth, 1 East Bird Street, Shippensburg, Pennsylvania 17257 (husband); George Douglas, Esquire, Douglas Law Office, 27 West High Street, Carlisle, Pennsylvania 17013 (attorney), either perso, nal~'i ~ registered or certified mail. ~¥THE9 IRT: J. IN RE: EMMA C. WENTZEL an incapacitated person On the Petition of E. K. Weitzel · IN THE COURT OF COMMON PLEAS · OF CUMBERLAND COUNTY, · PENNSYLVANIA · ORPHANS' COURT DIVISION · NO. CITATION YOU ARE HEREBY NOTIFIED THAT THE ATTACHED PETITION FOR THE APPOINTMENT OF A GUARDIAN HAS BEEN FILED WITH THE ORPHANS' COURT OF CUMBERLAND COUNTY AND THAT A HEARING ON THE PETITION HAS BEEN SCHEDULED BEFORE , IN COURTROOM NUMBER _, LOCATED IN THE CUMBERLAND COUNTY COURTHOUSE, AT HANOVER AND HIGH STREETS, CARLISLE, PENNSYLVANIA, ON THE DAY OF ,2003, AT O'CLOCK _.M. (PREVAILING TIME). THE PURPOSE OF THIS HEARING IS TO DETERMINE: 1. WHETHER YOU SUFFER FROM ANY MENTAL OR PHYSICAL IMPAIRMENT WHICH WOULD AFFECT YOUR ABILITY TO RECEIVE AND EVALUATE INFORMATION EFFECTIVELY AND COMMUNICATE DECISIONS; AND 2. WHETHER SUCH IMPAIRMENT, IF ANY, IS SIGNIFICANT ENOUGH TO RENDER YOU PARTIALLY OR TOTALLY UNABLE TO MANAGE YOUR FINANCIAL RESOURCES OR TO MEET ESSENTIAL REQUIREMENTS FOR YOUR PHYSICAL HEALTH AND SAFETY. AT THE TIME OF THE HEARING, THE COURT WILL RECEIVE EVIDENCE ABOUT YOUR ALLEGED INCAPACITIES OR FUNCTIONAL LIMITATIONS. IF THE COURT DETERMINES THAT INCAPACITIES OR FUNCTIONAL LIMITATIONS EXIST, THE COURT MAY APPOINT A GUARDIAN TO ACT ON YOUR BEHALF. THE APPOINTMENT OF A GUARDIAN IS A MATTER OF GREAT IMPORTANCE SINCE IT WOULD RESTRICT AND INFRINGE UPON YOUR LEGAL RIGHT TO PERFORM CERTAIN ACTIVITIES OR TO MAKE CERTAIN DECISIONS, POSSIBLY INCLUDING THE RIGHT TO HANDLE YOUR OWN MONEY AND TO DECIDE WHERE YOU LIVE. DUE TO THE SERIOUSNESS OF THIS PROCEEDING, YOU HAVE THE RIGHT TO REQUEST THE APPOINTMENT OF COUNSEL AND TO HAVE COUNSEL APPOINTED IF THE COURT DEEMS IT APPROPRIATE. IF YOU CANNOT AFFORD COUNSEL, YOU HAVE THE RIGHT TO HAVE SUCH COUNSEL PAID FOR BY THE COUNTY. IF YOU DO NOT HAVE AN ATTORNEY, OR CANNOT AFFORD ONE, GO TO, OR TELEPHONE THE OFFICE LISTED BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. CUMBERLAND COUNTY LAWYER REFERRAL SERVICE 2 LIBERTY AVENUE CARLISLE, PA (717) 249-3166 YOU ALSO HAVE THE RIGHT TO REQUEST THE COURT TO ORDER AN INDEPENDENT EVALUATION OF YOUR ALLEGED INCAPACITIES. ADDITIONALLy, YOU HAVE THE RIGHT TO A TRIAL BY JURY ON THE ISSUE OF YOUR ALLEGED INCAPACITIES. YOU HAVE A RIGHT TO BE PRESENT AT THE COURT HEARINGS UNLESS YOUR PHYSICAL OR MENTAL CONDITION WOULD BE HARMED BY YOUR PRESENCE, OR IF YOU ARE OUT OF PENNSYLVANIA. YOU HAVE THE RIGHT TO APPEAL THE COURT'S DECISION REGARDING INCAPACITY OR FUNCTIONAL LIMITATIONS AND THE APPOINTMENT OF GUARDIANS BY FILING NOTICE OF APPEAL TO THE SUPERIOR COURT OF PENNSYLVANIA WITHIN DAYS OF THE COURT'S DECISION. YOU ALSO HAVE THE RIGHT TO PETITION THE ORPHANS' COURT OF CUMBERLAND COUNTY FOR A REVIEW HEARING TO MODIFY OR TERMINATE THE GUARDIANSHIPS WITHIN 10 DAYS OF THE COURT'S DECISION. YOU MUST ACT PROMPTLY IF YOU HAVE REASONS WHY YOU THINK YOU ARE NOT AN INCAPACITATED PERSON, AND IF YOU OBJECT TO HAVING A GUARDIAN APPOINTED FOR YOUR PERSON AND/OR FOR YOUR PROPERTY. YOU MUST TELL THE COURT YOUR REASONS, OR HAVE YOUR ATTORNEY TELL THE COURT THE REASONS BEFORE OR AT THE TIME OF THE HEARING. WITNESS MY HAND AND SEAL THIS DAY OF ,2003. By: IN RE: EMMA C. WENTZEL, AN INCAPACITATED PERSON : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : : NO. 21-2003-0413 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 E.K. WEITZEL is attached. You are hereby ordered to appear at a heating to be held in Court Room No. 2, Cumberland County Courthouse, Carlisle, Pennsylvania, on JUNE 9 ,2003, at 2:30 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 tights 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 heating in your absence and may appoint the Guardian requested. Clerk, Orphans' Court Division i/l I ~ ~c.~ (~(_~) Cumberland County, Carlisle, PA ("x [1. My Commission Expires 1st Monday, January, 2006 SHERIFF' S RETURN - REGULAR CASE NO: 2003-00413 0 COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND IN RE: EMMA C. WENTZEL VS AN INCAPACITATED PERSON RONALD HOOVER , Sheriff or Deputy Sheriff of Cumberland County, Pennsylvania, who being duly sworn according to law, says, the within ORDER OF COURT was served upon WENTZEL EMMA Cthe RESPONDANT at 242 WEST POMFRET ST CARLISLE, PA 17013 EMMA C WENTZEL , at 1438:00 HOURS, on the 19th day of May , 2003 by handing to a true and attested copy of ORDER OF COURT together with NOTICE, CITATION, REQUEST FOR ASSIGNMENT OF NON JURY PROCEEDING, PETITION TO APPOINT GUARDIAN and at the same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing 18.00 Service 3.45 Affidavit .00 Surcharge 10.00 .00 31.45 So Answers: R. Thomas Kline 05/20/2003 E K WEITZEL Sworn and Subscribed to before me this ~ ~ day of C~erk of Orh~ Cohr~ ~ By: Deputy Sheri f~f OMMONWF..AI~TH OF PENNSYLVANIA NOTIFICATION OF MENTAL HEALTH COMMITMENT The Unifon'n Firearms Act. 18 PA. C.S. 6105 (c)(4) spedfies ~hat it shall be unlawful I~' any person adjudicated as an incornpetent or who has been involuntarily committed to a mental institution for inpatient care and treatment under Section 302. 303, or 304 of the Mental Heal[h Procedures Act of July 9. 1976 (P.L817, No. 143) to possess, use, manufacture, conlrol, sell or transfer ~'earms. This would include adjudication of incapacity pursuant ~ 20 Pa.C.S.A. §5501. Pursuant to the Pennsylvania Mental Health Procedures Act, Section 109, nol~ca[ion shall be I~ansmitted to the Pennsylvania State Police by the judge, mental health review ofF. er or county mental health and mental reta~a[ion administrator within SEVEN days of the adjudication, commitment or trealment by first class mail to the Pennsylvania State Police, AttenUon: Firearm Unit, 1800 Elmerton Avenue, Harrisburg, PA 17110. NOTE: The envelope shall be marl(ed "CONFIDENTIAl_" Place an 'X' on either Involuntary Commitment or Adjudicated Incompetent INVOLUNTARY COMMITMENT ADJUDICATED INCOMPETENT Date of Involuntary Commitment or Adjudicated Incompetent INDIVIDUAL INFORMATION (INDIVIDUAL INVOLUNTARILY COMMI'I'r'ED OR ADJUDICATED INCOMPETENT') J.., nc. IDEN.AME AL,AS DATE OF BIRTH . . , . . SOCIAL SECURITY NUMBER ? Counb/Mental Health and Mental Retardation Administrator CouNty Mental Health Review Officer NOTIFICATION BY (Please print name, address, area code, and phone number ct' agency or county court.) Counbj Submitting Notification Physician Certifying Necessity of Involuntary Commitment ( Required in accordance with Section 6105(c)(4) ct' the Uniform Firearms Act ) Hospital / Facility Providing Treatment / Address Judge ' t 'SIGNATURE OF NOTIFYING OFFICIAL DATE ~ Court Case Number Date of Court Order NOTIFICATION OF PHYSICIAN'S DETERMINATIONTHAT NO SEVERE MENTAL DISABILITY EXISTS The physician shall provide signed con~rmation ct' the deten'nina[ion of the lac~ of severe mental disability t'ollowing the iniUal examination under Section 302(b) of the Mental Health r~rocedums'Act and pursuant to the Uniform Firearms Act. Section 6111.1 (g)(3). No[ice shall be transmitted by the physidan lo the Pennsylvania State Police through the county mental health and mental retardation administralor or mental health review officer. Na~me 0~' Physician (Please print.) Signature of Physician Date IN RE: EMMA C. WENTZEL an incapacitated person On the Petition of E. K. Weitzel · IN THE COURT OF COMMON PLEAS · OF CUMBERLAND COUNTY, · PENNSYLVANIA · ORPHANS' COURT DIVISION REQUEST FOR ASSIGNMENT OF NON-JURY PROCEEDING We hereby request that this matter be assigned for judicial disposition· We certify that the following matter is ready for judicial disposition. Captions of related cases and names of judges previously assigned: None Date Respectfully Submitted, l{4arielle'~F~az-en, Esq. PA I.D. No. 68003 2000 Linglestown Road, Suite 303 Harrisburg, PA 17110 (717) 5404332 MAY 1 o NOT F;CAT;ON OF MENTAL HEALTH COMrvl;TMENT The Uniform Fimam3s Act " ' · · · 18 PA. C.S. 6105 (c)(4) spec~l~es that it ~ be unlawful Itx' any person adjudicated as an ancompetent ~ who has been involuntarily committed to a mental institution rot inpafienl care and b'eatment under Section 302. 303, or 304 o1' the Mental Health Procedures Act et July 9. 1976 (P.L. 817. No. 143) to possess, use, manufacture, conb'ol~ sell or transfer firearms. This would include adjudication of incapadty PUrsuant to 20 Pa.C.S.A. §5501. Pursuant to the Pennsylvania Men~al Health Procedures Act Section 109. not, cation shall be lmnsmiffed to the Pennsylvania State Police by the judge, mental health review otflcer or ceunty mental health and mental retardation administrator within SEVEN days of the adjudicaUon, commilment or trealment by Ifrst class mail to the Pennsylvania State Police, AttmnUon: Firearm Unit, t800 Elmerton Avenue, Harrisburg, PA 17110. NOTE: The envelope shall be marked 'CONFIDENTIAL.' Place an 'X' on either InvolUntary Commitment or Adjudicated Incompetent INVOLUNTARY COMMITMENT ADJUDICATED INCOMPETENT Date of Involuntary Commitment or Adjudicated Incompetent. . JR., ETC. INDIVIDUAL INFORMATION (INDIVIDUAL INVOLUNTARILY COMMI'CI'ED OR ADJUDICATED INCOMPETENT) FIRST HAIR b ro~..~ ~x EYES F, NOTIFICATION BY (Please print name, address, area code, and phone number of agency or county court.) Coun~ Submitting Notification D~ Count,/Mental Health and Mental Retardation Administrator Cou~]ty Mental Health Review Officer Physician Cerfi~lng Necessity of Involuntary Commitment~ (Required in accordance with Section 6105(c)(4) of the Uniform Fire~ Hospital / Facility Providing Treatment / Address 2003 Judge ' 'SIGNATURE OF NOTIFYING OFFICIAL DATE a Court Case Number Date of Court Order NOTIFICATION OF PHYSICIAN'S DETERMINATIONTHAT NO SEVERE MENTAL DISABILITY EXISTS The physidan shall provide signed con~rmation et' the determination of the lack o~ severe mental disability I'ollowing the initial examination under Section 302(b) et' the Mental Health ~rccedums'Act and pursuant to the Uniform Firearms Act. Section 6111.1 (g)(3). Notice shall be transmitted by Ihe physician lo the Pennsylvania Slate Police through the county mental health and mental retardation administrator or mental health review officer. Nam~e of Physician (Please print.) Signature of Physician Date 2000 Linglestown Road Suite 303 Harrisburg, PA 17110 HazenElderLaw~paonline.com Marielle F. Hazen Attorney at Law (717) 540-4332 (717) 540-4313 Certified Elder Law Attorney by the National Elder Law Foundation Licensed in Pennsylvania and Texas May 27, 2003 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 In Re: Emma C. Wentzei, an alleged incapacitated person No. 21-03-413 To: The Register of Wills: Enclosed for filing please find the original and one copy of a Certificate of Service in the above-referenced matter. Please date-stamp the copy and remm it to me in the enclosed envelope. Thank you for your time and assistance. E.K. WeitZe!~ Sincerely, // \- Jessica A. Holland Legal Assistant EMMA C. WENTZEL an incapacitated person : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, : PENNSYLVANIA : ORPHANS' COURT DIVISION : : NO. 21-2003-413 On the Petition of E. K. Weitzel CERTIFICATE OF SERVICE I, Marielle F. Hazen, Esquire, certify that on May 23, 2003, I served a true and correct copy of the within Petition for Appointment of Guardian of the Person and Estate of an Alleged Incapacitated Person on the parties named below, by depositing same in the United States mail, certified mail, postage prepaid as follows: Frank Toth 1 East Bird Street Shippensburg, PA 17257 George Douglas, Esquire Douglas Law Office 27 West High Street Carlisle, PA 17013 Respectfully Submitted, PA I.D. No. 68003 2000 Linglestown Road Suite 303 Harrisburg, PA 17110 (717) 540-4332 IN RE: EMMA C. WENTZEL an incapacitated person On the Petition of E. K. Weitzel : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, : PENNSYLVANIA : ORPHANS' COURT DIVISION : : NO. 21-2003-413 NOTICE REGARDING REPRESENTATION OF ALLEGED INCAPACITATED PERSON In conformity with statute 20 Pa. C.S. Section 5511(a), please take notice that counsel has not been retained by or on behalf of the alleged incapacitated person, and that the hearing to determine this matter is scheduled on June 9, 2003, at 2:30, p.m. in the Cumberland County Courthouse, Carlisle, Pennsylvania. Respectfully Submitted, Date Ma/~e~l~ I~ ~az~en, Esq. PA I.D. No. 68003 2000 Linglestown Road Suite 303 Harrisburg, PA 17110 (717) 540-4332 IN RE: EMMA C. WENTZEL an incapacitated person On the Petition of E. K. Weitzel · IN THE COURT OF COMMON PLEAS · OF CUMBERLAND COUNTY, · PENNSYLVANIA · ORPHANS' COURT DIVISION JOINDER I, Frank Toth, husband of Emma C. Wentzel, join in this Petition for the Appointment of Limited Guardian of the Estate of an Alleged Incapacitated Person filed by E. K. Weitzel to have E. K. Weitzel appointed as Limited Guardian of the Estate of Emma C. Wentzel. Witness: STATE OF PENNSYLVANIA COUNTY OF ~/?lj~-,t j') ~ /L /~ . d,~ Frank Toth i~ ~ IN WITNESS WHEREOF, I have hereunto set my hand and official seal. WPeggy' '" ' Notarial Seal ~--- ] A. Gll~on, Notary Pubilc IShl _l~on-~l/u.r~ r,o~:o, C. am .beria~l~ C~o,u.a!yI IN RE: EMMA C. WENTZEL an incapacitated person : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, : PENNSYLVANIA : ORPHANS' COURT DIVISION : · No. o?1 -_200 3 - C/!3 : On the Petition of E. K. Weitzel FINAL ORDER OF COURT APPOINTING PLENARY GUARDIAN AND NOW, this(~ day of ~)~ ,2003, a hearing in this case having been held on June 9, 2003 at 2:30 p.m., and it appearing to the Court that EMMA C. WENTZEL was served with a Citation and Notice of this hearing on May 19, 2003, the Court finds from the testimony: 1. That EMMA C. WENTZEL suffers from depression and obsessive compulsive disorder, conditions which impair her capacity to receive and evaluate information effectively and to make and communicate decisions concerning her management of financial affairs or to meet essential requirements for her physical health and safety. 2. That there are insufficient supports available to assist EMMA C. WENTZEL in such decisions and that there exists no other less restrictive alternative mechanism for decision-making. 3. That EMMA C. WENTZEL's physical health and safety is significantly at risk if the debt against her residence is not paid immediately; and due to EMMA C. WENTZEL's impaired ability to receive and evaluate information and to make or communicate decisions, a limited Guardian of the Estate is required. NOW, THEREFORE, based on the clear and convincing evidence supporting the foregoing findings it is ORDERED, ADJUDGED and DECREED that EMMA C. WENTZEL be and is hereby adjudged a partially incapacitated person, and E. K. Weitzel is appointed Limited Guardian of the Estate. As Limited Guardian of the Estate, E.K. Weitzel has the authority to endorse on behalf of EMMA C. WENTZEL that check presently in the possession of George Douglas, Esquire, and to use the funds to satisfy the lien against EMMA C. WENTZEL's real property and to pay the other fines against EMMA C. WENTZEL that she has incurred due to the condition of her property. The remaining funds will be used to pay the costs associated with this proceeding, including filing costs, attorney fees, court reporter fees, and witness fees. Any remaining funds after payment of the listed items will be held by E. K. Weitzel and may be used to satisfy any further fines against EMMA C. WENTZEL resulting from the unsanitary, or otherwise unsatisfactory, condition of her real property. An Inventory must be filed within ninety (90) days. A report by the Guardian shall be filed within 12 months and annually thereafter. Bond in the amount of ~ t. N3 ~ shall be posted by the Guardian. EMMA C. WENTZEL, an incapacitated person, has the right to appeal this Order of Court by filing exceptions within ten (10) days of this date or to petition this Court for a review hearing to modify or terminate the guardianship herein established. If EMMA C. WENTZEL was not present at this hearing on appointment of a guardian then petitioner shall serve upon and read to EMMA C. WENTZEL the Statement of Rights, a copy of which is Attached to this Order as Exhibit "A", and file proof of such service with this Court within ten days. Y E CO / '7 EMMA C. WENTZEL an incapacitated person : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY : PENNSYLVANIA : ORPHANS' COURT DIVISION : : NO. 21-3-413 STATEMENT OF RIGHTS UPON APPOINTMENT OF A GUARDIAN AN ORDER HAS BEEN ENTERED WHEREBY YOU HAVE BEEN ADJUDICATED AN INCAPACITATED PERSON AND UNABLE TO CARE FOR YOURSELF AND/OR MANAGE YOUR PERSONAL AFFAIRS. YOU HAVE THE RIGHT TO FILE EXCEPTIONS TO THE COURT'S DECISION WITHIN TEN (10) DAYS OF THE DATE OF THE COURT'S ORDER. IF YOU FAIL TO FILE EXCEPTIONS, THE ORDER WILL BECOME FINAL. IN THE EVENT THAT YOU FILE EXCEPTIONS AND THEY ARE DENIED, YOU HAVE A RIGHT TO FILE AN APPEAL TO THE SUPERIOR COURT WITHIN THIRTY (30) DAYS OF THE DATE OF THE DENIAL OF THE EXCEPTIONS. IN ADDITION, YOU MAY PETITION THE COURT AT ANY FUTURE TIME TO MODIFY OR TO TERMINATE THE GUARDIANSHIP IF THERE IS A CHANGE IN YOUR CAPACITY OR IF YOUR GUARDIAN FAILS TO PERFORM HIS/HER DUTIES IN ACCORDANCE WITH THE COURT'S ORDER. IF YOU WISH TO APPEAL THE ORDER OR TO PETITION THE COURT TO MODIFY OR TERMINATE THE GUARDIANSHIP, YOU HAVE THE RIGHT TO BE REPRESENTED BY AN ATTORNEY. IF YOU DO NOT HAVE AN ATTORNEY, THE COURT MAY APPOINT ONE TO REPRESENT YOU. IF YOU CANNOT AFFORD AN ATTORNEY, THE SERVICES OF AN ATTORNEY WHOM THE COURT MAY APPOINT FOR YOU MAY BE PROVIDED AT NO COST TO YOU. Exhibit A IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: EMMA C. WENTZEL, an incapacitated person FILE NO. 21-2003-413 GUARDIAN OF THE ESTATE ANNUAL REPORT [20 Pa.C.S.A. 5521 (c)] FROM ..~t4 ~ q ., 200.5 TO 064: '7 ,200 ~ 1) 2) I am the X Limited __ Plenary Guardian of the Estate of my ward, named above. I was appointed Guardian by Order of Court dated , which __ was X was not modified by Court Order(s) dated Is the incapacitated person still living? Yes If no, answer the following: (a) Date of Death (b) Place of Death (c) Name of Administrator/trix or Exeuctor/trix (d) Date Guardian of the Person filed the last Annual Report PLEASE ANSWER THE FOLLOWING QUESTIONS WHETHER THE INCAPACITATED PERSON IS LIVING OR DECEASED: 3) My initial Inventory was filed on (gr_~ '7t ~oo~ and listed a total estate value of $ ~j ~t~ ~. 3~ This is thefirstlnventoryfiling. The Inventory listed a total monthly income of $ the following: comprised of Disbursements Made Date To Whom Paid Reason for Payment Amount 6/9/03 Borough of Carlisle Payment of lien imposed by Borough $16,509.67 6/11/03 Central Pa Court Report fee for court reporting $107.98 6/23/03 Mountain Lakes yard work at 242 W. Pomfret $1,404.50 7/9/03 Marielle Hazen legal fees (shared with F. Toth) $1,708.68 8/12/03 Cash cash payments for clean up of interior $1,350.00 8/15/03 Merry Maids cleaning of interior 242 W. Pomfret $159.00 8/20/03 Jumpers Electric repairs of interior fan and switches $180.00 9/12/03 DJ Correal payment of fines for yard $1,758.50 9/24/03 EK Weitzel repayment of motel charges 8/7-8/18/03 $453.60 $23,631.93 4) At the beginning date of this reporting period, my initial balance on hand was $ 5) During this reporting period, the following reflects all sources of income (other than social security) received by me for my ward: (Add additional pages if needed) Date Received Source of Income Amount o o 6) During this reporting period, the following reflects all payments I have made for my ward: (Add additional pages if needed) Date To Whom Paid Reason for Payment Amount _ -- _ 7) The present principal assets of my ward are: Description of Asset(s) Present Value ° TOTAL: 8) The present amount and sources of income for my ward are: Source of Income Amount of Income (indicate whether monthly, quarterly, annually) 3 o o 9) The regular monthly expenses of my ward which I pay are: To Whom Paid Amount o o 10) I ~ircle one) petitioned the Court for permission to invade principal to meet the needs of my ward. (If applicable) The following expenses of my ward have been paid fro___m princip~: Amount To Whom Paid. Purpose 4 o o 11) I ~circle one) paid guardian. The amount I paid myself totaled $ following rate: $ myself compensation for services and was per week/month (circle one). I rendered as calculated at the 12) Check the correct response and complete, if appropriate. v'/ There will be no need for extraordinary expenditures on behalf of my ward in the next twelve (12) months. There will be a need for extraordinary expenditures on behalf of my ward in the next twelve (12) months because: 13) Check the correct response and complete, if appropriate. v/ A. My ward receives monthly social security benefits directly. ~B. I am the designated payee to receive my ward's social security benefits. ~C. The designated payee of my ward's social security benefits is: Whose address is And is/is not (circle one) related to my ward as (insert relationship:) 14) Please note any concerns about the incapacitated person's physical or mental well-being or the finances that the Court should know. 15) I ~am attached. X _ am not guardian of the incapacitated person's person. If yes, report is I CERTIFY under the penalties of perjury that the information contained in this report is true and correct to the best of my knowledge, information and belief. Name: E.K. Weitzel Telephone No. Address: 445 West Penn Street 717-249-4466 ._ (home) 717-240-7878 (work) Carlisle, PA 17013 E. IC Weitzel, Limite~Guardian of Estate Date 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 IN RE: EMMA C. WENTZEL : : : : : An incapacitated person : : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-2003-0413 Deposition of: Taken by: Before: Date: Place: RODNEY K. ~OUGH, M.D. The Petitioner Amy R. Fritz, R.P.R. Notary Public May 27, 2003, 3:45 p.m. Brookwood Family Medicine 49 Brookwood Avenue Carlisle, Pennsylvania APPEARANCES: LAW OFFICE OF MARIELLE F. HAZEN BY: MARIELLE F. HAZEN, ESQUIRE FOR - PETITIONER Reporting Services · 717-258-3657 · 717-258-0383fax courtreporters4u@aol, corn 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 INDEX TO TESTIMONY DEPONENT EXAMINATION Rodney K. Hough, M.D. By Ms. Hazen NO. A INDEX TO EXHIBIT DESCRIPTION Curriculum Vitae PAGE 3 PAGE 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 RODNEY K. HOUGH, M.D, called as a witness, being duly sworn, was examined and testified as follows: EXAMINATION BY MS. HAZEN: Q. This is the deposition of Rodney Hough regarding Emma Wentzel, an alleged incapacitated person. Dr. Hough, I have some questions for you. If you do not hear a question, please let me know so I can repeat it; and if you do not understand a question, please let me know so that I can rephrase it for you. In attendance here today are myself, Dr. Hough and the court reporter. Dr. Hough, could you please state your name and professional address? A. Yes. Rodney K. Hough; 49 Brookwood Avenue, Carlisle, PA, 17013. Q. And would you please describe your education, training and background with particular emphasis on your experience in evaluating individuals with incapacities? A. Yes. I'm a family doctor, board certified by the American Academy of Family Practice. I finished my residency in family and community medicine at the Hershey Medical Center. I spent two years as a general medical officer in the Air Force. I was on the staff at Hershey 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O 21 22 23 24 25 Medical Center. I have been in private practice for about 30 years. The majority of my patients are elderly, and I deal with a lot of elderly problems and situations at this point in time. I will enclose you a copy of my CV. Q. Right. And when that comes in, we'll get that admitted as part of the deposition. When did you first examine Emma Wentzel? A. I'll have to refer to my charts just to be exact. 1995. Q. I first examined Emma Wentzel on June 30th, And was she referred to you by anyone? A. She actually sought me out because she was going to another practice at the time and had fired them. Q. And did you receive her history from another physician? A. No, I did not. At that point, I didn't. I have since then gotten the history. Q. And since that first visit, how frequently have you examined her? A. Infrequently. I had mentioned when I first saw her. The next time I saw her was in December 22nd, 1995, and the third time was May 6th, 1996 and February 4th, 1996; January 27th, '98; July 19th, '99; September 20th, 1999; January 17th, 2000; August 22nd, 2000. That was the 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 last time that I had personally seen her. Q. She had been seen by the practice since then? A. Yes. Q. And she~s had a couple of visits, the likes of which you have reviewed? A. Yes. She was seen on May 6th, 2002, was for a driver's physical and May 2nd, 2003 for another driver's physical. Q. And you've also received her discharge notes from an admission at the Hershey Medical Center geriatric psychiatric unit? A. That's correct. Q. And the date of those notes are? A. The date of admission was 8/9/2001; discharge was 8/23/2001. Q. And I have here, we have the curriculum vitae now. So if we can stop and if you could confirm that this is a copy of your curriculum vitae outlining your experience. A. Yes, it is. MS. HAZEN: And we'll include that with the deposition as Exhibit A. (Deposition Exhibit A was marked.) BY MS. N_AZEN: Q. What is Emma Wentzel's diagnosis? 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O 21 22 23 24 25 A. She is being followed for depression, underactive thyroid and obsessive compulsive disorder. Q. Are any of those conditions progressive? A. In my ,opinion, I think her obsessive compulsive disorder is progressive. Q. Does she have any physical impairments that you're aware of? A. Not that I'm aware of. Q. A_nd can you describe her mental impairments? You mentioned depression and OCD. Can you describe what day-to-day those diagnoses mean for her life? A. Well, Emma Wentzel, I think, is very paranoid about anyone including family, her doctor, her friends; she is very angry all the time, and she must control all aspects of her life. This was confirmed by her admission to Hershey Medical Center where they really had difficulty titling her with a diagnosis. But the history is compatible with unmanageability. Whether it's an unyet diagnose cryptogenic psychiatric disorder or acceleration exacerbation of her obsessive compulsive disorder is almost irrelevant because of her unmanageability. Q. And in what way is she unmanageable? A. People who live in horrid; newspapers, people who live in homes with no flushing toilet in today's 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 society in town, people who are unwilling to help themselves when it's for their betterment shows lack of mental balance. Q. Do you believe she's able to make rational decisions regarding her financial management and personal safety? A. No. Q. Do you believe that her obsessive compulsive disorder impairs her ability to receive and evaluate information to such a significant extent that she's partially unable to manage financial resources and make decisions regarding her welfare? A. I do not feel she's capable of doing that, primarily because of the recent and continued unmanageability of her person, place of living, environment. Q. Is she on medications? A. She was prescribed medication, and Hershey and myself questioned the compliancy of taking the medication. She was prescribed Prozac, which is an antidepressant, and thyroid replacement medication. Is she on anything for the obsessive compulsive Oo disorder? A. Well, Prozac is very good for obsessive compulsive disorder, if you take it. 1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Q. Okay. What recommendations would you make concerning services necessary to meet essential requirements for her physical health and safety? A. I think taking it, on account of her safety, I think somebody should manage her affairs. I think that she probably ought to get therapy in regard to her obsessive compulsive disorder, and I think that someone is going to have to assure her living environment be safe and sound. Q. So do you believe a guardianship is appropriate for management of her financial resources? A. I think not only for her financial resources, but also for her physical safety. Q. You believe her ability to receive and evaluate information effectively is impaired to such a significant extent that she cannot make decisions regarding her personal well-being? A. I agree that she cannot. Q. Do you expect the extent of her incapacities to significantly lessen or change? A. Well, by the records I've seen from what I've read, I think it's getting worse; I don't anticipate it will get better unless she gets some intensive therapy. Q. You believe with therapy and medication she could have some improvement? A. Unknown. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Q. In your history of meeting with her, is there anything else you think the Court should be aware of regarding her condition? A. In my opinion, the fact that she's oriented as to time, place and person is somewhat irrelevant in someone who is living in the conditions that she's living in. And someone who accepts the conditions she was having to live in in 2001 indicates that there is a mental problem. She's so uncooperative; it's very difficult to put a total label on it. Q. Do you believe when you meet with her that you receive rational responses, that she's able to evaluate your discussion and provide you with rational responses? A. Rational responses, yes. Q. So she's able to evaluate information and respond appropriately? A. Depends on what you mean by appropriate. She is negative to anything that you would suggest that's different than what she's doing presently. She knows time, place and my name. But if you make any recommendations to change her life-style, it's like hitting a brick wall. Q. And that's not because it's a choice of hers; you believe that that is a result of her mental illnesses including obsessive compulsive disorder which override her ability to make decisions for herself? 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 A. I agree. I think her obsessive compulsive disorder, or whatever it turns out to be in the future, is causing her not to be able to accept changes which she needs for her safety. MS. HAZEN: Okay. I have no other questions for you, but I appreciate your time. THE WITNESS: My pleasure. (Whereupon, the deposition was concluded at 4:00 p.m.) 11 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 COMMONWEALTH OF PENNSYLVANIA ) ) COUNTY OF CUMBERLAND ) SS. I, AMY R. FRITZ, R.P.R., a Court Reporter-Notary Public authorized to administer oaths and take depositions in the trial of causes, and having an office in Carlisle, Pennsylvania, do hereby certify that the foregoing is the testimony of RODNEY K. HOUGH M.D. I further certify that before the taking of said deposition the witness was duly sworn; that the questions and answers were taken down stenotype by the said Reporter-Notary, approved and agreed to, and afterwards reduced to computer printout under the direction of said Reporter. I further certify that the proceedings and evidence are contained fully and accurately in the notes taken by me on the within deposition, and that this copy is a correct transcript of the same. In testimony whereof, I have hereunto inscribed my hand this 30th day of May, 2003. NOTARIAL SEAL Amy R. Fritz, Notary Public City of Carlisle, Cumberland County My commission expires February 9, 2006 Curriculum Vitae Born Rodney K. Hough, M.D. Greensburg, Pennsylvania on March 26, 1944 High School Sweickley Area Joint High School, Herminie, PA Valedictorian College University of Virginia Charlottesville, Virginia - 1962 - 1966 (Football scholarship) (Graduate with distinction) Medical School University of Virginia School of Medicine Charlottesville, Virginia - 1966 - 1970 Internship The Western Pennsylvania Hospital (Rotating internship) Military United State Air Force General Medical Officer, Andrews Air Force Base 1971 - 1973 Residency Family and Community Medicine Th'e Milton S. Hershey Medical Center Hershey, Pa- 1973 - 1975 Chief Resident Teaching Experience Instructor, Dept..of Family and Community Medicine .. : 1' 973.- 1974 . Assistant Professor - 1974 - 1975 CONTINUED Dil~lomate American Board Family Practice - 1975 - 2002 Medical Licensures ' Pennsylvania - MD 012607E Virginia - 01 01020583 Presently Active staff, Carlisle Hospital, Carlisle, PA Practitioner, Family Medicine, 1975 - present Clinical Preceptor, Dept. of Family and Community Medicine The Milton S. Hershey Medical Center of Pennsylvania State University- Hershey, PA Deputy Coroner of Cumberland County Related Experiences Medical Director of Adam Wholesalers Carlisle, PA Medical Director of Frog, Switch Manufacturing Company Carlisle, PA Medical Director Lane Enterprises Carlisle, PA Medical Director of Carlisle Syntec Rubber Co. Medical Director of Carlisle Tire and Rubber Co. Carlisle, PA Medical Director of McCoy Electronics, Co. Mt. Holly Springs, PA Medical Director and Consultant of Piezo Crystal, Co. Carlisle, PA Past chairman of Utilization Review Committee, Carlisle Hospital Carlisle, PA President of Cumberlarid County Medical Society 1983 - 1985 Member P&T Committee Carlisle Hospital Professional. Organi'zati0ns . ' American Academy of. Family Physicians .. ... ~- PennSylVania ACademy of Family Physicians AmeriCan. Medical 'Association · Penns,y. lvania..Medical SOciety : .. CONTINUED Related Community Activities Past President, Rotary Organization of Carlisle, PA Rotarian of the Year, 1996 Awards Chosen as Pennsylvania Academy of Family Physicians of the Year" for Pennsylvania. Hobbies Family Flying Hunting "1997 Family Physician IN THE MATTER OF THE IN THE COURT OF COMMON PLEAS PERSON and ESTATE OF OF CUMBERLAND COUNTY, EMMA C. WENTZEL TOTH, PENNSYLVANIA °'_ .,: , AN ALLEGED INCAPACITATED :_ rL c~ .. PERSON ORPHAN'S COURT DIVI$1'C ~ v NO. 2995 '?~ `3 • ~ 13 ~_ .~ __..._ -- ,~ ; ~-• - : ~~ ~._ PETITION FOR THE APPOINTMENT OF ''_ _~, ~,;~ EMERGENCY PLENARY GUARDIAN OF THE PERS~T AND ~, P, ESTATE IN ACCORDANCE WITH 20 P.S.§5513 ~' AND NOW COMES THE PETITIONER, Emma K. Weitzel, daughter of the alleged incapacitated person, Emma C. Wentzel Toth, by her attorney, George F. Douglas, III, represents and avers as follows: 1. The Petitioner, Emma K. Weitzel, resides at 445 West Penn Street, Carlisle, Cumberland County, Pennsylvania. 2. The alleged incapacitated person is Emma C. Wentzel Toth, age 96, formerly of 242 West Pomfret Street, Carlisle, Cumberland County, Pennsylvania and has resided there for a period of three (3) months prior to the filing of this Petition. 3. Emma C. Wentzel Toth is currently a patient at the Carlisle Regional Medical Center, 361 Alexander Spring Road, Carlisle, Cumberland County, Pennsylvania. 4. Emma C. Wentzel Toth exhibits symptoms of mental incapacity, including, but not limited to, senile dementia Alzheimer's type. 5. Emma C. Wentzel Toth's mental incapacity prevents her from managing and SAIDIS, LINDS~ nTTOttt.~vs•,n•tww 26 West High Street Carlisle, PA caring for the affairs of her person and estate. 6. Emma C. Wentzel Toth is being treated by Dr. Joseph Acri at the Carlisle Regional Medical Center and her social worker there is Jeremy Hicks. 7. The emergency temporary guardianship of the person is necessary for the following reasons: a) Ms. Wentzel Toth is an elderly woman who lacks the capacity to live independently. Her current home at 242 West Pomfret Street, Carlisle, Pennsylvania is in a deplorable condition characterized by extreme disorganization, uncontrolled filth and generally unhealthy conditions. The Borough of Carlisle recently cited her home for the stated conditions as is evidenced by the Notice to Occupant attached as Exhibit "A". b) At this time, there is no other reasonable alternative to affect the proper care of Ms. Wentzel Toth besides the appointment of a guardian of the person. c) Ms. Wentzel Toth will require placement in a proper nursing facility to provide the necessary care she needs. d) Ms. Wentzel Toth needs a guardian to admit her to a nursing care facility because she lacks the capacity to sign a consent for admission. e) Ms. Wentzel Toth is physically stable and not in need of hospital care. f) Ms. Wentzel Toth is not a candidate for further hospital care, she cannot be discharged to her home because such a discharge will pose a grave and serious danger to her wellbeing. g) Emma K. Weitzel is willing to accept appointment as an Emergency Guardian SAIDIS, FLOWER ~ LINDSAY 26 West High Street Carlisle, PA of her mother, Ms. Wentzel Toth. h) Without the appointment of a guardian, Ms. Wentzel Toth will be unable to receive the care necessary for her wellbeing. WHEREFORE, the Petitioner respectfully request that: 1. The Court appoint Emma K. Weitzel as Emergency Plenary Guardian of the person and estate of Emma C. Wentzel Toth pending a final hearing on this Petition with such Emergency Guardian having full power to place her in a nursing home or other appropriate facility and such other powers and restrictions the Court deems proper; 2. Pursuant to 20 Pa.C.S.A.§5513, the Court find that the emergency necessitating the filing of this Petition will continue beyond seventy-two (72) hours from the date of any Emergency Order; and 3. The Court appoint Emma K. Weitzel as Emergency Plenary Guardian of the person and estate of Emma C. Wentzel Toth. Respectfully submitted, SAIDIS, FT~OWER Sz LINDSAY ~'toervEVS•.v:uw 26 West High Street Carlisle, PA Date: (.,1.~~~.~.~,,n-~' ((, ~it~ ~i l~ . t,~ eorge F. Douglas, III, Esquire Saidis, Flower & Lindsay 26 West High Street Carlisle, PA 17013 Supreme Court No. 61886 VERIFICATION I hereby verify that the facts and information set forth in the foregoing Petition for the SAIDIS, ~~OWER ~ LINDSAY ATIURNEY'S•AT•IAW 26 West High Streer Carlisle, PA appointment of Emergency Plenary Guardian of the Person and Estate in accordance with 20 P.S. §5513 of Emma C. Wentzel Toth 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 authorities. Date: Cl~ ~- 11 :~L'(:;.5' ~7-' -~ ~, ~ 1. 1 Emma K. Weitzel I30ROUGH OF CARLISLE "C'onzmitled To Excelle~ace In Conznaunit~~ Service" NOTICE TO OCCUPANT STRUCTURE UNFIT FOR OCCUPANCY POSTED Ms. Emma Wentzel Aug. 08, 2008 242 West Pomfret St. Carlisle, PA 17013 Re: 242 W. Pomfret Street-single family residence This structure has been deemed unfit for human occupancy and therefore must be vacated by order of the Code Department of the Borough of Carlisle according to Section PM- 108.1.3 of the 2000 International Property Maintenance Code which was adouted as Chapter 183 of the Borough of Carlisle Code. This property, due to the unsanitary conditions inside and the lack of maintenance to the exterior is unfit for occupancy. The condemnation will remain in effect until the building is restored to habitable conditions. Failure to comply with the terms of this notice shall constitute a violation of this code, for which, upon conviction thereof, you may be subject to a fine of not less than $50 nor more than $1000. Each day that the violation continues after due notice has been served shall be deemed a separate offense. Should you desire to appeal this order, you will have 10 days from the date of your receipt of this letter to file a written notice of appeal with the Carlisle Board of Appeals pursuant to Section 5-7 of the Code of the Borough of Carlisle. Please contact me at our office at 240-6937 for the procedures necessary to re-occupy this structure. Sincerely, ~Q ~ Michael H. Landis Code Enforcement Officer cc: prop. file, M. Keiser E. K. Weitzel 242wpomfret,cond.doc 53 West South Street, Carlisle, PA 17013 „~,~ Tel. (717} 249-4422 IN RE: EMMA C. WENTZEL TOTH IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA 03-413 ORPHANS' COURT AND NOW, this ORDER OF COURT 2-- day of August, 2008, a hearing for the appointment of an emergency guardian pursuant to 20 Pa.C.S. Section 5513, shall be conducted in Courtroom Number 2, Cumberland County Courthouse, Carlisle, Pennsylvania at 3:00 p.m., Thursday, August 14, 2008. Wayne Melnick, Esquire, is appointed to represent Emma C. Wentzel Toth. Cou George F. Douglas, III, Esquire For Petitioner Wayne Melnick, Esquire Court-appointed for Emma C. Wentzel Toth Court Administrator sal Edgar B. Bayley, J. 1' cn ~ ~,- ~ . r1 _ w , _ "~; ~~~ tiU -o ~,~ In Re: EMMA C. WENTZEL TOTH ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 03-0413 ORDER DATE: JUDGE'S INITIALS: TIME STAMP DATE: CERTIFICATE OF SERVICE OF ORDER ~ ~~ ORDER OF COURT SERVICE TO: GEORGE DOUGLAS METHOD OF MAILING: ® USPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: 08/13/08 ENVELOPES PROVIDED BY• ^ PETITIONER ^ JUDGE ® CLERK OF ORPHANS COURT SERVICE TO: WAYNE MELNICK METHOD OF MAILING: ^ USPS ^ RR-R ^ HAND DELIVERED ^ OTHER MAILED: 08/13/08 ENVELOPES PROVIDED BY• ^ PETITIONER ® JUDGE ^ CLERK OF ORPHANS COURT Clerk of Orph~ Court IN RE: IN THE COURT OF COMMON PI~EAS EMMA C. WENTZEL TOTH CUMBERLAND COUNTY, PENNSYLVANIA 03-413 ORPHANS' COURT ORDER OF COURT AND NOW, this 14th day of August, 2008, this; matter having been called on a hearing for the appointment of an emergency plenary guardian of the person and estate of Emma C. Wentzel Toth, and counsel for Emma C. Wentzel Toth having been appointed and being present, and the Court being satisfied that: Emma C. Wentzel Toth is incapacitated and completely unable to care for_ herself or understand the nature and circumstances of her condition or her estate, IT IS ORDERED that Emma K. Weitzel, her only child, is appointed emergency plenary guardian. of the person of Emma C. Wentzel Toth and emergency plenary guardian of the estate of Emma C. Wentzel Toth. It appearing without question that the current emergency regarding the need for continued care and the discharge from the Carlisle Hospital to a nursing home will extend beyond a 72 hour period, IT IS ORDERED that this appointment shall be for 72 hours and automatically extend for 20 days from the expiration of the 72 hours, the original period commencing at 3:30 p.m.,_-1~crg~~4, 2008. By the Co ~ ,;/;; ,~ George F. Douglas, III, Esquir For Petitioner Wayne Melnick, Esquire Court-appointed for Emma C. Wentzel Toth _ ~-, ~. ; -. f' , ' " ,~ Edgar B. Bayley, J~ J• ~` e ~ '; °i N w prs In Re: ECWT ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA N O. 21-03 -0413 ORDER DATE: 08/1 JUDGE'S INITIALS: EBE TIME STAMP DATE IN RE: CERTIFICATE OF SERVICE OF ORDER 08/14/2008 ORDER OF COURT SERVICE TO: GEORGE F DOUGLAS III METHOD OF MAILING: ^ USPS ^ RRR ® HAND DELIVERED ^ OTHER MAILED: 8/14/2008 ENVELOPES PROVIDED BY: ^ PETITIONER ^ JUDGE ^ CLERK OF ORPHANS LOUR"t SERVICE TO: ~~ I~l"~ I~Y'~C.~ ~, t ~ ~'~,~ ~ its METHOD OF MAILING: V SPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: ENVELOPES PROVIDED BY: PETITIONER ^ JUDGE ^ CLERK OF ORPHANS COURT "~ , ~~C~~~ C J~lf't ( 't ~ ~( ''t_~L<~_--L Deputy Clerk of Orphans' Court IN THE MATTER OF THE PERSON and ESTATE OF EMMA C. WENTZEL TOTH, AN ALLEGED INCAPACITATED PERSON IN THE COURT OI~~1V~/Lb~'~~,~AS OF CUMBERLAI~~COUNTY `1 PENNSYLVANIA ORPHAN'S COURT DIVISION NO. X998-~ ac~~.~ - ~ ( 3 PETITION FOR THE APPOINTMENT OF PERMANENT PLENARY GUARDIAN OF THE PERSON AND ESTATE IN ACCORDANCE WITH 20 P.S.§5511 AND NOW COMES THE PETITIONER, Emma K. Weitzel, daughter of the alleged incapacitated person, Emma C. Wentzel Toth, by her attorney, George F. Douglas, III, represents and avers as follows: The Petitioner, Emma K. Weitzel, resides at 445 West Penn Street, Carlisle, Cumberland County, Pennsylvania. 2. The alleged incapacitated person is Emma C. Wentzel Toth, age 96, formerly of 242 West Pomfret Street, Carlisle, Cumberland County, Pennsylvania and has resided there for a period of three (3) months prior to the filing of this Petition. Emma C. Wentzel Toth is currently a patient at the Carlisle Regional Medical SAIDIS, FIAWER ~ LINDSAY ,~~.~.aW 26 West High Street Carlisle, PA Center, 361 Alexander Spring Road, Carlisle, Cumberland County, Pennsylvania. 4. Emma C. Wentzel Toth exhibits symptoms of mental incapacity, including, but not limited to, senile dementia Alzheimer's type. 5. Emma C. Wentzel Toth's mental incapacity prevents her from managing and caring for the affairs of her person and estate. 1 6. Emma C. Wentzel Toth is being treated by Dr. Joseph Acri at the Carlisle Regional Medical Center and her social worker there is Jeremy Hicks. 7. The emergency temporary guardianship of the person is necessary for the following reasons: a) Ms. Wentzel Toth is an elderly woman who lacks the capacity to live independently. Her current home at 242 West Pomfret Street, Carlisle, Pennsylvania is in a deplorable condition characterized by extreme disorganization, uncontrolled filth and generally unhealthy conditions. The Borough of Carlisle recently cited her home for the stated conditions as is evidenced by the Notice to Occupant attached as Exhibit "A". b) At this time, there is no other reasonable alternative to affect the proper care of Ms. Wentzel Toth besides the appointment of a guardian of the person. c) Emma K. Weitzel is willing to accept appointment as an Permanent Guardian of her mother, Ms. Wentzel Toth. d) Without the appointment of a guardian, Ms. Wentzel Toth will be SAIDIS, FLOWER Sz I-INDSAY nrno~uvers•nnuw 26 West High Street Carlisle, PA unable to receive the care necessary for her wellbeing. WHEREFORE, the Petitioner respectfully request that: 2 The Court appoint Emma K. Weitzel as Permanent Plenary Guardian of the SAIDIS, FLOWER ~ LINDSAY ~~.~.aW 26 West High Street Carlisle, PA person and estate of Emma C. Wentzel Toth. Date: _ ~3,2~~ Respectfully submitted, .1F ~ George F. Douglas, II ,Esquire Saidis, Flower & Lindsay 26 West High Street Carlisle, PA 17013 Supreme Court No. 61886 } VERIFICATION I hereby verify that the facts and information set forth in the foregoing Petition for the SAIDIS, rIAWER ~ LINDSAY nrtowvevs•nnuw 26 West High Street Carlisle, PA appointment of Permanent Plenary Guardian of the Person and Estate in accordance with 20 P.S.§5511 of Emma C. Wentzel Toth 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 authorities. Date: 13 0~O0~ 7(~ Emma K. Weitzel 4 BOROUGH OF CARLISLE "Committed To Excellence 1~~ Co~n~nunit~~ Service" NOTICE TO OCCUPANT STRUCTURE UNFIT FOR OCCUPANCY POSTED Ms. Emma Wentzel 242 West Pomfret St. Carlisle, PA 17013 Aug. 08, 2008 Re: 242 W. Pomfret Street-single family residence. This structure has been deemed unfit for human occupancy and therefore must be vacated by order of the Code DeQartment of the Borough of Carlisle according to Section PM- 108.1.3 of the 2000 International Property Maintenance Code which was adopted as Chapter 183 of the Borough of Carlisle Code. This property, due to the unsanitary conditions inside and the lack of maintenance to the exterior is unfit for occupancy. The condemnation will remain in effect until the building is restored to habitable conditions. Failure to comply with the terms of this notice shall constitute a violation of this code, for which, upon conviction thereof, you maybe subject to a fine of not less than $~0 nor more than $1000. Each day that the violation continues after due notice has been served shall be deemed a separate offense. Should you desire to appeal this order, you will have 10 days from the date of your receipt of this letter to file a written notice of appeal with the Carlisle Board of Appeals pursuant to Section 5-7 of the Code of the Borough of Carlisle. Please contact me at our office at 240-6937 for the procedures necessary to re-occupy this structure. Sincerely, ~u~Q ~ Michael H. Landis Code Enforcement Officer cc: prop. file, M. Keiser E. K. Weitzel 242wpomfret,cond.doc C2 ~7,TPOt Qnnth Ctraat (~arliclP PA 17f11~ Tel. (717) 249-4422 i 1 IN RE: ESTATE OF IN THE COURT OF COMMON PLEAS OF EMMA C. WENTZEL TOTH CUMBERLAND COUNTY, PENNSYLVANIA • ORPHANS' COURT DIVISION • NO. 2003-413 • PERMANENT GUARDIANSHIP ESTATES PETITION PURSUANT TO SECTION 5511 OF THE PROBATE, AND FIDUCIARY CODE TO ADJUDICATE EMMA C. WENTZEL TOTH TO BE INCAPACITATED N OR HER P RSON AND HEREESTATE AS PERMANENT GUARDIA PRELIMINARY DECREE SAIDIS, FLpWER Sz LINDSAY A'["CORN6Y5•AT•IAW 26 West High Street Carlisle, PA AND NOW, this `~ day of , 2008, upon consideration of the annexed Petition, it is ORDERED and DECREED that a hearing on this matter is set for the /~ ~~ , 2008, in Court Room No. ~- , at a ' 3y P .M. at the ~_ day of ~ Cumberland County Courthouse, One Courthouse Square, Carlisle, Pennsylvania, and that a Citation be issued to Emma C. Wentzel Toth commanding her to show cause why she cannot appear at the aforementioned hearing pursuant to the Petition of Emma K. Weitzel, to have Emma C. Wentzel Toth adjudicated as an Incapacitated Person and to have a Plen~ajr,~y Guard/ian appointed for her person and her estate. Notice of the hearing shall be given to Emma C. ~'~ Wentzel Toth in accordance with 20 P.S.§5511(a) ,~,// ~,,~ `/ ~ ( is ~ ~~. It is hereby ORDERED and DECREED that appointed to represent the alleged Incapacitated Person, Emma C. Wentzel Toth. - -' ' . ,,' v (_. 1 IN RE: EMMA C WENT'ZEL TOTH AN ALLEGED INCAPACITATED PERSON IN THE COURT OF COMMON PLEAS OF a CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-03-0413 ~ ~~ IMPORTANT NOTICE CITATION WITH NOTICE =~~~ A petition has been filed with the Court to have you declared an Incapacitated Person. If~ tie Court finds you to be an Incapacitated Person, your rights will be affected, including your right to manage money and property and to make decisions. A copy of the petition which has been filed by the Petitioner, Emma K. Weitzel, 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 September 3rd , 2008, at 2:30 P.M. to tell the Court why it 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 or 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 or other property. If the court finds that you are partially incapacitated, your legal rights will also be limited as directed by the Court. If you do not appear at the hearing (either in person or by an attorney representing you) the court will still hold the hearing in your absence a may appoint the Guardian requested. Date:08/19/2008 gy. a~ ' a ~' ~ ~'~ Clerk, Orphans' Court Division Cumberland County, Carlisle, PA ~ My Commission Expires 15~ Monday, January, 2010 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF In Re: EMMA C WENTZEL CUMBERLAND COUNTY PENNSYLVANIA NO. 21-03-0413 CERTIFICATE OF SERVICE OF ORDER ORDER DATE: JUDGE'S INITIALS: EDGAR B BAYLEY TIME STAMP DATE: 8/20/OR IN RE: HEARING ORDER/CITATION SERVICE TO: GEORGE F DOUGLAS EMMA K WEITZEL - EMMA C WENTZEL TOTH - METHOD OF MAILING: ENVELOPES PROVIDED BY• ® USPS ®PETITIONER ^ RRR ^ JUDGE ^ HAND DELIVERED ^ CLERK OF ORPHANS COURT ^ OTHER MAILED: 8/20/08 SERVICE TO: WAYNE MELNICK METHOD OF MAILING: ® USPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: 8/20/08 ENVELOPES PROVIDED BY• ^ PETITIONER ® JUDGE ^ CLERK OF ORPHANS COURT i - , Deputy ( ~ Clerk of Orphans' Court AUTHORITY TO PAY COURT APPOINTED COUNSEL "" OC~ 13 ZOOS 1. COURT 2. VOUCHER ^ District Justice Common Pleas ^ Appellate ^ Other N ~ ~ 3 2 O 8 3. FOR (D.J., C.P., APPELLATE) 4. AT (CITY/STATE) ET CODE 5. BUDG / ~~ //~~\\ ^ -'/ -(j~~7vU 6. IN THE CASE OF 7. CHARGE/OFFENSE (PURDON CITATION) 8. ^ PETTY OFFENSE vs ^ FELONY ^ MISDEMEANOR 9. PROCEEDINGS (Describe briefly) 11. PERSON REPRESENTED 12. CIVIL DOCKET NO. sh ~ ~ L 1 ^ Defendant -Adult 2 ^ Delendant•Juvenila U~~" ~'~"( ar ~r, .n ~~~~ ll.. ~u ,e,~ . 3 ^ Appellant a ^ Appenee 13. CRIMINAL DOCKET NO. 5 ^ Habeas Petitioner 6 ^ Matenal Wdness 10. PERSON REPRESENTED (Full Name) 7 O Parolee Charged With Violation B ^ Probationer Charged With Violation 14. APPEALS DOCKET NO. ~Ma u~ ~ n~iEl Tb~'h 9 ~Othec ~ I~.,~ 16. NAME OF ATTORNEYlPAYEE AND `C Appr Date VV MAILING ADDRESS ~ ~ (~ ~ (~~ is l~ ~Y11 ~ ~ I~ ~~C~ ~ati,j2~V~ ~1~ S. j-~,rjpV~ ~. , CQ I llS1~ ~~ (~~' ~~ NAME OF COMMON PLEAS JUDGE ASSIGNED TO CASE , / ~~~f~~~ 17.TELEPHOGNErNo 1 ~ l.~l,~ O ~LJ 18. SOCiA~SECURiTVNOOR ~ ~ wN0 CLAIM FOR SERVICES OR EXPENSES `-- o 19. SERVICE HOUP.S DATES _ i AMOU CLAIMr=D--; a. Arraignment and/or Plea MukiplY rate per~tour time's to~bl b Preliminary Hearlnp houla f0 obta~'In Court" cbm- . • penpatiOn. En1 GLtotal below c Motions and Requests , . t_. .. -- ft d. Bail Hearings r '_-~~-~ ~ ~ ~_ - _ ~ ~ e. Sentence Hearings _ -. - _~ -~ _~ U 2 I. Trial ~' '_~ g. Revocation Hearings y h. Juvenile Hearings i. Appeals Court 19A. TOTAL IN COURT COMP. j. Other (Specify on additional sheets) J ~ n ~O ^ • f 7 TOTAL HOURS = ,L~66'fER HGUR - $ , , 20. a. Interviews and conlerences (` Mulfipty rate per hour times total b. Obtaining and reviewing records hours. Enter total "Out of Court" compensation below. O ¢ c. Legal research and briel writing ~ ~ ;~ ~ O OU d. Investigative and other work (Specify on additional sheets) 20A. TOTAL OUT OF COURT COMP. TOTAL HOURS = `7 + " X $45 PER HOUR $ ~ ~ ~ . ~V V 2t. ITEMIZATION OF REIMBURSABLE EX PENSES AMT. PER ITEM Milage $.48 per mile X Q W 2 ~ 21 A. TOTAL ITEMIZED EXP. =S 22. CERTIFICATION OF ATTORNEY/PAYEE / 23. QRAND TOTAL CLAIMED Has compensation and/or reimbursement for work in this case previously been applied foR ^ YES t~ n~o = a }~-~~i /~G ~ tt yes were you paid? ^ YES ^ NO If whom were es b aid? How m ou h? • . y , y y p uc Has the person represented paid any money to you, or to your knowle a anyone else, In connection with the matter for 24. DEDUOj. PRIOR PYMTS. = S C~ which you were appointed to provide representatiq 7 ^ YES NO If ye eteils one dition I heats ~ 1 swear or aflirm the truth or cortectness ~ ~ ~~_ 25: NET AMOUNT Cl~-IMED of the above statements n of Attorney/Payee Dete s s ~~/ •~ 2fj nr'Pgt7vE U Farr Signature of ~` /1~ r'AYMENf Judge , ,Date: ~~ ~ ~ ~ 27. AMT. APPR VFD Q r ` ,~ = E / h / V f 7 l I Copy t -Mail to Court Administrator at completion of service ^ Abom 8c Kutulakis 36 South Hanover Street Carlisle, PA 17013 Court Appointed Cumberland County Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Ph: (717) 249-0900 Fax: (717) 249-3344 Federal I.D. 25-1877844 OCT 13 2008 Sep 30, 2008 FILE #: 08-245 INVOICE #: 25958 Attention: RE: Guardianship Hearing re: Emma Wentzel Toth DATE DESCRIPTION Aug-14-08 Call from George Douglas, Esquire Review of file and statute Call to George Douglas, Esquire Travel to Carlisle Regional Medical Center Visit client's residence to check condition of structure and fitness Hearing on Petition of emergency guardian Call from client's daughter Aug-21-08 Call from MelLine re: E Toth finances Aug-28-08 Call to Attorney Douglas Sep-02-08 Check condition of clients home, visit client at hospital Sep-03-08 Attendance at Court Hearing on final guardianship Sep-09-08 Review incoming Order re: guardianship Totals HOURS AMOUNT LAWYER 0.10 4.50 WM 0.40 18.00 WM 0.10 4.50 WM 0.60 27.00 WM 0.20 9.00 WM 0.50 27.50 WM 0.10 4.50 WM 0.20 9.00 WM 0.10 4.50 WM 0.70 31.50 WM 0.60 33.00 WM 0.10 4.50 WM 3.70 x Q,~;~ :=~ / ~ G . S'~ NS/t+~. Total Fees, Disbursements $~~0 /L ~ • ~ Retainer Applied $0.00 Retainer Remaining $0.00 Previous Balance $0.00 Previous Payments $0.00 Interest Paid Since Previous Invoice $0.00 Interest Due $0.00 Balance Due Nov x:50 ~ GG •~ t ENTZEL TOTH IN THE COURT OFOUN MMPENN YLVANIA IN RE. EMMA C. W :CUMBERLAND C 21-2003-413 ORPHANS' COURT ORDER OF COURT this ~~~/~-- day of September, 2008, following a hearing, AND NOW, lenary hat Emma C. Wentzel Toth is an incapacitated person in need of a p and finding t f her erson and plenary guardian of her estate, IT IS ORDERED: guardian o P ointed 1 Emma K. Weitzel, the daughter of Emma C. Wentzel Toth, is app () lenary guardian of the lenary guardian of the person of Emma C. Wentzel Toth and p P estate of Emma C. Wentzel Toth. (2) No bond is required. Weitzel shall comply with the reporting requirements set forth in 20 (3) Emma K. Pa.C.S. Section 5521(c). ~~ ~,, , By the Court, ~` Edgar t~. r~ay~Cy, ,,. George F. Douglas, III, Esquire For Petitioner Wayne Melnick, Esquire Court-appointed for Emma C. Wentzel Toth :sal w = ~~ N . r -, m 3 = i t ` .~ '' ~ l In Re: EMMA C WENTZEL TOTH ORPHANS' COURT DIVISION • COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-03-0413 ORDER DATE: JUDGE'S INITIALS: TIME STAMP DATE: IN RE: CERTIFICATE OF SERVICE OF ORi)ER SERVICE TO: GEORGE F DnT ir;r e c ""' " • • ~ • ~ ~ ~ ~ ~ • ~ ~ ~ "„ METHOD OF MAILING ® USPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: 9/4/08 ENVELOPES PROVIDED BY: ® PETITIONER ^ JUDGE ^ CLERK OF ORPHANS COURT SERVICE ,,,,,,,,,,,,,,,,,,,,,,,,,,, TO: WAYNE MEI,Niru ...................... METHOD OF MAILING ® USPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: 9/4/08 ENVELOPES PROVIDED BY: ^ PETITIONER ® JUDGE ^ CLERK OF ORPHANS COURT Deputy Clerk of Orphans' Court F:\FILES\Clients\13571 Weitzel\13571.2\13571.2.petl.wpd No V. Otto III, Esquire ~ Seth T. Mosebey, Esquire ",:~ :-~ rT , ' ~ --~ LD. No. 203046 ~ _,. r~, -- ~ ~ --; MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER . ~.~ = . ... `" ~" r ~' `° =~~ ' ' - -' MARTSON LAW OFFICES ~ ~ -. --, V ~ `= ~ ~ '=~i,::~ 10 East Hi h Street g , ~ `.~~' ~; Carlisle, PA 17013 --~ ~ .~ ~~::~~ ~-~ ~ (717) 243-3341 ~ IN RE: EMMA C. WENTZEL TOTH, : IN THE COURT OF COMMON PLEAS OF AN INCAPACITATED PERSON :CUMBERLAND COUNTY, PENNSYLVANIA N0.21-2003-0413 ORPHANS' COURT DIVISION PETITION PURSUANT TO 20 P.S. § 5536 FOR AUTHORITY TO MAKE GIFTS AND TO ADOPT AN ESTATE PLAN ON BEHALF OF EMMA C. WENTZEL TOTH AND NOW, comes Emma K. Weitzel, plenary guardian of the person and estate of Emma C. Wentzel Toth, by and through her attorneys, MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER, and hereby petitions the Court pursuant to 20 P.S. § 5536 for the authority to make gifts and to adopt an estate plan on behalf of Emma C. Wentzel Toth as follows: 1. Emma K. Weitzel ("Petitioner") is an adult individual residing at 67 Greenfield Drive, Carlisle, Cumberland County, Pennsylvania. 2. Emma C. Wentzel Toth, age 97, is an adult individual currently residing at Sarah A. Todd Memorial Home, 1000 West South Street, Carlisle, PA. 3. Petitioner is the daughter of Emma C. Wentzel Toth. 4. On August 15, 2008, Petitioner filed a Petition for the Appointment of Permanent Plenary Guardian of the Person and Estate in Accordance with 20 P.S. § 5511. 5. On September 3, 2008, Judge Bayley issued an Order of Court appointing Petitioner plenary guardian of the person and estate of Emma C. Wentzel Toth. 6. Emma C. Wentzel Toth has not executed a Will or otherwise adopted an estate plan. 7. Petitioner is the only child of Emma C. Wentzel Toth. 8. Emma C. Wentzel Toth has no surviving spouse. 9. If Emma C. Wentzel Toth died intestate, Petitioner would be the sole heir to her mother's estate. 10. The Pennsylvania Estates and Fiduciaries Code, 20 Pa. C. S. A. Section 5536, provides authority to Petitioner to make gifts and to adopt an estate plan on behalf of Emma C. Wentzel Toth. 11. Under Section 5536, Petitioner must give notice of this Petition to "all parties in interest." 12. Because Petitioner is the sole heir to her mother's estate, she is the only individual who is entitled to notice of this Petition. 13. As set forth in Petitioner's Annual Report of the Guardian of the Estate through September 30, 2009, and the Guardian's Inventory, filed contemporaneously with this Petition, and attached hereto as Exhibits "A" and "B" respectively, Emma C. Wentzel Toth `s estate consists of approximately $1,860,000.00, of which approximately $1,800,000 consists of cash and securities. 14. As set forth in Exhibit "A", Emma C. Wentzel Toth's annual income is approximately $47,500.00 and her annual expenses are approximately $110,000.00. 15. Petitioner, as Guardian, seeks the authority to make annual gifts on behalf of Emma C. Wentzel Toth to herself as the said Emma C. Wentzel Toth's sole heir, in an amount not to exceed the annual Federal gift tax exclusion, currently $13,000.00. 16. Petitioner, as Guardian, seeks authority to make an inter vivos gift on behalf of Emma C. Wentzel Toth to herself as the said Emma C. Wentzel Toth's sole heir, in an amount not to exceed the lifetime Federal gift tax exclusion, currently $1,000,000.00. 17. After the foregoing gifts would be made, the said Emma C. Wentzel Toth's estate would amount to some $800,000.00. Her annual income would be approximately $32,000.00 and her annual expenses would be approximately $102,500.00. Accordingly, if inter vivos gifts are made as set forth herein, Emma C. Wentzel Toth will have sufficient funds to pay for her continuing care throughout her lifetime. 18. Petitioner, as guardian, seeks permission to create an inter vivos trust on behalf of Emma C. Wentzel Toth with the assets remaining after the foregoing gifts. 19. Throughout her lifetime, Ms. Toth has made donations to the following charities: Lincoln Fellowship at Gettysburg College, Dickinson College, Wilson College, the United States Olympic Committee, the ASPCA, American Cancer Society, United Way, the Carlisle Chapter of the American Red Cross and Todd Baird Lindsay Foundation. 20. The proposed inter vivos trust would have the following characteristics: a. Emma C. Wentzel Toth would be the sole lifetime beneficiary of income from the proposed trust; b. Petitioner would be the Trustee; c. George F. Douglas III, Esquire, would be the successor Trustee; d. The Trustee would have the authority to invade the principal of the trust for the health, maintenance and support of Emma C. Wentzel Toth; e. If Petitioner survives Emma C. Wentzel Toth, then the residue of the trust would be distributed to Petitioner; and e. If Petitioner predeceases Emma C. Wentzel Toth, then upon Emma C. Wentzel Toth's death, the residue of the trust would be distributed in equal shares to the charities identified in Paragraph 19. 21. All interested parties have joined in this Petition. WHEREFORE, Petitioner requests that this Court grant her the authority to make gifts within the amounts set forth herein and to adopt an estate plan as set forth herein, which is consistent with her mother's lifetime pattern of giving. Respectfully submitted, Date::Z /9 /U MARTSON LAW OFFICES By:~~ll'~~~_ No V. Otto III, Esquire I.D. No. 27763 Seth T. Mosebey, Esquire I.D. No. 203046 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Petitioner ANNUAL REPORT OF GUARDIAN OF THE ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of EMMA C. WENTZEL-TOTH No. 21-03-0413 an Incapacitated Person I. INTRODUCTION EMMA K. WEITZEL was appointed Plenary ~ Limited Guardian of the Estate by Decree of EDGAR B. BAYLEY ~ J dated September 3, 2008 A. This is the Annual Report for the period from September 3 2008 to _ September 30 ' 2009 (the "Report Period"); or B. This is the Final Report for the period from to for the following reason: (the "Report Period"), and is filed 1. The death of the Incapacitated Person. Date of death: Name of Personal Representative: 2. The Guardianship was terminated by the Court by Decree of J., dated Form G-OZ rev. 10.13.06 Page 1 of 5 Estate of EMMA C. WENTZEL-TOTH II. SUMMARY A. State the value of the estate reported on the Inventory B. State the value(s) of principal assets at the beginning of the Report Period. (Same as Inventory if first Report, otherwise, ending balance from last Report.) C. What is the total amount of income earned during the Report Period? An Incapacitated Person $ 1,870,837.00 $ 1,870,837.00 $ 47,500.00 D. What is the total amount of income and principal spent for all purposes during the Report Period? $ 152,250.00 E. What are the balances remaining at the end of the Report Period? 1. Principal $ 1,855,944.00 2. Income $ 4,600.00 3. Total of Principal and Income $ 1,860,544.00 III. ADDITIONAL INFORMATION (If more space is needed, please attach additional pages.) A. Principal 1. How is the principal balance listed above currently invested? (Please specify, e.g., real estate, certificates of deposit, restricted bank accounts, etc.): 2. Have there been any expenditures from the principal during the Report Period? ............. ............. ~ Yes ~ No If yes: a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? ....... ~ Yes ~ No Furm G-01 rev. 10.13.06 Page 2 of 5 Estate of EMMA C. WENTZEL-TOTH An Incapacitated Person b. List purpose and amount of expenditures: Utilities, repairs & maintenance to former residenc ~ 6,407.00 Bank charges, stock fees, postage, misc admin. $ 5,213.00 Storage $ 652.00 [see attached) c. Was Court approval received prior to expending the principal? ................ ....... ~ Yes ~ No 3. Were additional principal assets received during the Report Period which were not included in the Inventory or a prior Report filed for the Estate? .... ....... ®Yes ®No If yes: a. Was Court approval requested prior to receiving the additional principal? ......... ....... ~ Yes (~ No b. State the sources and amounts of the additional principal received: Stocks/funds $ 91,906.00 B. Income 1. State sources and amounts of income received during the Report Period (e.g., Social Security, pension, rents, etc.): Social Security $ 4,000.00 Wentzel Trust $ 15,320.00 Interest $ 13,000.00 Dividends $ ~ 15,150.00 Total income received during Report Period: $ 47,500.00 Form c-oz rev. 10.J3.06 Page 3 of 5 F:\FILES\Clienu\13571 Weitzel\13571.2\13571.2.report.est.09.add ATTACHMENT TO ~-NNUAL REPORT OF GUARDIAN OF ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of Emma C. Wentzel Toth, an Incapacitated Person N0.21-03-0413 III. ADDITIONAL INFORMATION A. Principal 2• b. List purpose and amount of expenditures: Attorney/tax prep fees Real estate tax survey fee for MacClays Mills Income tax Medical expenses Nursing Home Gifts/donations 809.00 1,540.00 15,194.00 2,844.00 91,947.00 27,645.00 Estate of EMMA C. WENTZEL-TOTH 2. How is income currently invested? (Please specify, e.g., restricted bank accounts, client care account, etc.): An Incapacitated Person Restricted bank accounts, certificates of deposit, stocks and mutual funds C. Expenses for Care and Maintenance Specify what expenditures were made from the principal and income for the care and maintenance of the Incapacitated Person (e.g., clothing, nursing home, medicine, support, etc.): Clothing - $40 Nursing Home - $92000 Medical expenses - $2900 D. Other Expenditures Specify what other expenditures were made during the Report Period. (Do not include any items stated in response to question C above.) See Item III, A, 2, b. E. Guardian's Commissions List amounts of compensation paid as Guardian's commission and state how amount was determined: Amount Method of Determination Court Approval Obtained None [,~, Yes ~ No Yes ~ No Form G-OZ rev. 10.13.06 Page 4 of 5 Estate of EMMA C. WENTZEL-TOTH An Incapacitated Person F. Counsel Fee List amounts paid as counsel fee, and indicate whether Court approval was obtained. Amount Court Approval Obtained 655.00 ~ yeS ~ No Yes ~ No I verify that the foregoing information is correct to the best of my knowledge, information and belief; and that this Verification is subject to the penalties of 18 Pa.C.S. § 4904 relative to unsworn falsification to authorities_ ~~~9/jam Date Form G-OZ rev. 10.13.06 Q Signature of Guardian of the state Emma K. Weitzel Name of Guardian of the Estate (type or print) 67 Greenfield Drive Address Carlisle, PA 17015 City, State, Zip 717-249-4466 Telephone Page 5 of 5 GUARDIAN'S INVENTORY COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of EMMA C. WENTZEL-TOTH ~ an Incapacitated Person ' ~ ~ a Minor No. 21-03-0413 1. Real Estate: (Location, by whom occupied and rental Estimated Value: terms, if applicable) MacClays Mills, Franklin County, PA, two undeveloped lots 40,000.00 Sub-Total for Real Estate: 40,000.00 2. Personal Property: VW Camper Estimated Value: Orrstown Checking account 2,000.00 Ameritrade account 11,837.00 Beistle stock 700,000.00 Various Stocks AT&T, ( Axceles, Comcast, Daimler, EDS, Eaton, Encana GM 650,000.00 , , Goodyear, Marathon Oil, Pfizer, Qwest, USSteel, Union Pacific, Verizon) Mutual Funds (Alliance, Nuveen, Putnam, Riversource) 229,000.00 238,000.00 3. Jointly Held Property: (Set forth real and personal property owned by the Incapacitated Person JOINTLY with any other person(s). State whether held as tenants b the e ti i Estimated Value: y n ret es; if not, whether the right of survivorship exists.) Jointly Held Property None 0.00 Form G-04 rev. 10.13.06 Page 1 of 2 Estate of EMMA C. WENTZEL-TOTH 4. Anticipated Assets: (Set forth property of any ki»d expected to be acquired hereafter, together with a»ticrpated date of acquisitio».) Property Anticipated Date ojAcquisition Sub-Total for Personal Estate: (Attach additional sheets if necessary) TOTAL OF ITEMS 1, 2, 3, and 4:........ . Commonwealth of Pennsylvania ss. County of Cumberland Emma K. Weitzel ll~ an Incapacitated Person I~ a Minor Estimated Value: 1,830,837.00 ................... 1,870,837.00 says that the foregoing is a full, Guardian true and complete Inventory of the Estate of EMMA C. WENTZEL-TOTH the aforesaid Incapacitated Person or Minor; and that all of the information set forth herein is true and correct to the best of the Guardian's knowledge and belief. I verify that the statements made in this ) Inventory are true and correct. I under- ) stand that false statements herein are ) made subject to the penalties of ) 18 Pa.C.S. § 4904 relating to unsworn ) falsification to authorities. ) ~~~ Guardian Attorney for Guardian: No V. Otto III Supreme Court I.D. No.: 27763 Address: Martson Deardorff Williams Otto Gilroy & Faller 10 East High Street, Carlisle, PA 17013 Telephone: (717) 243-3341 Form G-04 rev. 10.13.06 Page 2 of 2 VERIFICATION The foregoing Petition is based upon information which has been gathered by my counsel in the preparation of the lawsuit. The language of the document is that of counsel and not my own. I have read the document and to the extent that it is based upon information which I have given to my counsel, it is true and correct to the best of my knowledge, information and belief. To the extent that the content of the document is that of counsel, I have relied upon counsel in making this verification. This statement and verification are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities, which provides that if I make knowingly false averments, I may be subject to criminal penalties. Emma K. Weitzel CERTIFICATE OF SERVICE I, Mary M. Price, an authorized agent for Martson Deardorff Williams Otto Gilroy & Faller, hereby certify that a copy of the foregoing Petition was served this date by depositing same in the Post Office at Carlisle, PA, first class mail, postage prepaid, addressed as follows: George F. Douglas, III, Esquire SALZMANN HUGHES 354 Alexander Spring Road, Suite 1 Carlisle, PA 17015 MARTSON LAW OFFICES By: t r M ry .Price Ten st High Street Carlisle, PA 17013 (717) 243-3341 Dated: ~ ~ ~ ~~ M F:\FILES\Clients\13571 Weitzel\13571.2\13571.2.joinderl.wpd/ Created: 9/20/04 0:06PM Revised: 2/9/10 9:22AM No V. Otto III, Esquire I.D. No. 27763 Seth T. Mosebey, Esquire I.D. No. 203046 MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES 10 East High Street Carlisle, PA 17013 (717) 243-3341 IN RE: EMMA C. WENTZEL TOTH, : IN THE COURT OF COMMON PL~aS Ur AN INCAPACITATED PERSON :CUMBERLAND COUNTY, PENNSYLVANIA No. ~!- ~,vo3- o ~!3 ORPHANS' COURT DIVISION JOINDER I, George F. Douglas, III, Esquire, as the proposed successor Trustee of the inter vivos trust sought to be created on behalf of Emma C. Wentzel Toth, hereby join in the Petition Pursuant to 20 P.S. § 5536 for Authority to Make Gifts and to Adopt an Estate Plan on Behalf of Emma C. Wentzel Toth, and hereby state that the information set forth therein is true and correct to the best of my knowledge, information, and belief, and request that this Court grant the Petitioner, Emma K. Weitzel, the authority to make gifts and to adopt an estate plan on behalf of Emma C. Wentzel Toth which is consistent with the above-referenced Petition. ..d- III Douglas eorge F , . ~ w ~ ~ , 1 ., F~~ ~ ~.~ '> z~~ "" co ~~~ a ~ J f J ~ "'. " W '~ ....! _ -, r .!~~ ~7 +~ ~ t _i.. ~ ;, L ~ ~ " N 1 ~ (-T rJ ,~ ~ .. .• ~Y~ ' 1 W ~w ~~ COMMONWEALTH OF PENNSYLVANIA ) ): ss. courr~ of ~ ~,~,rvl, lat,/ l apt ~- > On this, the ~ ~~day of ~ ~j ~(rCG,!''~ 2010, before me, the undersigned officer, personally a eared Geor e F. Dou las, III, Es wire, known to me (or satisfactorily proven) to be the person pP g g q whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. (~ SEAL) Notary Public COMAgONWEALTH OF PENNSYLVANIA Notarial Seal South ~L CToyle, Notary Public wp., Cumberland County ~ Commission Expires July 6, 2010 Momber, Pennsylvania Association of Notaries FEB 19 2010 ~, IN RE: EMMA C. WENTZEL TOTH, : IN THE COURT OF COMMON PLEAS OF AN INCAPACITATED PERSON :CUMBERLAND COUNTY, PENNSYLVANIA N0.21-2003-0413 ORPHANS' COURT DIVISION DECREE AND NOW, this ~ 2''day of ~.~,v~„R,., , 2010, upon consideration of the foregoing Petition Pursuant to 20 Pa.C. S. A. § 5536 for Authority to Make Gifts and to Adopt an Estate Plan on Behalf of Emma C. Wentzel Toth, it is hereby DECREED that the Petitioner, Emma K. Weitzel, guardian of Emma C. Wentzel Toth, is granted the authority to make gifts and to adopt an estate plan on behalf of Emma C. Wentzel Toth which is consistent with the foregoing Petition. BY THE COURT: n o a ~~ ~ `,~_~ ~ ~,-~~m N ~" /~ ~ N ~~~ ~ ~~~ ~~ ~ N 7b N O r ~-' ,+ V c`i? :-:~ r z- -;..} ~ ~ -~ e-j =` :i7 { In Re: EMMA C WENTZEL TOTH NO.21-03-0413 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF SERVICE OF ORDER ORDER DATE: 02-22-10 JUDGE'S INITIALS: TIME STAMP DATE: 2-22-10 IN RE: DECREE SERVICE TO: SETH T MOSEBEY METHOD OF MAILING: ® USPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: 2-22- I O SERVICE TO: ENVELOPES PROVIDED BY: ® PETITIONER ^ JUDGE ^ CLERK OF ORPHANS COURT METHOD OF MAILING: ^ USPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: ENVELOPES PROVIDED BY: ^ PETITIONER ^ JUDGE ^ CLERK OF ORPHANS COURT - ~ t .~~~ Deputy Clerk of Orphans' Court r~ _: _~ ANNUAL REPORT OF ~ ~ ~ ~-~'~ `~~=~~ GUARDIAN OF THE ESTATE ~~ ~ ~ ~ ~ ~~ ~' , , , :~ T^~ ..~ ~,. ~ ~~., ~ _. COURT OF COMMON PLEAS OF _ } ;~ r` CUMBERLAND COUNTY, PENNSYLVANIA - --r~, --`~ N <~~'] ORPHANS' COURT DIVISION ~'/~ t Estate of EMMA C. WENTZEL-TOTH No. 21-03-0413 an Incapacitated Person I. INTRODUCTION EMMA K. WEITZEL ,was appointed Plenary ~ Limited Guardian of the Estate by Decree of EDGAR B. BAYLEY ~ J dated September 3, 2008 A. This is the Annual Report for the period from September 3 2008 to September 30 2009 (the "Report Period"); or B. This is the Final Report for the period from , to (the "Report Period"), and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: Name of Personal Representative: 2. The Guardianship was terminated by the Court by Decree of Form G-02 rev. 10.13.06 J., dated Page 1 of 5 "`/ ~ Estate of EMMA C. WENTZEL-TOTH , An Incapacitated Person II. SUMMARY A. State the value of the estate reported on the Inventory B. State the value(s) of principal assets at the beginning of the Report Period. (Same as Inventory if first Report, otherwise, ending balance from last Report.) C. What is the total amount of income earned during the Report Period? D. What is the total amount of income and principal spent for all purposes during the Report Period? E. What are the balances remaining at the end of the Report Period? 1. Principal $ 1,855,944.00 2. Income $ 4,600.00 3. Total of Principal and Income III. ADDITIONAL INFORMATION (If more space is needed, please attach additional pages.) A. Principal 1. How is the principal balance listed above currently invested? (Please specify, e.g., real estate, certificates of deposit, restricted bank accounts, etc.): $ 1,870,837.00 $ 1,870,837.00 $ 47,500.00 $ 152,250.00 $ 1,860,544.00 2. Have there been any expenditures from the principal during the Report Period? ............................ ~ Yes ~ No If yes: a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? ........ ~ Yes ~ No Form G-02 rev. 10.13.06 Page 2 of 5 Estate of EMMA C. WENTZEL-TOTH , An Incapacitated Person b. List purpose and amount of expenditures: Utilities, repairs & maintenance to former residenc $ 6,407.00 Bank charges, stock fees, postage, misc admin. $ 5,213.00 Storage $ 652.00 [see attached] ~ c. Was Court approval received prior to expending the principal? ............... ........ ~ Yes No 3. Were additional principal assets received during the Report Period which were not included in the Inventory or a prior Report filed for the Estate? ... ........ m Yes ~ No If yes: a. Was Court approval requested prior to receiving the additional principal? ........ ........ ~ Yes ~ No b. State the sources and amounts of the additional principal received: Stocks/funds $ 91,906.00 B. Income 1. State sources and amounts of income received during the Report Period (e.g., Social Security, pension, rents, etc.): Social Security $ 4,000.00 Wentzel Trust $ 15,320.00 Interest $ 13,000.00 Dividends $ 15,180.00 Total income received during Report Period: $ 47,500.00 Form G-OZ rev. 10.13.06 Page 3 of 5 F:\FILES\Clienu\13571 Weitzel\13571.2\13571.2.report.est.09.add ATTACHMENT TO ANNUAL REPORT OF GUARDIAN OF ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of Emma C. Wentzel Toth, an Incapacitated Person N0.21-03-0413 III ADDITIONAL INFORMATION A. Principal 2. b. List purpose and amount of expenditures: Attorney/tax prep fees Real estate tax/survey fee for MacClays Mills Income tax Medical expenses Nursing Home Gifts/donations 809.00 1,540.00 15,194.00 2,844.00 91,947.00 27,645.00 Estate of EMMA C. WENTZEL-TOTH , An Incapacitated Person 2. How is income currently invested? (Please specify, e.g., restricted bank accounts, client care account, etc.): Restricted bank accounts, certificates of deposit, stocks and mutual funds C. Expenses for Care and Maintenance Specify what expenditures were made from the principal and income for the care and maintenance of the Incapacitated Person (e.g., clothing, nursing home, medicine, support, etc.): Clothing - $40 Nursing Home - $92000 Medical expenses - $2900 D. Other Expenditures Specify what other expenditures were made during the Report Period. (Do not include any items stated in response to question C above.) See Item III, A, 2, b. E. Guardian's Commissions List amounts of compensation paid as Guardian's commission and state how amount was determined: Amount Method of Determination None Court Approval Obtained Yes ~ No Yes ~ No Form G-02 rev. 10.13.06 Page 4 of 5 Estate of EMMA C. WENTZEL-TOTH An Incapacitated Person F. Counsel Fee List amounts paid as counsel fee, and indicate whether Court approval was obtained. Amount Court Approval Obtained 655.00 ~ Yes ~ No Yes ~ No I verify that the foregoing information is correct to the best of my knowledge, information and belief; and that this Verification is subject to the penalties of 18 Pa.C.S. § 4904 relative to unsworn falsification to authorities. Date Signature of Guardian of the state Emma K. Weitzel Name of Guardian of the Estate (type or print) 67 Greenfield Drive Address Carlisle, PA 17015 City, State, Zip 717-249-4466 Telephone Form G-02 rev. 10.13.06 Page 5 of 5 ANNUAL REPORT OF GUARDIAN OF THE PERSON c? `~ ::-~ COURT OF COMMON PLEAS OF 11..~ VII ~ r~ -~ ~ ~ cw A Y ~ ~ ./ . ~ ~ CUMBERLAND COUNTY PENNSYLVANIA "~' =~'''~ ~ '~` ` • ~ -- ~ t ~ ~ ' '- -' ` -~ ~ ~ ~ , ORPHANS' COURT DIVISION ; r _'_ 4.1rJ j~ -' ~°~ ~~:~~ v ~ : ~: `-~ ` -' . , ~" ~ f N Estate of EMMA C. WENTZEL-TnTu an Incapacitated Person No. 21-03-0413 I. INTRODUCTION Emma K. Weitzel was appointed Plenary Limited Guardian of the Person by Decree of Edgar B. Bayley dated September 3, 2008 ~ J•' A. This is the Annual Report for the period from September 3 2008 to September 30 2009 ' (the "Report Period"); or Q B. This is the Final Report for the period from to (the "Report Period"), and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: 2. The Guardianship was terminated by the Court by Decree of For a Final Report, omit Sections II through IV. Form G-03 rev. 10.13.06 J., dated Page 1 of 4 J yJ Estate of EMMA C. WENTZEL-TOTH II. PERSONAL DATA an Incapacitated Person Age of the Incapacitated Person: 97 Date of Birth: 2/19/1912 III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: Sarah A. Todd Memorial Home 1000 West South Street Carlisle, PA 17013 B. The Incapacitated Person's residence is: own home /apartment nursing home boarding home /personal care home Guardian's home /apartment Q hospital or medical facility relative's home (name, relationship and address) Q other: C. The Incapacitated Person has been in the present residence since August 14, 2008 If the Incapacitated Person has moved within the past year, state prior residence and reason(s) for move: Form G-03 rev. 10.13.06 Page 2 of 4 J Estate of EMMA C. WENTZEL-TOTH an Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: E. K. Weitzel 67 Greenfield Drive Carlisle, PA 17015 IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: Senile dementia (Alzheimer's) B. Specify what, if any, social, medical, psychological and support services the Incapacitated Person is receiving: Regular visits from primary care physician Additional services provided by nursing home V. GUARDIAN'S OPINION A. It is the opinion of the Guardian of the Person that the guardianship should: continue be modified be terminated Form G-03 rev. 10.13.06 Page 3 of 4 Estate of EMMA C• WENTZEL-TOTH an Incapacitated Person The reasons for the foregoing opinion are: The incapacitated person continues to suffer from senile dementia (Alzheimer's). B. During the past year, the Guardian of the Person has visited the Incapacitated Person 2 0 0 times with the average visit lasting - - hours 4 5 minutes. The report of a social service organization employed by the Guardian to oversee and coordinate the care of the Incapacitated Person for the period covered by this Report ma be attached to supplement this Report. y I verify that the foregoing information is correct to the best of my knowledge, information and belief; and that this Verification is subject to the penalties of 18 Pa. C.S.A. 49 relative to unsworn falsification to authorities. § 04 1./J'/~o Date Form G-03 rev. 10.13.06 Signature of Guardian of the Person Emma K. Weitzel Name of Guardian of the Person (type or print) 67 Greenfield Drive Address Carlisle, PA 17015 City, State, Zip 717-249-4466 Telephone Page 4 of 4 ~ GUARDIAN'S INVENTORY COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of EMMA C. WENTZEL-TOTH an Incapacitated P~e,~son ~ ' ~ a Min ° ~ 21-03-0413 No _ ~ .. ~"`~ -~ ='` ` ~4~ - . ~, i.7 ~-. :... _ ~ ~"r:.~~ (~~ fE 1. Real Estate: (Location, by whom occupied and rental r"~-1`-~~i Estim~i ValueN terms, if applicable) ~ ~ ,~. t°,~~ ;;~, MacClays Mills, Franklin County, PA, two undeveloped lots 40,000.00 Sub-Total for Real Estate: 40,000.00 2. Personal Property: Estimated Value: VW Camper Orrstown Checking account 2,000.00 Ameritrade account 11,837.00 Beistle stock 700,000.00 Various Stocks (AT&T, Axceles, Comcast, Daimler, EDS, Eaton, Encana, GM, 650,000.00 Goodyear, Marathon Oil, Pfizer, Qwest, USSteel, Union Pacific, Verizon) 229,000.00 Mutual Funds (Alliance, Nuveen, Putnam, Riversource) 238,000.00 3. Jointly Held Property: Estimated Value: (Set forth real and personal property owned by the Incapacitated Person JOINTLY with any other person(s). State whether held as tenants by the entireties; if not, whether the right of survivorship exists.) Jointly Held Property None 0.00 Form G-04 rev. 10.13.06 Page 1 of 2 Estate of EMMA C. WENTZEL-TOTH 11~,~an Incapacitated Person ' I~ a Minor 4. Anticipated Assets: (Set forth property of any kind expected to be acquired hereafter, together with anticipated date of acquisition.) Property Anticipated Date of Acquisition Sub-Total for Personal Estate: (Attach additional sheets if necessary) Estimated Value: 1,830,837.00 TOTAL OF ITEMS 1, 2, 3, and 4: ............................. 1,870,837.00 Commonwealth of Pennsylvania ss. County of Cumberland Emma K. Weitzel says that the foregoing is a full, Guardian true and complete Inventory of the Estate of EMMA C. WENTZEL-TOTH the aforesaid Incapacitated Person or Minor; and that all of the information set forth herein is true and correct to the best of the Guardian's knowledge and belief. I verify that the statements made in this ) Inventory are true and correct. I under- ) stand that false statements herein are ) made subject to the penalties of ) 18 Pa.C.S. § 4904 relating to unsworn ) falsification to authorities. ) ~~~ Guardian Attorney for Guardian: No V. Otto III Supreme Court I.D. No.: 27763 Address: Manson Deardorff Williams Otto Gilroy & Faller 10 East High Street, Carlisle, PA 17013 Telephone: (717) 243-3341 Form G-04 rev. 10.13.06 Page 2 of 2 ANNUAL REPORT OF GUARDIAN OF THE ESTATE t'f=j~~ C'1 ~~J "i G~~ ~- ._ CO[ `R'T OF CO'~1MON PLEAS OI' ~ ~'_ m r Cumberland CO[:'~TY. PE~`NSYEVAN[A ~.-~~~ - ORPH~~~NS' COI:RT DIVISIOti `-;~~~~, ~ -~-{ ~ ~ ~_.. ..T~ L!~ ~'~ - .~ !state o1` Emma C. Wentzel-Toth an (ne<~p.~citated Pcr-son r. ~wT~zo~ucTlow E:mr1~a K. ~~'eitrel . ~~as appointed ©P~enar-~ ^ 1_imited Guardian of the E-atate b~ [~r~cree ot~ Edgar B. Bay~ley~ . J dazed Sept . ?{}{) ^ .~. I~his is the Annual Report f-or the period from Sept 3 __-~_, ?C}(}~) to Sept 30 _ 2010 (the "Report Period' t: rtr ^ E3.This is the Final Report for the period fi-om _____ tta _ _ _ (.the "Report Period"). ar~ui is tiled f~n~ the follo~~~in~~ reason: i . "The death of the Incaaacitated Person. Date of deati~. '~iamc of Personal Representative: 2. The Guardianship e~~as terminated by the Court b~~ Decree cif J., dated f state of Emma C Wentzel-Toth I I. St_ !~I11AE2Y ~. State the value of the estate reported on the [nventor~ f3. State the value(s) of principal assets at the beginning of~ the Report Period. (Same as Inventory if~ first Report. otheriyise. ending balance from last Report.) C. ~~'hat is the total amount of income earned during the Report Period? D. ~'v~hat is the total amount of income and principal spent for al! purposes duri~~g the Report E'eriod:' F.. ~~hat are the balances remainin<~ at the end of the Report Period`' 1. Principal $ 995,616.00 ~, Income $ ! x,050.00 .. -Total of Principal and Income III. ADDITIONAL INFORMATION (Ifnn~a•c ~sjurce is nec~lec~~, ~~leu.ti~e utmch u~~ditiorurl pune.S~,J A. Principal An Inrap~i_;tated Person $ 1,0I ~,66~.U0 S 1..01 ~.666.OC) 1. How is the principal balance listed above currently invested? (Please specify°. c.,~.. real estate, certiticates of deposit restricted bank accounts. etc. j: Restricted bank accounts. CD's. stocks, and muriial funds ?. Have there been any expenditures from the principal d~.u•in<~ the Report Period'? .......................... . . [~ Yes ^ Iti'~~ If yes: a. Have all expenditures fi-u~in the principal been fior the sole benefit ofthe incapacitated Person'? ........ ~ Yes ^'~~~ Pa~~e ? ~~~'; f ~t~:ltc of f~rn•,na C. V4'entzcl-Toth _ . ;1n Inc:apa~itatcd Perm n b. List purpose and amount of expenditures: F3k chg. postage. ,tod< fetes, storage, admin trey ~ 3,'E,.t)1 ~ttorne~ CPA fens 5~-- - ~.?~l.t)ti (;itts'Dimations Estate F'lannin<~ ~ ~._ i.1)i,.',>.r~ti Real Istatc Tax ~9cC'lav ~1i11~• land ~ ;-1?.Ut) c. Was Court approval received prior to expendin~~ the principal'? ....................... [~ Yes ^ 11.c, ~. titi'ere additional principal assets received durin~~ the Report Period tivhich were not included in the lnventory~ or a prior Report fined tier the Estate? ........... [~ 1`c~ ~ Nc~ 1 f yes: a. Was Cottrt approval requested prior to receivin~~ the additional principal`? ................ J l'cs '~~ \<~ b. State the sources and amounts of the additional principal reeeivcd: }3. I ncoine State sources and amounts of income received durin~~ the Report Period (c.<.;., Social Security pension, rents. etc.): Social Srcuritti~ tiyrntrel Trust. Interest [lip idrnds Total income received during Report Period `5 ` ,~', ,fit' S ' ~.i?Ofi.si(~ ., ..-Ft' rer_ ~ Pa`~~: .` Ut~ I~state oI~ Etx~ma C. VG'entzel-Toot ~'. Ho~~~ is income currently in~~ested`' (Please specifi. e.,~., restricted bank accui.tnts. client care account. etc.): An [ncaP~7.:itated Person Restricted banl: accounts, CD's_ stocks and mutual funds C'. Expenses for Care and IVlainte~nance Specifti~ ~4~hat expenditures ~~ere made from the principal and income for the care and maintenance of the Incapacitated Person (e.g.. clothing. nursing home. medicine. support. etc.): 1\tu~sin~~ dome - ~ 93030. i)r ~~ Rx- ~ 1926. Miscellaneous expenses- S 3ti?. D. Other Expenditures Specifi ~~-hat other expenditures ~~~ere made durir~« the Report Period. (Do not include an~~ items stated in response to clt~estion C aboti e.) See item III. ~~, ?, b. E. Guardian's Commissions List amounts of compensation paid as C~~.iardian's commission and state how amo~mt ~~~as determined: ( r;ti?'t .Intrurrtt _l-lethcxl ref Dete~r•ntitac~~`l~>rt 1,t?~~t~r>?•rrl Ohlufrtc~c/ (.ante of ~nu1~~~ C. ~~'entzel-Toth :1n lnctil},~~ iratcd 1'er~sc~~~ F. Counsel fee List amounts paid as counsel fee. and indir~~Lte ~ti~llether Court appro~~~~[ ~;~~ obtaini:Cl. ~otn~t .1xtrltlttl :~t~~~~rzr~ r,'tlTt~crinc~cd 1 vcri f~~ that the fore~oin~ information is correct to the best of rn~~ l.nord~led ~e. information and belief: and that this Verification is subject to the penalties of 1 R P:r.CS. ~ 4904 ~~ciaiive to uns~~orn falsification to authorities. ~ . ~ , ~~ ~~ ~ f C)ctobei b, ~O l .) ~~ - S, ~nciNna~ u! (~ucnrGorr ot71n° F+rur~ ~~~~ I~mma K. Weitzel \urur of C~trardiun olr.:+e I uu1~° rt o.' ~ ~- r ~~ C71'eetlfteld I~1' h1;G'ese -------J ~--- Carlisle, P~'~ 17015 <r,, s,~,r~ r,ia - - --~ X17-249-4466 r~,,;;>>,,,,r~ ~~ttachmcnt to ~~nnual Repoit of Guaidian of I;statc C;octrt of Common Plca~ of Cumbciland Count,-, Pcnn~~-h-ani:~ C)rphan~' Ccnirr lli~isu~t~ ~.~rate of F~anma C. A~entz~l-1~ot17, an Tnc.~tnacitatcd Per~o:i 11. ~ddirional li~ti>rmation 1. 1'rinci~rai ?. b. l.isr purp{~sc and amount of r-~p~t5,dirures: 1 r;a~mc ~l a~ `~ 1, i t ~.t)l) \ur;in~~ ficnnc }.~~I~ctt~,c:~ ti 9.i,t4i).(1() `~Icdical t~ ltd I;l~~cn~~•~ :~ 1,<1?G.()i) `,Ilsc~liancEnt~ I~~ptnc~ ~ iti-.~i1 FFB .j 9 X010 ~, IN RE: EMMA C. WENTZEL TOTH, AN INCAPACITATED PERSON IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO.21-2003-0413 ORPHANS' COURT DIVISION DECREE AND NOW, this Z Z day of~ , 2010, upon consideration of the foregoing Petition Pursuant to 20 Pa.C. S. A. § 5536 for Authority to Make Gifts and to Adopt an Estate Plan on Behalf of Emma C. Wentzel Toth, it is hereby DECREED that the Petitioner, Emma K. Weitzel, guardian of Emma C. Wentzel Toth, is granted the authority to make gifts and to adopt an estate plan on behalf of Emma C. Wentzel Toth which is consistent with the foregoing Petition. BY THE COURT: C7 a _ _~ ~ r-~ -,~ ~. : D r„~ ~ ~ ~ ~ _ :.j7 ~`~ _~ -- _ '.7 ' O l~ ~~1 J attachment to ,annual Report of Guardian of Estate Ccnut of Common Pleas of Cumbcdand Count-, Penns h-ania Orphans' Court 1~i~-ision Iatatc of 1~:mma C;. ~a'cntul-~1'ot}~, an Incaaacitatcd Perscm !~.sr;trc' 1'lannin~-r C,itt to Guardian, L.~nrna 1~. ~t~ettzel as per hO ?1-?~)(1~-O4t3 sia?l~-c? I ebruar~~ ~'=. ?i)~l to 1,~~,.~ {u~~l,rc~ ]~e~in _~. I-less upon consideration of the fore~oin~ hC'tlti(:)il Pursua~~t rv ?~) !'.A.t :.ti._1. '+ ~ 53~~ for ~luthoritti~ to '~Iakc (Fitts and to .ldopt an l~;state I'laii on l~c'~t:~lf ~,t l=.mn~a t ~~4enr-r_el-~I~~~th. ,'see copy- of document attached). Ucscriptivn of Items included in Gitt: ~t~~~1:s i.1~1~&~I, i~l'L Croup, Yumj S -(>,345.Gt1 `~l~~t~..al Funds ~ `'3G. 43.2f) licisrle Conlpan~, ~r~>ck S 3-li.fi-l-1.(ii! t ;~<:1i ~ 31,545.4 ~ccrucd [tlt~rest S ?,9~?5.4fi ANNUAL REPORT OF GUARDIAN OF THE PERSON COURT O1= COti~I;~9Oti PLEAS OI: Cumberland C'OI '~iT1`. PI ti':tiSYt.VANiA ORPF-TANS' COUF:7- DIVISION I atate of L:mma C. VVentzel-Toth Nt~ai -o -c~=~ I t. I~TR()DLCTION Emma K. Weitzel N C~~ __ y. __ (~~ ~,~ W .._ .~ ~ , ~ ~ ~~ r°'J ._F~ 3~ r.: ~_~r` l ~ ` z _ o • ~ c ~r an I!~c<II'_!i !fated Per~ea!1 `.t as appoir~tc,.I © Plenar~~ ^1_imited Guardian of the Person h~ Decree of Edgar J. Bayle~~ ~ _ . ,~ dated Sept ;. ?.008 Q -4. ~l-his is the Annual Report I~~r the period from Sept 3 - _~ _?i)~l`)-- t+~ Sept 30 2.010 (the "Report Pori<~d'~!: ~~r ^ I3. This is the Final Report for the period trolr~ c~? (the "Report Period ~ `,. a!~d is riled for the toilo4~~in~~ reason: I . The death of`the Incapacitated Person. Date of death: 2. The Guardianship ~~~as te!-rrinated b~ the Court h~ Decree ~! J.. dated Fo~• ri Fi~aal ReE~ort, omit Sec•tulns II tFtr~ors~;l~ I G; .,,,,, ~ _ ~ _ ~; ; r;>> }>~«~ ~ ~,t' ~ C-: !_~tate oi~ f;mma C. Wentzel-Toth . an Incap~~_itated Pers~,~~~~ 11. PERSONAL DATA 1t,~e ~7f`the Incapacitated Person.. ~~~ _ Date of Birth: ~~'' I `~ ' `~_~ 1[I. L.1~'I'tiG .aRRANGE!~~1EtiTS ~1. C?rrrent address of the [r~capacitated Person: ~arai~ A. Todd Memorial Eic>n3, l t)(}U Vl cst South Street B. t l1e Incapacitated Person's residence is; ^ o~~n home ~ apartment © riiu•sin« home ^ boardin~~ home ! personal care home ^ Guardian's home ,'" aparhnent ^ hospital or medical tiacilit~~ ^ relative's home (name. relationship and address) ^other: C. I~he Incapacitated Person has been in the present residence since '~rr`~3~st 1~~ -'~~~~ I#~the Incapacitated Person has moved t~ithin the past ~ear_ state prior residence and reason(sl for move: i~.ctate of Emm~~ C. Wentzel-Toth an ]ncaf~~a: hated Persc7i~ U. Name and address ofthe Incapacitated Persons prilnal-y car•e~~iver: I-.n~m<I K. 4Veitzet ~)~ ~7I'CE',ntleld I~I~1VE', Carlisle, PA 170 i 5 ~~'. ~1E:DICAL INFORMATIOti >>. ~fhe major medical or mental problems of the Incapacitated Persol: are as t~,11~3~,~~:: Se.~ile dementia (Alzheimer's] I3. Specify tivhat, ifany, social. medical. psycholo~~ica) and support sert~~es the Incapacitated Perron is receivin<~: Retrular visits from Primary Care Physician ~s needed nursing sere-ices as prop ided. b~° staff at rnu-sin`, home ~'. G[~,aRI)IA~i'S OPINION :~. It is the opinion of the Guardian of the Person that the,~ual'dianship should: ® continue ^ be modified ^ be terlliinated ~~,_, r; ._ ;~,-;~,~; Pa~re~iz~l~l [:Mate of f~m~i~a C. Wentzel-Toth The masons tot- the foregoing opinion are: an Ir~ca~aitated Ptr~c?±~ The medical diagnosis is senile dementia and nlzheimer's dise_tse. t3. Du~-in~~ t}le Past year. the Guardian ~,f the Pei°st,~? has ~ kited the lnttt~.:citated Pers~~z~, l ~ times with the aver-age visit lztstin~_ _ hours. `~ ._. n,intlt~~. r6x~ ~°c~~ort qfa social sert~iee oi;~>tryai~crtiun ,er~~~~Toi~c~c~ ht• the Guuy-diun to ~ ~~~e~~•s~c~c~ ur~c~ ~~~~ru-dirlate the car-r of the h~ca~~acitutec/ Pcrs«~7 fnr the ~terioc~ corere~l hr thi+~ fZ~ ~.r~~rt ~~1.,1~ he uttacheil ti, +~r~~~j~lenrcr~t this Rc~~nrt. 1 verife that the foregoing information is correct to the best of my kno~~ ierl~~e. inf~~rrnation and belief: and that this Verification is stihject to the Penalties of lk "a C' ~ ,~ ~ pct{~~~ relative to unsworn falsification to authorities. _ 1 C)ctober 8. 2010 ~'~~/~'i~ ~ ~ _ _ 'j, /; ~' ~' ~~ 1 1';!1'C' f)s f ~7 - il~i. ffl ()~ lit(' %~['1','~r tll L,n~ma K. Weitzel an« nF < ~~ ~ ~dinre r:1 t .'~°r'rr z ~,~ j,, , _ ~~ __~__ b7 Greenfield Drive Carlisle, P:1 1701 <~;r,~_ s,~,t~. z;,, 7 [ 7-249-466 . _ Cf>fl. +Fi~ GUARDIAN'S INVENTORY ~. ~ , .. ~ ,~ a ~o _-~,, ~~ ~:~ ~, COURT OF COMMON PLEAS OF Cutnberland COI ~ _~ iNTY, PE~:~I~~ANI?X~ ~, ORP~-CANS' COURT D[V1S[ON i m ~~ O0 ,,,;-~ ~ ' -~ ~ ~, a~ ; . } - ; . ~ ,.i.,t ~ _~ , - , , _ _ ,-=a -A l,C) ,.rc ~ ~ t~{1 ~11C;t~ltilte(~ ~l'f:~311 ~~~~ ~~ , , l~:state of Lmma C. Wentzel-Toti~ o . f~a Min~,i. No, ~ 1-03-O41 1. Real Estate: (Location, by whom occapierl and rental Estimated Value: terms, if applicable) ficC~la~, A'iills, 2 undc~~cloped lots, Franklin County- -iU,000.0~"? Sub-Total,for IZecrl Esfccte: __ -~ca.~~o~:~.0~_ 2. Personal Property: Estimated Value: 13ci;tlc Stock ~t~~.~)t)0.(~°;1 Orrsto~~ n Bank 12~.t)jO.OtJ furious Stocks (AT&T, Axcelis, Cenovus. Daimler. Satan, I:ncana, Comcast, I,~~,l?b.t)il _ Frontier ('omm, Goodyear, h-Iarathon Oil, Pfizer, Q~~~est. C'~nion Pacitic,L`S Steel Vcrizon) ?~4utual Funds I Putnam Equity and Vista) ?6,1!~~ I .OU - Cash in Bank Detiosit Program 99.01 ~i.lHi ~ ertificaics o1` Drt?o~it ! -~,;;q.O;t 3. Jointly Held Property: Estimated Value: ~~~c'! )r,/'!h l i'i Jt~:titd ~~e!'t t177(!~ j77'[lj>ert~' f)t1 Y7['cI hi' (h~' il7t'[1~1CIC t(Gt~'cJ I'L?".t'C;ll .~t.)~ ~ ~1, 1 11-77?7 [/!!l nl{ter h~~rs~>nts~. .Snrte u~heRrer held as l,~ruirus h_r lhr entiretn~v: i(~iro/. xFrether the right of a~ta rvrurshrn ,>.r!,ct~s. 7 Joirulr Helr! Property \onc hr~rni <i-(L! 3'u~r. !l~ l' I~8 hi1S!t ~ ~)t:..~ Emma C. Wentzel-Toth 1Qan Incapacitated Pcrsor, l state of - - f~a ~1ini~r. -t. anticipated Assets: n~~; /cr:~lr ~,~n~>erl1~ nJ an,r ki~uf e.r~ecle:! to he ~rcy~ured her u1t e .,;~E~h~r viN~ antic(~r,~te<t:t~u~ o/ucc{uisttion.l Properl„1~ .-i nJicipated Dale of ~Icr/uisition Estimated ti'alue: !:l~~cu°6r crcfc~i~iorxrisl7cets if~r7ecessat~t'~ TOTAL OF I'TEYIS 1, 2, 3, and -1. .............................. . Common~~ealtll of Penns~~lvania Cour~~t~~ of Cumberland Emma K. Weitzel Safi-Tofuf-for Persorucl Estate: ss. l .(i 1 ~.664.Of i . saes that the for~:~~>in~, is a tir?I. Guat~rG~trt n•ue and complete Inventor~~ oftlle Estate of Emma C. Wentzel-Toth the aforesaid Incapacitated Person or Minor; and that all of the information set firth herein is true and correct to the best of the Guardian's kno~~led<,~e avid belief. { ~erifv that the statements made in this ) fsnentor~~ are true and correct. 1 under- j stand that false statements herein are ) made subject tc~~ the penalties of ) S $ Pa.C'.S. ~ 404 relating to uns~vorn ) falsification to authorities. ) Attorneti~ ter Guar•dian~~ ~~~~~ ~~. ~,u~- Guardian ~~ Supreme Court 1.D. '`~o.: Address: Telephone: nra~C~ r).{ ri ~. i0. ~_d. ~at5 GUARDIAN'S INVENTORY COURT OF COMMON PLEAS OF Cumberland ORPHANS' COURT DIVISION COUNTY, PENNSYLVANIA 1 ®an Incapacitated Person Estate of Emma C. Wentzel-Toth ' I ^ a Minor 21-03-0413 No ,_ . C'7 c~a .- Q °~C~ i i T ~'* t rn - ~ m N ~1 1. Real Estate: (Location, by whom occupied and rcntal Estimah~'k-3 "ae: ~ `~ o terms, it applicable) nklin County F t l d l ~ ='~ - ra s, ope o McClays Mills 2 undeve -- '~'~ .. ~'•~ t,? Sub-Total for Real Estate: ~~~•~ 2. Personal Property: Estimated Value: Beistle Stock 546,236.00 ~~~ Bank 15,985.00 Various Stocks (AT&T, Axcelis, Cenovus, Daimler, Eaton, Encana, Crnturylitilc 221,046.00 Comcast, Frontier Com, Goodyear, Marathon Oil, Pfizer, Qwest, Union Pacific US Steel, Verizon) Mutual Funds (Putnam Equity and Vista) 42,358.00 Cash in Bank Deposit Program 82,200.00 Certificates of Deposit 1 ~'~'~ 3. Jointly Held Prnperty: Estimated Value: (Set forth real and personal properly owned by the Incapacitated Person JOINTLY with arty other person(s). Slate whether held as tenantr lry the entireties; jJ'not, whether the right of swrivorshlp a:fists.) JoLetiy Halt Propnry Form G-o4 rev. 10.13.06 Page 1 of 2 ~~ ®an Incapacitated Person Estate of Emma C. Wentzel-Toth ' ^ a Minor (Ser, forth ProPer7Y o.IanY ~FJn~d expected to be acgtrtred hererJGer~ together with mrticipated date oJaagnisttion.) Antlc~6ed Drtt ojAgw6tNmr Estimated Value: 4. Anticipated Assets: Sub-Total for Personal Estate: 1,007,825.00 (Attach additional sheets if»ecessary) TOTAL OF ITEMS 1, 2, 3, and 4 :............................. 1,047,825.00 Commonwealth of Pennsylvania . ss. County of Cumberland Emma K. Weitzel ,says that the foregoing is a full, Guardian true and complete Inventory of the Estate of Emma C. Wentzel-Toth the aforesaid Incapacitated Person or Minor; and that all of the information set forth herein is true and correct to the best of the Guardian's knowledge and belief. I verify that the statements made in this ) Inventory are true and correct. I under- ) stand that false statements herein are ) made subject to the penalties of ) 18 Pa.C.S. § 4904 relating to unswom ) Guardian falsification to authorities. Attorney for Guardian: Supreme Court I.D. No.: Address: Telephone: Form G-04 rev. 10.13.06 Page 2 of 2 ANNUAL REPORT OF GUARDIAN OF THE ESTATE ~, ~.., ~~ ~~ COURT OF COMMON PLEAS OF ~ ~~ `-i Cumberland COUNTY, PENNSYLVANIA ~ ~x ~ ORPHANS' COURT DIVISION ~~Q ._„~ -, c _ . m ~~' Estate of Emma C. Wentzel-Toth an Incapacitated Person No. 21-03-0413 I. INTRODUCTION Emma K Weitzel ,was appointed ®Plenary ^ Limited Guardian of the Estate by Decree of Edgar B. Bayley J dated Sept 3, 2048 ® A. This is the Annual Report for the period from Sept 3 2010 to apt 30 2 11 (the "Report Period"); or ~ B. This is the Final Report for the period from to (the "Report Period"), and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: Name of Personal Representative: 2. The Guardianship was terminated by the Court by Decree of J., dated Form G-Ol sev. ]0.73.06 Page 1 of 5 ,-; ~: , -- -_„ _~ c.~ ~V' ;-r, Estate of Emma C. Wentzel-Toth II. SUMMARY A. State the value of the estate reported on the Inventory B. State the value(s) of principal assets at the beginning of the Report Period. (Same as Inventory if first Report, otherwise, ending balance from last Report.) C. What is the total amount of income earned during the Report Period? D. What is the total amount of income and principal spent for all purposes during the Report Period? An Incapacitated Person $ 1,047,858.00 $_ 1,013,664.00 $ 39,711.00 $ 133,539.00 E. What are the balances remaining at the end of the Report Period? 1. Principal $ 959,672.00 2. Income $ 88,186.00 3. Total of Principal and Income $ 1,047,858.00 III. ADDITIONAL INFORMATION (If more space is needed please attach additional pages.) A. Principal 1. How is the principal balance listed above currently invested? (Please specify, e.g., real estate, certificates of deposit, restricted bank accounts, etc.): Restricted bank accounts, CD's, stocks and mutual funds 2. Have there been any expenditures from the principal during the Report Period? ............................ ®Yes ~ No If yes: a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? ........ ®Yes ^ No Form G-OZ rev. 10.13.06 Page 2 of 5 Estate of Emma C. Wentzel-Toth An Incapacitated Person b. List purpose and amount of expenditures: GiRs/Donations $ 21,939.00 Taxes (IItS, Pa Revenue,Real Estate) $ 3,303.52 CPA $ 595.00 Misc and Postage $ 732.00 c. Was Court approval received prior to expending the principal? ....................... ®Yes Q No 3. Were additional principal assets received during the Report Period which were not included in the Inventory or a prior Report filed for the Estate? ........... ^Yes ®No If yes: a. Was Court approval requested prior to receiving the additional principal? ................ ^Yes ^ No b. State the sources and amounts of the additional principal received: B. Income 1. State sources and amounts of income received during the Report Period (e.g., Social Security, pension, rents, etc.): Social Security Wentzel Trust Interest Dividends Total income received during Report period: Fam G-01 rev. 10.13.06 $ 3,342.00 $ 15,659.00 $ 1,599.00 $ 13,115.00 $ $ 33,715.00 Page 3 of 5 Estate of Emma C. Wentzel-Toth An Incapacitated Person 2. How is income currently invested? (Please specify, e.g., restricted bank accounts, client care account, etc.): Restricted bank accounts, CD's, stocks, and mutual funds C. Expenses for Care and Maintenance Specify what expenditures were made from the principal and income for the care and maintenance of the Incapacitated Person (e.g., clothing, nursing home, medicine, support, etc.): Nursing Home- $ 103,576. Dr Visits and Medications - $2106. D. Other Expenditures Specify what other expenditures were made during the Report Period. (Do not include any items stated in response to question C above.) See above E. Guardian's Commissions List amounts of compensation paid as Guardian's commission and state how amount was determined: Amount Method of Determination Court Approval Obtained ^Yes ^No ^Yes ^ No Form c-oz rev. /0.13.06 Page 4 of 5 Estate of Emma C. Wentzel-Toth An Incapacitated Person F. Counsel Fee List amounts paid as counsel fee, and indicate whether Court approval was obtained. Amount Court Approval Obtained ^ Yes ^ No ^ Yes ^ No I verify that the foregoing information is correct to the best of my lmowledge, information and belief; and that this Verification is subject to the penalties of 18 Pa.C.S. § 4904 relative to unsworn falsification to authorities. October 26, 2011 ~~ Emma K. Weitzel Name ofGmrdirm ojrhe Estate (type or pert) Form G-02 rev. 10.13.06 717-249-4466 Stgrrohve ofGrmdrmr oftlm Estaite 67 Greenfield Drive Address Cazlisle, PA 17015 City, Stare, Zip Telephone Page 5 of 5 ANNUAL REPORT OF GUARDIAN OF THE PERSON ~o r.. ~ ~ ~.~; ~i ~,~ ~ ~t t ~,. COURT OF COMMON PLEAS OF ~ :-,-, Cumberland COUNTY, PENNSYLVANIA ~~ ORPHANS' COURT DIVISION ~ `;> ~~ 4w~ Estate of Emma C. Wentzel-Toth . an Incapacitated Person No. 21-03-0413 I. INTRODUCTION Emma K. Weitzel was appointed ®Plenary ^Limited Guardian of the Person by Decree of Edgar J. Bayley _ J., dated Sept 3, 2008 ® A. This is the Annual Report for the period from Sept 3 2010 to Sept 30 2011 (the "Report Period"); or ^ B. This is the Final Report for the period from , to , (the "Report Period"), and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: 2. The Guardianship was ten~ninated by the Court by Decree of For a Final Report, omit Sections II througk IY. J., dated Form G-03 rev. 10.13.06 Page 1 of 4 ~~ Estate of Emma C. Wentzel-Toth an Incapacitated Person II. PERSONAL DATA Age of the Incapacitated Person: ~ III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: Sarah A. Todd Memorial Home 1000 West South Street Carlisle, PA 17013 B. The Incapacitated Person's residence is: ^ own home /apartment ® nursing home ^ boarding home /personal care home ^ Guardian's home /apartment ^ hospital or medical facility Date of Birth: 02/19/1912 ^ relative's home (name, relationship and address) ^ other: C. The Incapacitated Person has been in the present residence since August 14, 2008 If the Incapacitated Person has moved within the past year, state prior residence and reason(s) for move: Form G-03 rev. 10.13.06 Page 2 of 4 Estate of Emma C. Wentzel-Toth an Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: Emma K. Weitzel 67 Greenfield Drive Carlisle, PA 17015 IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: Senile dementia (Alzheimer's) B. Specify what, if any, social, medical, psychological and support services the Incapacitated Person is receiving: Regular visits from Primary Care Physician and nursing care provided by staff at nursing home. V. GUARDIAN'S OPINION A. It is the opinion of the Guardian of the Person that the guardianship should: ®continue ~ be modified ~ be terminated Foy c-os rev. IO.I3.oe Page 3 of 4 Estate of Emma C. Wentzel-Toth , an Incapacitated Person The reasons for the foregoing opinion are: The medical diagnosis is senile dementia and Alzheimer's disease B. During the past yeaz, the Guardian of the Person has visited the Incapacitated Person 180 times with the average visit lasting hours, 30 minutes. Phe report of a social service organization employed by the Guardian to oversee and coordinate the care of the Incapacitated Person for the period covered by this Report may be attached to supplement this Report. I verify that the foregoing information is correct to the best of my laiowledge, information and belief; and that this Verification is subject to the penalties of 18 Pa. C.S.A. § 4904 relative to unsworn falsification to authorities. October 26, 2011 paw Sigrmhve of Guardime of the Person Emma K Weitzel Name ofGuardkw of Nee Person (type w print) 67 Greenfield Drive Address Cazlisle, PA 17015 c;ry, score, zp 717-249-4466 Telephone Form G-03 rev. 10.13.06 Page 4 of 4 ANNUAL REPORT OF ~ GUARDIAN OF THE ESTATE ~ _ o rn ~~ - , ~ r COURT OF COMMON PLEAS OF ~ cn ~'~`~ N ~ C' ~'' a Cumberland COUNTY, PENNSYLVANIA ~ ~ `-- , 3 c.;:> r-~ ~ ~ ~; ORPHANS' COURT DIVISION ~ ~ o ~ ~; ~ ,c- cn w Estate of Emma C. Wentzel-Toth an Incapacitated Person No. 21-03-0413 I. INTRODUCTION Emma K. Weitzel was appointed ®Plenary ^ Limited Guardian of the Estate by Decree of Edgar B. Bailey ~ J dated Sept 3, 2008 ^ A. This is the Annual Report for the period from , to (the "Report Period"); or ® B. This is the Final Report for the period from Sept 3, 2011 to January 1, 2012 (the "Report Period"), and is filed for the following reason: The death of the Incapacitated Person. Date of death: 1/1/2012 Name of Personal Representative: Emma K. Weitzel 2. The Guardianship was terminated by the Court by Decree of J., dated Farm G-o2 rev. 10.13.06 Page 1 Of S Estate of Emma C. Wentzel-Toth An Incapacitated Person II. SUMMARY A. State the value of the estate reported on the Inventory B. State the value(s) of principal assets at the beginning of the Report Period. (Same as Inventory if first Report, otherwise, ending balance from last Report.) C. What is the total amount of income earned during the Report Period? D. What is the total amount of income and principal spent for all purposes during the Report Period? $ 1,038,742.89 $ 1,047,858.00 $ 2,522.68 $ 41,365.44 E. What are the balances remaining at the end of the Report Period? 1. Principal $ 1,020,886.30 2. Income $ 17,856.59 3. Total of Principal and Income $ 1,038,742.89 III. ADDITIONAL INFORMATION (If more space is needed, please attach additional pages.) A. Principal 1. How is the principal balance listed above currently invested? (Please specify, e.g., real estate, certificates of deposit, restricted bank accounts, etc.): Restricted bank accounts, CD's, stocks, and mutual funds. 2. Have there been any expenditures from the principal during the Report Period? ............................ ®Yes ~ No If yes: a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? ........ ®Yes ^ No F~ c-o2 rev. 10.13.06 Page 2 of 5 Estate of Emma C. Wentzel-Toth An Incapacitated Person b. List purpose and amount of expenditures: Gifts/Donations $ 8,250.00 Fees $ 70.00 Postage $ 44.00 c. Was Court approval received prior to expending the principal? ....................... ®Yes ^ No 3. Were additional principal assets received during the Report Period which were not included in the Inventory or a prior Report filed for the Estate? ........... ^Yes m No If yes: a. Was Court approval requested prior to receiving the additional principal? ................ D Yes ^ No b. State the sources and amounts of the additional principal received: B. Income State sources and amounts of income received during the Report Period (e.g., Social Security, pension, rents, etc.): Social Security Wentzel Trust Beistle Stock dividend Other dividends Total income received during Report Period: $ 1,133.74 $ 10,189.48 $ 4,010.69 $ 2,522.68 $ 17,856.59 Form G-02 re% 10.13.06 Page 3 of 5 Estate of Emma C. Wentzel-Toth An Incapacitated Person 2. How is income currently invested? (Please specify, e.g., restricted bank accounts, client care account, etc.): Restricted Bank Accounts, CD's, stocks, and mutual funds. C. Expenses for Care and Maintenance Specify what expenditures were made from the principal and income for the care and maintenance of the Incapacitated Person (e.g., clothing, nursing home, medicine, support, etc.): Nursing Home- $32,492.49 Dr. Visits, Rx- $ 508.95 D. Other Expenditures Specify what other expenditures were made during the Report Period. (Do not include any items stated in response to question C above.) See above E. Guardian's Commissions List amounts of compensation paid as Guardian's commission and state how amount was determined: Court Amount Method of Determination Approval Obtained ^ Yes ^ No ^ Yes ^ No Form c-oa rev. 10.13.06 Page 4 of 5 Estate of Emma C. Wentzel-Toth An Incapacitated Person F. Counsel Fee List amounts paid as counsel fee, and indicate whether Court approval was obtained. Amount Court Approval Obtained ^ Yes ^ No ^ Yes ^ No I verify that the foregoing information is correct to the best of my knowledge, information and belief; and that this Verification is subject to the penalties of 18 Pa.C.S. § 4904 relative to unsworn falsification to authorities. October 25, 2012 71/}YY~t. , ~/(~ Hate .~,e-~e orc~ala., of the Estate Emma K. Weitzel Name of Cnrarrtian of die Estate (tYPe ~pnnt) 67 Greenfield Drive aaa.~ss Carlisle, PA 17015 clty, sa,~, Zip 717-249-4466 Telephone Form c-oa rev. 10.13.06 Page 5 of 5 r,a ANNUAL REPORT OF GUARDIAN OF THE PERSON COURT OF COMMON PLEAS OF Cumberland COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION k_ N ~.~ ~ ~ ~ r- . ;~ N 1 r~ ~ ~, ~~-~ ~ .J o~ ~ ~ ~- ~ o ~= ~ .~ ~~ ~ Estate of Emma C. Wentzel-Toth an Incapacitated Person No. 21-03-0413 I. INTRODUCTION Emma K. Weitzel ,was appointed ®Plenary Limited Guardian of the Person by Decree of Edgar J. Bayley . J,~ dated Sept 3, 2008 ^ A. This is the Annual Report for the period from , to (the "Report Period"); or m B. This is the Final Report for the period from Sept 3, 2011 to January 1, 2012 (the "Report Period"), and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: January 1, 2012 2. The Guardianship was terminated by the Court by Decree of J., dated For a Final Report, omit Sections II through IY. Form G-03 rev. 10.13.06 Page 1 of 4 Estate of Enuna C. Wentzel-Toth an Incapacitated Person II. PERSONAL DATA Age of the Incapacitated Person: ~ III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: Sarah A. Todd Memorial Home 1000 West South Street Carlisle, PA 17013 B. The Incapacitated Person's residence is: own home /apartment ®nursing home ^ boarding home /personal care home Guardian's home /apartment ^ hospital or medical facility Date of Birth: 2/19/1912 relative's home (name, relationship and address) ^ other: C. The Incapacitated Person has been in the present residence since August 14, 2008 . If the Incapacitated Person has moved within the past year, state prior residence and reason(s) for move: Form G-03 rev. 10.13.06 Page 2 of 4 Estate of Emma C. Wentzel-Toth an Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: Emma K. Weitzel 67 Greenfield Drive Carlisle, PA 17015 IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: Senile dementia (Alzheimer's) B. Specify what, if any, social, medical, psychological and support services the Incapacitated Person is receiving: Regular visits from Primary Care Physician and nursing care provided by staff at the nursing home. V. GUARDIAN'S OPINION A. It is the opinion of the Guardian of the Person that the guardianship should: continue ^ be modified ®be terminated Form G-03 rev. 10.13.06 Page 3 of 4 Estate of Emma C. Wentzel-Toth an Incapacitated Person The reasons for the foregoing opinion are: Emma C. Wentzel-Toth passed away on January 1, 2012. B. During the past year, the Guardian of the Person has visited the Incapacitated Person 180 limes with the average visit lasting hours, 30 minutes. The report of a social service organization employed by the Guardian to oversee and coordinate the care of the Incapacitated Person for the period covered by this Report may be attached to supplement this Report. I verify that the foregoing information is correct to the best of my knowledge, information and belief; and that this Verification is subject to the penalties of 18 Pa. C.S.A. § 4904 relative to unsworn falsification to authorities. ~f~ ~5 a01 ~ ~~71i1'h/~. Signat~ve ofGaardian of the Person Emma K. Weitzel Nam ofCumdimr 'the Person (type orpri~#) 67 Greenfield Drive Ad~ess Carlisle, PA 17015 Ciry, Stare, Zip 717-249-4466 Telephone Form G-o3 rev. 10.13.06 Page 4 of 4 GUARDIAN'S INVENTORY COURT OF COMMON PLEAS OF Cumberland COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of Emma C. Wentzel-Toth 1®an In itated Peron f ~ a Mino ~ N a ~ ' No.21-03-0413 ~ ~ ..~'.t ~ cam ~ ` . ~ ~.-- 1. Real Estate: (Location, by whom occupied and rental -+ j Estimi~e' d Value; r= ~~ ~ terms, if applicable) , r' McClays Mills, 2 undeveloped lots, Franklin County- Real value 2,899.40 Sub-Total for Real Estate: 2,899.40 2. Personal Property: Estimated Valae: Cash 85,166.28 CD's 99,984.64 Beistle Company Stock 546,236.80 Various Stocks (Att, Axcelis, BYD, Cenovus, Comcast, Daimler, Eaton, Encana, Frontier, Goodyear, Lockheed) 173,324.90 Mutual Funds- Columbia 8t Putnam Equity Income 47,558.74 Various Stocks (Marathon Oil, Marathon Petro Corp, Nextera, Pfizer, Teck, US Steel, and Verizon) 83,572.13 3. Jointly Held Property: Estimated Value: (Set forth reol and personal property owned by the Incapacitated Person JOINTLYwith any oilier person(s). State whether held as tenants by the entireties; if not whether the right of swvivorsldp exists.) JoLvtly Add Agpcrly None Form G-04 rev. 10.13.06 Page 1 of 2 b Estate of Emma C. Wentzel-Toth i®an Incapacitated Person I©a Minor 4. Anticipated Assets: (set forth properly ol'm+Y+~~~ ~ ~ ~.~ ~~., together with muicipated dote of a+cgrdsitlon.) Aid DwAe ofAapri~ar Sub-Total jot Personal Estate: (Attach additional sheets if necessary) TOTAL OF ITEMS 1, 2, 3, and 4 :............................. . Commonwealth of Pennsylvania . ss. County of Estimated Value: 1,035,843.49 1,038,742.89 says that the foregoing is a full, Guardian true and complete Inventory of the Estate of Emma C. Wentzel-Toth the aforesaid Incapacitated Person or Minor; and that all of the information set forth herein is true and correct to the best of the Guardian's knowledge and belief. I verify that the statements made in this ) Inventory are true and correct. I under- ) stand that false statements herein are ) made subject to the penalties of ) 18 Pa.C.S. § 4904 relating to unsworn ) falsification to authorities. ) ~~G~ Guardian Attorney for Guardian: Supreme Court LD. No.: Address: Telephone: Form G-oo rev. 10.13.06 Page 2 of 2