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Home My WebLink About12-21-11b Andrew H. Shaw, Esquire I.D. No: 87371 200 S. Spring Garden St., Suite 11 Carlisle, PA 17013 (717)243-7135 Attorney for Good News Consulting, Inc., Petitioner IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ~ `' _' ~-o = -' T, ~~ r ,-~ IN RE: MARGARET H. FICK ~q~ ~' _c~ ~=~ ~ _? NO. 21-11'4 ~ '~ na T ,: An Incapacitated Person ~~ ~ ' ° ' ' ~' c' ~ -- -~ :: _:_- ;a. `~: PETITION TO SURRENDER LIFE INSURANCE POLICIES AND LIQUIDATE -' STOCK, IN ACCORDANCE WITH 20 PA. CONS. STAT. ANN. § 5521 Petitioner, Good News Consulting, Inc., guardian of the Estate of Margaret H. Fick, an incapacitated person, represents that: 1. Margaret H. Fick was adjudged incapacitated after a hearing, by Decree of this Honorable Court, dated Apri120, 2011. 2. The incapacitated person is now a patient at Green Ridge Village, 210 Big Spring Road, Newville, Pennsylvania 17241. 3. The incapacitated person is 90 years of age, and is never expected to return to her home or be released from the nursing home. 4. The incapacitated person is the owner of a life insurance policy with Prudential, Policy Number M50152120 (hereinafter "Prudential Policy"). A copy of the summary page of the policy is attached hereto as Exhibit A. 5. The cash surrender value of the Prudential Policy is $3,517.44. 6. The name and relationship of the beneficiary of the Prudential Policy is Vincent Lambressi, the incapacitated person's brother. 7. The incapacitated person is the owner of a second life insurance policy with CUNA Mutual Group, Policy Number 41 JV0409143 (hereinafter " CUNA Policy"). A copy of the summary page of the policy is attached hereto as Exhibit B. 8. The cash surrender value of the CUNA Policy is $1,807.75. 9. The names, relationships and addresses of the named beneficiaries of the CLJNA Policy are the incapacitated person's sons: a. Gary Fick, son, 105 E. Allen Street, Apt. 202, Mechanicsburg, PA 17055; b. Kevin Fick, son, 105 E. Allen Street, Apt. 202, Mechanicsburg, PA 17055: 10. The incapacitated person is the owner of shares of stock in 3 different corporations. A copy of the summary page of the shares held is attached hereto as Exhibit C. 11. As of October 21, 2011, the incapacitated person owned stock as follows: a. AT&T, Inc., 174 shares, closing price per share $29.09, total value $5,061.66; b. Frontier Communications Corporation, 151 shares, closing price per share $5,98, total value $902.98; c. Verizon Communications, Inc., 630 shares, closing price per share $37.05, total value $23,341.50. 12. The total value of the incapacitated person's stock is $29,306.14. 13. The total value of the incapacitated person's assets is as follows: a. Prudential Life Insurance Policy, set forth above, $ 3,517.44; b. CUNA Mutual Life Insurance Policy, set forth above $ 1,807.75; c. Stock, set forth above $ 29,306.14; d. Personal residence, as appraised July 26, 2011, $155,000.00; e. Total Value: $189,631.33. 14. No creditors currently exist but within the month, upon the termination of insurance benefits, annual expenses of approximately $108,000 for the nursing home will be incurred by petitioner on the incapacitated person's behalf. 15. It is necessary that the life insurance be surrendered and the stock be liquidated in order to pay for the incapacitated person's on-going care and medical expenses. 16. The incapacitated person receives total annual income of $23,532.00, comprised of Social Security of $15,792.00, pension payments of $7,740.00 and annual dividends of approximately $1,527.80, which annual income will be insufficient to pay the expenses of Green Ridge Village. 17. Petitioner is not authorized to surrender the life insurance or liquidate the stock except by order of the Court. 18. Petitioner is not required to post bond, but has been directed by this Honorable Court to maintain current liability insurance. WHEREFORE, petitioner requests that the Court enter an order authorizing the surrender of the life insurance policy. Date: ~~ '- '~ ~ By: Andrew H` Shaw, Esquire Sup. Ct. ID No. 87371 200 S. Spring Garden St., Suite 11 Carlisle, PA 17013 (717)243-7135 Attorney for Petitioner, Good News Consulting, Inc. 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. Section 4904, relating to unsworn falsification to authorities. Date: ~ ~ ~~~ -! Tina Hess, Vice President of Operations of Good News Consulting, Inc. Prudential Inswance Company of America Customer Inauranee Office PO Box 7217 Philadelphia, PA 19176-7217 (800) 575-7780 Pl`t1~I1 ~ I''iIt8I1C181 MARGARET H FICK 1677 OLD KILN DR CHAMBERSBURG, PA 17201 SEPTEMBER 30, 2011 ri " o ~ ~' RE-POLICY M5O152120 FICK - DEAR POLICYOWNER, WE APPRECIATE YOUR RECENT INQUIRY. THE VALUES QUOTED IN THIS LETTER HAVE BEEN CALCULATED AS OF SEPT 30, 2011. CASH SURRENDER VALUE PLUS CASH VALUE OF PAID-UP ADDITIONAL INSURANCE PLUS TERMINATION DIVIDEND LESS POLICY INDEBTEDNESS TOTAL CASH VALUE PAYABLE AMOUNT OF LOAN AVAILABLE DEATH CLAIM VALUE (INCLUDING THE AMOUNT OF PAID-UP ADDITIONAL INSURANCE OR ACCUMULATED DIVIDENDS LESS ANY POLICY INDEBTEDNESS). 567.31 2935.13 15.00 0.00 3517.44 3502.44 3885.88 WHILE GREAT CARE HAS BEEN TAKEN TO MAKE THIS QUOTATION CORRECT, THERE IS NO WARRANTY OF COMPLETE ACCURACY. PRUDENTIAL RESERVES THE RIGHT TO MAKE CORRECTIONS IN CASE OF MISSTATEMENT. IF YOU HAVE ANY FURTHER QUESTIONS, PLEASE LET US KNOW. SINCERELY, YOUR PRUDENTIAL REPRESENTATIVE BAL2 XXX 2 201109 11121951 500 30 PL 0 184 324388 LH no ~oaa .a. s-at G ~81' -°~ ~ (CUNA MUTUAL SUP ' - CUNA Mutual /naursnce Society VY2 Que9liwis -epsndln0 this WYman qii 800l779.5~33. 1 ~ inrolca Numiwr ~ Imrobe Daly~ -VoucMr ID ~ AprNmept Nambar ~ Cblm Nun~r PaW Amourrt 41JV0409143 10/18/20ii 01300536 41JV0409143 i,807,7g ~I FULL/PARTIAL 5liiFiENDER Cash Value: 61,929.79 Dividends: ~ ~ Cash Ya1us of Paid-up Additional Insurance 60,00 Premium Refund: f0,00 Premium Deposit: ~ ~ Unapplied Payments: 60,00 Outstanding Loan Balance: 6122.04 Federal withholding: ~ ~ State withholding: ~ ~ Delivery Charge: ~ ~ Amount of Distribution.: 61,807.75 ThTS trarrsa~ativrr-diet-rtol: -haae- a--:axabla-'i e~:e-rapcrt- to --EMa- ~ - -- -- _- - - _ . ,Internal Revenue Service. FOR OUESTIOMS, PLEASE CONTACT OUR MEMBER SERVICtS TEAM AT 1-800-779-5433. CMCk Number CMek Data Payee Name Total Amount 0003410862 10/18/ZOti LFR0ISPCFK 11ARPAI~T M FTM! .,. ~~.~ ,r 1 .yl Wl -7 Did you know? Most shareholders can manage their holdings online with free access to Computershare's Investor Centre''' website. Use this simple foal to quickly and easily update account information, sign up for electronic delivery of documents and mare. Enroll FREE today at www.computershare.com/investor. TINA HASS GOOD NEWS CONSULTING INC 140 ROOSEVELT AVE SUITE 206 YORK PA 17401 October 21, 2011 Company: Registration: Holder Account Number: Document I.D.: Our Reference: , AT&T INC. MARGARET H FICK 03002059991 11287WF00298374 ATT/0002805854/14/RS/66032 Dear Sir/Madam: ^ Thank you for your inquiry. We appreciate the opportunity to be of service to you. ~,omputershare Computershar~ Investor Services 250 Royall Street Canton Massachusetts 02021 www.computershare.com Bekmr is the account balance Information that you requested for Margaret H Fick as of October 19, 2011. Company Name: AT&T Inc. Account Number: 03002059991 Shares Held by Agent: 174 Shares Held in Certificate Form by Holder: 0 Total Shares: 174 cc..~~ 1` __ Closing Price Per Share: $29.09 ~ ~.J~ ' • ~ W Company Name: Frontier Communicatons Corporation Account Number: 00004523504 Shares Held by Agent: 151 Shares Held in Certificate Form by Holder: 0 Total Shares: 151 C g' Closing Prke Per Share: $5.98 = ~ ~ ~ ~ . Company Name: Verizon Communications Inc. Account Number: 00007446985 Shares Held by Agent: 630 Shares Held in Certificate Form by Holder: 0 Total Shares: 630 dosing Price Per Share: $37.05 ~~ ~~~ ( (J~`~ EXHIBIT d9,3o~ "'