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HomeMy WebLinkAbout10-24-11i •, -~ IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSLYVANIA ORPHANS' COURT DIVISION IN THE MATTER OF ARLENE K. ARMOLT An Alleged Incapacitated Person No. ~~ - ~ I - I PETITION FOR ADJUDICATION OF INCAPACITY AND APPOINTMENT OF A GUARDIAN AND NOW COMES, Petitioner, Ronald E. Armolt, Sr., by and through his attorney, and hereby petitions for an adjudication of incapacity and appointment of a guardian under 20 Pa.C.S. § 5511, and in support thereof represents as follows: 1. The name of the alleged incapacitated person is Arlene K. Armolt, hereinafter referred to as Ms. Armolt. 2. Petitioner is Ronald E. Armolt, Sr., the brother of Ms. Armolt. 3. Ms. Armolt is single, 51 years old, and resides with Ronald E. Armolt Sr. at 1019 Grahams Wood Road, Newville, PA 17241. 4. To the best of Petitioner's knowledge, information and belief, Petitioner, who is a sui juris adult, is the only person who would be entitled to the alleged incapacitated person's estate if she died intestate at this time; the Petitioner's name, address and relationship to the alleged incapacitated person are as follows: Ronald E. Armolt, Sr. 1019 Grahams Wood Road Newville, PA 17241 Brother 5. The name and address of Ms. Armolt's primary physician is as follows: Michael O. Daniels, M.D. Three Springs Family Practice 303 Baltimore Street ~ ., _: Mt. Holly Springs PA 17065 ~ yo ~ `- `~ P 1"l ~ T ~ C J --~ 3 :D 6. Ms. Armolt attends an adult day program at: `~ ~ ~ ~-~ United Cerebral Palsy (UCP) -Alternatives Carlisle j C ~ ~ _ 't 20 East North Street ~ ~ - ~= m Carlisle, PA 17013 - ~'' ~~- "' o u.~. b i ~ 7. The names and addresses of those who provide caregiver services for Ms. Armolt at her residence are as follows: Tina Hoyaux 825 Doubling Gap Road Newville, PA 17241 8. Ronald E. Armolt, Sr. is the proposed Guardian of Ms. Armolt; he currently resides at 1019 Grahams Wood Road, Newville, PA 17241. is $0. 9. Upon information and belief, Ms. Armolt has no assets, and the value of her estate 10. Upon information and belief, Ms. Armolt currently receives a Social Security check in the amount of approximately $920.00 per month; Ms. Armolt received a total of $11,076 in social security benefits during 2010. 11. Ronald E. Armolt, Sr. serves as representative payee for Ms. Annolt's Social Security benefits. 12. Ronald E. Armolt, Sr. uses the monthly Social Security check to provide clothing, food, care, and other essentials for Ms. Armolt. 13. The alleged incompetent was never a member of the Armed Services of the United States and has never received any benefits from the United States Veterans Administration or its successor. 14. Ms. Armolt suffers from severe Mental Retardation and Tourette's syndrome. 15. Due to Ms. Armolt suffering from severe Mental Retardation, she is not capable of making medical or financial decisions. 16. The attending physician named above will be available to provide testimony via telephone as to Ms. Armolt's incapacity. 17. Due to her condition, Ms. Armolt is: a. Unable to manage her financial affairs; b. Unable to make and communicate responsible decisions relating to her fmancial affairs; c. Unable to make responsible decisions concerning her person, health, welfare, and safety; d. Unable to communicate her needs concerning her health, welfare, and safety; e. Unable to reside alone; f. Unable to provide for her personal safety; g. Unable to keep herself properly nourished and hydrated; .~ h. Unable to tend to her personal hygiene; i. Unable to medicate herself; j. Unable to make responsible decisions with regard to her medical care, including, but not limited to, obtaining health care services and entering herself into a hospital, convalescent home, skilled care facility, residential care facility, or similar institution. 18. Ms. Armolt receives Medical Assistance based on her net income. 19. This proposed guardianship is in the best interest of Ms. Armolt for the purpose of medical decisions and management of her financial resources. 20. Due to Ms. Armolt's medical condition, no less restrictive alternative to a guardianship is feasible. 21. The proposed guardian, Ronald E. Armolt, Sr., has no interest adverse to Ms. Armolt. 22. No court has ever assumed jurisdiction in any proceeding to determine competency of the alleged incapacitated person. 23. No court has previously appointed a guardian for Ms. Armolt. 24. The type of guardianship sought is plenary of Ms. Armolt's person and estate. WHEREFORE the Petitioner, Ronald E. Armolt, Sr., prays the Court to direct the attached citation to the alleged incompetent, with notice thereof to her next of kin and to such other persons as the Court may direct, to show cause why she should not be adjudicated an incapacitated person and Ronald E. Armolt, Sr. not be appointed guardian of her estate. Respectfully Submitted, ~/a ~~ Date Stephanie E. Chertok Attorney for the Petitioner PA Supreme Court ID # 52651 61 West Louther Street Carlisle, PA 17013 (717) 249-1177 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSLYVANIA ORPHANS' COURT DIVISION IN THE MATTER OF ARLENE K. ARMOLT An Alleged Incapacitated Person No. CONSENT OF PROPOSED GUARDIAN Ronald E. Armolt, Sr. does hereby certify that he is willing to act as guardian of the person and guardian of the estate of Arlene K. Armolt, an alleged incapacitated person, if the Court shall so appoint. Date: ~~Q~/~ By: ~~~ ~3r R nald E. Armolt, Sr. IN THE COURT OF COMMON PLEA5 CUMBERLAND COUNTY, PENNSLYVANIA ORPHANS' COURT DIVISION IN THE MATTER OF ARLENE K. ARMOLT An Alleged Incapacitated Person No. VERIFICATION I, ~j041gLL ~ ~r ~~~~ ,hereby acknowledge that I have read the foregoing petition and verify that the facts stated therein are true and correct to the best of my knowledge, information and belief. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. §4904, relating to unsworn falsification to authorities. ate By: dL Ronald E. Armo t r. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSLYVANIA ORPHANS' COURT DIVISION IN THE MATTER OF ARLENE K. ARMOLT An Alleged Incapacitated Person No. AFFIDAVTI' OF SERVICE The undersigned hereby verifies that he or she made personal service of the citation and copies of the petition and preliminary decree upon the alleged incapacitated person. Such personal service was made on location: at .M. at the following T'he undersigned hereby verifies that at such time, he or she explained the contents and terms of the petition to the alleged incapacitated person to the maximum extent possible in language and terms the alleged incapacitated person was most likely to understand. The above statements are made subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn falsification to authorities. Date Signature Printed Name: