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Duncan & Hartman, P.C.
Susan J. Hartman, Esquire
I Irvine Row, Carlisle, Pennsylvania 17013
7 17-249-7780
717-249-7800 FAX
Attorney ID 65184
IN RE: : IN THE COURT OF COMMON PLEAS OF
NOAH HARRISON, a minor :CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
PETITION FOR APPOINTMENT OF GUARDIAN
TO THE HONORABLE, THE JUDGES OF THE SAID COURT:
Petitioner, through his undersigned attorney, petitions Your Honorable Court for his
appointment as Guardian of the person of NOAH HARRISON, and in support thereof,
respectfully requests:
1. Petitioner, William A. Harrison, of 26 Woodcrest Drive, Carlisle, Cumberland
Cound, Pennsylvania, 17015, a sui juris adult, is the natural father of NOAH HARRISON.
2. NOAH HARRISON , is a 12 year old minor male, born June 7, 1999. A copy of this
birth certificate is attached hereto, incorporated by reference and marked Exhibit "A".
3. NOAH HARRISON resides with the Petitioner and his mother, Lisa M. Harrison at 26
Woodcrest Drive, Carlisle, Cumberland County, Pennsylvania 17015.
4. NOAH HARRISON has been named as a beneficiary on a Metlife Insurance Company
of Connecticut Annuity Contract 8942269, payable upon the death of Janet E. Hege
5. The portion of the proceeds payable to NOAH HARRISON under the contract is
approximately $8,646.37.
6. Metlife Insurance Company requires that a guardian be appointed prior the payment of
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any sums on behalf of the minor. A letter from Metlife is attached hereto, incorporated by
reference and marked Exhibit "B".
7. Upon receipt, the proceeds from the above-mentioned annuity will be placed into a
custodial account for the benefit of Noah Harrison.
WHEREFORE, Petitioner respectfully requests that he be appointed Guardian of his son,
Noah Harrison for the purpose of receiving the proceeds from the aforementioned annuity.
Duncan & Hartman, P.C.
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,: '~'"Susan J. Hartma~;.Esq`uire
Attorney for Petitioner
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VERIFICATION
I verify that the statements made in the foregoing Petition for Appointment of Guardian
are true and correct. I understand that false statements herein are made subject to the penalties of
18 Pa.C.S. section 4904 relating to unsworn falsification to authorities.
Dated: /' _~i"
~~~, ~ Y ~~ William A. Harrison
Duncan & Hartman, P.C.
Susan J. Hartman, Esquire
I Irvine Row, Carlisle, Pennsylvania 17013
717-249-7780
717-249-7800 FAX
Attorney ID 65184
IN RE:
IN THE COURT OF COMMON PLEAS OF
NOAH HARRISON, a minor :CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
CONSENT TO BE APPOINTED GUARDIAN
William A. Harrison, being duly sworn according to law, deposes and says that he agrees
to serve as Guardian of the Estate for his son, NOAH HARRISON, for the purpose of receiving
the proceeds from Metlife Insurance Company of Connecticut Contract 8942269.
My residence is 26 Woodcrest Drive, Carlisle, Cumberland County, Pennsylvania.
My occupation is retired.
I speak, read and write in the English language.
I do not have any interest adverse to Noah Harrison.
I am not a fiduciary or an officer or employee of a corporate fiduciary of an Estate in
which Noah Harrison has an interest; nor the surety or an officer or employee of a corporate
surety of such a fiduciary.
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William A. Hamson
Sworn to and subscribed by
MONWEALTH OF PENNSYLVANIA
William A. Harriso~n~~b"efore me this
c?I.~-I'~1 Day of DuFpib P~ , 2011. JOAN D. ADAMSLNotary Public
~' Carlisle 6oro., Cumberland County
flAy Commission Expires March 15, 2015
Notary ublic
Duncan & Hartman, P.C.
Susan J. Hartman, Esquire
1 Irvine Row, Carlisle, Pennsylvania 17013
717-249-7780
717-249-7800 FAX
Attorney 1 D 65184
IN RE: : IN THE COURT OF COMMON PLEAS OF
NOAH HARRISON, a minor :CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
ORDER OF COURT
AND NOW, this Day of
2011, upon
consideration of the within Petition and its attachments, it is ordered that William A. Harrison is
hereby appointed Guardian of the Estate of NOAH HARRISON, a minor, for the purpose of
receiving the proceeds from Metlife Insurance Company of Connecticut Annuity Contract
8942269, payable upon the death of Janet E. Hege. The proceeds are to be placed in a custodial
account for the benefit of Noah Harrison.
By the Court
MetLife
P.O. Box 10366
Des Moines IA 50306
MetLife
September 2, 2011
NOAH HARRISON
26 WOODCREST DRIVE
CARLISLE, PA 17015
RE: METIIFE INSURANCE COMPANY OF CONNECTICUT CONTRACT 8942269
OWNER JANET HEGE
Dear Mr. Harrison:
We have received your request to process a beneficiary claim for the above referenced contract. We are
unable to process your request for the following reason(s).
• Court-ordered guardianship paperwork is required
• The claim form must be signed by the parent/guardian listed on the court document
Please mail the additional requirements to the address listed above or fax to 877-547-9671
If you have any questions, please contact our Customer Service Center at 1-800-343-8496, Monday
through Friday between 8:30 a.m. and 6:30 p.m., ET.
Sincerely,
Eric Machholz
Sr. Annuity Representative -Post Issue Processing
MetLife Annuity Operations and Services