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HomeMy WebLinkAbout04-09691N THE MATTER OF AN ALLEGED INCOMPETENT The Petition of IN THE COURT OF COMMON PLEAS COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISIQN IN RE N0. PETITION FOR APPOINTMENT OF A TEMPORARY GUARDIAN OF THE PERSON PURSUANT TO 20 Pa. C.S.A. 5513 , respectfully represents: Your · Petitioner is is currently receiving care at domiciled at years of age having been bom on ~x'k~4'.a_,,orx.N-~/~ ,DM, ~¢Ic3T,_ marital status is Those persons, if any, who are {~(~t k3k Q_~\~3~'P~h ~_ ~ next-of- kin and their relationship to same, of whom your Petitioner has knowledge are as follows: No other Court within the Commonwealth of which Petitioner has knowledge has appointed a guardian for ~4'~(X),_x'L Qo~:i~'i'x~, ~'{X.k~ 0,.9~,-rd:~\ is mentally retarded. Because of mental deficiency, ~Qk.k'kC Qok,k_l'~xT, c~x lacks sufficient ca acit¥ to make or communicate responsible decisions conce ,m, ing his&er person as set forth in the attached Affidavit prepared by marked as Exhibit A and made a part hereof. 10. is ~ services. /vz/~<f / ,,,,,r,----- in need of residential .-menta-t- has been accepted for placement upon the condition that a guardian of the person be appointed to consent to said placement 12. on his&er behalf. t~r/'~FX~:~ ~{'{~(~L.Xic,,,,'X , ~,~. ~¢~lff~l-~2~having no interest adverse to xi~lTlX_X,k_Q,~k~C:~xrk9 ~ . has agreed to act as Temporary Guardian of the Person o( '~0k~ ~xlx-C-a. if this Honorable Court shall so appoint. WHEREFORE, Petitioner prays this Court place under the tempora~ guardianship of~X~ ~ kxc~ . , pursuant to 20 Pa. C.S.A. § 5513 and empower said temporary guardian to provide substitute consent for such community-based or institutional services as may be necessary to provide for his&er needs. COMMONWEALTH OF PENNSYLVANIA ~EPARTMENT O~ PUBUC WEL~AR~ OFFICE OF MENTAL RETARDATION. Central Region Willow Oak Building, Room_ 430 P.O. Box Harrisburg, Pennsylvania 1~/105-2675 September 30, TELEPHONE NUMBER [717} 772-6507 FAX: 772-6483 2004 Mr. Nlark W. Glessner C/O Beverly Health Care Camp Hill 46 Efford Road Camp Hill. Pennsylvama 170i 1 Dear Mr. Glessner: In 987 Con=re'ess enacted major nursing facility reform legislation that mandated a Preadmission Screening Prngram for individuals socking admtssion ~o any nursing faci it? participating 'n the Medica~ Assistance Program. The purpose of the screening is to determine whether ind v dua s who mav be mentally retarded need nursing facilities and if the5, also need specialized services to treat their condition. The Department of Public Welfare has completed its review of your application for admission to a nursing facili~'. The attachment (Appenc[ix l) contains our fmal determination regarding the above- mentioned needs Further information on available services for persons with mental retardation may be obtained by contacting the following agencies: Cotmty Mental Health/ Mental Retardation Office: Cumberland/PerD.' MI-I/MR Address: 16 West High Street Carlisle, PA 17013 Phone #: (717) 240-6325 Local Advocacy Agency: ARC, Cumberland/Perry Address: P.O Box 386 117 N. Hanover Street Carlisle, PA 17013 Phone#: (717) 249-2611 Sincerely, Pat~' L 'M{ C Reg/onal Program Manager Attachment - Appendix I Cumberland Count' Assistance Office Cumberland Count' A_A.A Cumberland/Per'o.' MIqJMR Program Ms. Stephame L. Kirk-pamck. BSW File APPENDIX I NOTIFICATION OF PREADMISSION SCREENING I CONTROL NUMBER: 166-52-1360 DETERi~IINATION The Department has completed its review of your application for admission to a nursing facilib'. The evaluation and review has been conducted in order to assist you ;x4th the deterrmnanon of the most appropriate level and ~pe of care for your current condition. The Department is required to determine whether you need the level of ser~dces provided by a nursing facili~~ and, if you do, whether you need specialized ser-,'ices for either mental illness, mental retardation, or other related conditions The Department has determined that You require the level of ser~'ices ~ You need specialized provided by' a nursing facili¢' and as desired ma}' be admitted to a nursing faciliD' enrolled with the Department ] 180 days or less [] More than 180 days You do not need specialized services You do not require the level of [~ Other as explained in our sen, ices provided by a nursing facili~' attached letter and may not be admitted to a nursing facility enrolled with the Department IF YOU NEED MORE INFORI~&~TION ABOUT THE EVALUATION OR DETER~MINATION PROCESS, YOU MAY CALL: (717) 772 -6507 RIGHT TO APPEAL AND FAIR HEARING If you have been determined not to require a level of service provided by a nursing facilib' and~or mental retardation spemahzed servmes, vou ma ' appeal that deterrmnation bv filing an appeal Bureau of He:rungs and Appeals Depa_,'tment of Public Welfare P.O Box 2675 Harrisburg, Pennsytvaraa 17105-2675 Information concerning the filing of appeals can be obtained by calling the Bureau of Heanngs and Appeals at any of'the follo~sng telephone numbers: Harrisburg (717) 783-3950 Pittsburgh Reading (610) 378-4189 Erie Pb_iladelphia (215) 560-2385 Wilkes Barre (412) 565-5213 (814) 871-4433 (717) 820-4904 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND AFFDAVIT z:~)z,-.w/,/~/ ./,.055..e.~,~,..,.../ /w,,~/./'~,w.- ,5~/~/W;£,x4,'~tZPetitioner in this matter, being duly sworn according to law, do depose and state that I am of and that the facts set forth in the foregoing Petition are true and correct to the best of my knowledge, information, and belief. Petitioner SWORN TO AND SUBSCRIBED BEFORE ME, THIS DAY OF ,20 . NOTARY PUBLIC IN RE: Mark Glessner an Alleged Incompetent · IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA 'ORPHANS' COURT DIVISION 'GUARDIANSHIP ORDER OF COURT AND NOW, this ,2 ~, ' day of ~,~-,¢ ~, ~- ,2004, upon review of the attached Petition, and pursuant to 20 PA. C.S.A § 5513, this Court appoints Dennis Marion, Emergency Guardian of the Estate and Person of Mark Glessner, an alleged incompetent for a period of seventy-two (72) hours. BY THE COURT, IN RE: Mark Glessner, an Alleged Incapacitated Person · IN THE COURT OF COMMON PLEAS · CUMBERLAND COUNTY, PA · ORPHANS' COURT DIVISION : NO. 21-04- : GUARDIANSHIP PETITION FOR AN EXTENSION OF APPOINTMENT OF AN EMERGENCY GUARDIAN PURSUANT TO 20 PA. C.S.A. § 5513 1. Petitioner is Robert L. O'Brien, Esquire, attorney for the Cumberland/Perry MHMR Office. MHMR obtained a 72 hour appointment of a Guardian for Ms. Kramer on October 26, 2004. A copy of that Petition is attached hereto. 2. Section 5513 permits an extension of 20 days after the initial 72 hours has elapsed. The initial 72 hours will end October 29, 2004. An extension to November 18, 2004 is requested. This is to determine if a family member will agree to serve as a permanent plenary guardian. A request for a permanent Guardian is being filed in conjunction with this request for an extension. WHEREFORE, Petitioner respectfully requests that Dennis Marion be appointed guardian of the estate and person of Mark Glessner for an additional 20 days. Respectfully submitted, O'BRIEN, BARIC & SCHERER Robert L. O'Brien, Esquire Attorney for Petitioner I.D. # 28351 17 West South Street Carlisle, Pennsylvania 17013 (717) 249-6873 I verify that the statements made in the foregoing Petition for an Extension of Appointment of an Emergency Guardian Pursuant to 20 PA. C.S.A. § 5513 are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904, relating to unsworn falsification to authorities. Robert L. O'Brien, Esquire Dated: IN RE: Mark Glessner an'Alleged Incompetent : IN THE COURT OF COMMON PLEAS · CUMBERLAND COUNTY, PENNSYLVANIA · ORPHANS' COURT DIVISION 'NO. · GUARDIANSHIP ORDER OF COURT AND NOW, this 2.~ day of O~L~...~...~ ,2004, upon review of the attached Petition, and pursuant to 20 PA. C.S.A. § 5513, this Court appoints Dennis Marion, Emergency Guardian of the Estate and Person of Mark Glessner, an alleged incompetent for a period of seventy-two (72) hours. BY THE COURT, IN THE MATTER OF AN ALLEGED INCOMPETENT IN THE COURT OF COMMON PLEAS COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION 1N RE NO. The Petition of PETITION FOR APPOINTMENT OF A TEMPORARY GUARDIAN OF THE PERSON PURSUANT TO 20 Pa. C.S.A. 5513 , respectfully represents: Your Petitioner is domiciled is currently receiving care at at years of age having been bom on ~('¥~_k'~ O"-9'~'~G.~ (' ~ marital status is Those persons, if any, who are {'~(~)C~i 0.._~\,~V~.' ~ next-of- kin and their relationship to same, of whom your Petitioner has knowledge are as No other Court within the Commonwealth of which Petitioner has knowledge has appointed a guardian for ~{'~ClJ~QD~LI2~X-x_~,'~ 0~,3,-~- 0-D~--~'~ .Tx-~x is mentally retarded. Because of mental deficiency, ~'~(~,~ Q,D~i~XIZ~, lacks 10. 11. sufficient capacity to make or communicate responsible decisions conce.rn,!ng his/her · as set forth in the attached Affidavit prepared by ,~,~rT'/-. ,,~ ~ ~,-~- ~,~rrz-6--w,~.~ person marked as Exhibit A and made a part hereof. ~d,,~,Ck,~k,512:~V~ is in need of residential q'rrmmd- ~ services. ~ ~ has been accepted for placement at ~/~IZ~ ¥~L}~,,~C!~,~ ~ (l_q~/~La, upon 12. the condition that a guardian of the person be appointed to consent to said placement on his/her behalf. ~52('~' ~.-~ ~(~(~X~c,,,'x , ~XC~. ~/~'~having no interest adverse to ~t~D,~Q._~:~xrx,~/,, , has agreed to act as Temporary Guardian of the Person of ~ XOqLA, if this Honorable Court shall so appoint. W]zlEREFORE, Petitioner under the temporary guardianship of~\~ prays this Court place Cl ,~¢~ . ,pursuant to 20 Pa. C.S.A. § 5513 and empower said temporary guardian to provide substitute consent for such community-based or institutional services as may be necessary to provide for his/her needs. COMMONWEALTH OF PENNSYLV^N,A DEPARTMENT OF PUBLIC WELFARE OFFICE OF MENTAL RETARDATioN Central Region " -. Willow Oak Building, Room 430 · ' P.O. Box 2675 Harrisburg, Pennsylvania 1'1i05-2675 September 30, 2004 TELEPHONE NUMBER (717) 772'6507 FAX: 772'E483 Nlr. Mark W. Glessner C/O Beverly Health Care Camp Hill 46 Erford Road Camp Hill, Permsylvarria 17011 Dcm' Mr. Glessner: In 1987, Con~ess enacted major nursing facility reform legislation that mandated a Preadmission Screening Program for individuals seeking admission to an), nursing facility participating in the Medical Assistance Program. The purpose of the screening is to determ2ne whether individuals who may be mentally retarded need nursing facilities and if they also need specialized services to treat their condition. The DeparUnent of Public Welfare has completed its review of your application for admission to a nursing hcili~,. The attachment (Appendix I) contains our £mal deterrrfination regarding the above- mentioned needs. Further information on available services for persons with mental retardation may be obtained by contacting the following agencies: CourtLy Mental Health/ Mental Retardation Office: Cumberland/Perry MH/MK Address: 16 West High Street Carlisle, PA 17013 Phone #: (717) 240-6325 Local Advocacy Agency: ARC, Cumberland/Perry Address: P.O. Box 386 117 N. Hanover Street Carlisle, PA 17013 Phone#: (717) 249-2611 .~erety, Regional Pro,'am Manager Attachment - Appendix [ c: Cumberland CounD' Assistance Office Cumbertand CounD' A-;s,A Cumberland/Perry MFUMR Program Ms. Stephame L. Kirk-patrick. BSW File APPENDIX I NOTIFICATION OF PREADMISSION SCREENING [ CONTROL NUMBER: 166-52-1360 D ETERaMINATION The Department has completed its review of your application for admission to a nursing facility. The evaluation and review has been conducted in order to assist you with the determination of the most appropriate level and type of care for 3'our current condition. The Department is required to determine whether you need the level of sendces provided bv a nursing facility and, if you do, whether you need specialized selwices for either mental illness, ment~I retardation, or other related conditions. The Department has determined that ] You require the level of services provided by a nursing facili~ and may be admitted to a nursing faciliLy enrolled with the Department I80 days or less [] More than 180 days You need specialized services, as desired You do not need specialized services You do not require the level of ['~ Other as explained in our services provided by a nursing facility attached letter and. mKv not be admitted to a nursing facility em-oiled ',',5th the Department IF YOU NEED MORE INFORAiATION ABOUT THE EVALUATION OR DETERI~IINATION PROCESS, YOU MAY CALL: (717) 772 -6507 RIGHT TO APPEAL AND FAIR HEARING If you have been determined not to require a level ofsemce provided by a nursing £acilit-,' and/or mental retardation specialiked services, you may appeal that determination by filing an appeal Bureau of Hearings and Appeals Department of Public Welfare P.O. Box 2675 Harrisburg, Penn.sylvania 17105-2675 Information concerning the filing of appeals can be obtained by calling the Bureau of Heanngs and Appeals at any of the follox~ing telephone numbers: Harrisburg (717) 783-3950 Pittsburgh Reading (610) 378-4189 Erie Ph/ladelpkia (215) 560-2385 Wilkes Bm-re (412) 565-5213 (814) 871-4433 (717) 820-4904 --- P~dO ~P..,acM OFFICER COMMONWEALTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND : AFFIDAVIT z~';(~"'/' / ,&.':.'d--'J .~,q-,/**ie-- .'~/.-/~'d;r,m4,'-Z~Petitioner in this matter, being duly sxvom according to law, do depose and state that I am of , and that the facts set forth in the foregoing Petition are tree and correct to the best of my knowledge, information, and belief. ~/~.~ .~~ .. Petitioner SWORN TO AND SUBSCRIBED BEFORE ME, THIS DAY OF ,20__ NOTARY PUBLIC IN RE: Mark Glessner, an Alleged Incapacitated Person : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PA : ORPHANS' COURT DIVISION : NO. 21-04- : GUARDIANSHIP PETITION FOR AN APPOINTMENT OF A GUARDIAN PURSUANT TO 20 PA. C.S.A. § 5511 1. Petitioner is Robert L. O'Brien, Esquire, attorney for the Cumberland/Perry MHMR Office. MHMR obtained an emergency appointment of a Guardian for Mark Glessner on October 26, 2004 and on October 28, 2004. 2. Attached hereto is the original Petition filed that provides information about Mark Glessner. The MHMR office has determined that Mark Glessner would benefit by having a permanent Guardian of the Estate and Person. 3. The MHMR office is soliciting family members to see if one would be willing to serve. In the alternative, the MHMR director and his successors, request appointment. WHEREFORE., Petitioner respectfully requests that a family member or Dennis Marion or his successor as Director of the MHMR office, be appointed Plenary Guardian of the Estate and Person of Mark Glessner. Respectfully submitted, O'BRIEN, BARIC & SCHERER By Robert L. O'Brien, Esquire Attorney for Petitioner I.D. # 28351 17 West South Street Carlisle, Pennsylvania 17013 (717) 249-6873 I verify that the statements made in the foregoing Petition for an Appointment of an Plenary Guardian Pursuant to 20 PA. C.S.A. § 5511 are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904, relating to unsworn falsification to authorities. Robert L. O'Brien, Esquire Dated: IN RE: Mark Glessner an Alleged Incompetent · IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA · ORPHANS' COURT DIVISION :NO. · GUARDIANSHIP ORDER OF COURT AND NOW, this 2(0 day of ~--~ ,2004, upon review of the attached Petition, and pursuant to 20 PA. C.S.A. § 5513, this Court appoints Dennis Marion, Emergency Guardian of the Estate and Person of Mark Glessner, an alleged incompetent for a period of seventy-two (72) hours. BY THE COURT, IN THE MATTER OF AN ALLEGED INCOMPETENT IN THE COURT OF COMMON PLEAS COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RENO. The Petition of PETITION FOR APPOINTMENT OF A TEMPORARY GUARDIAN OF THE PERSON PURSUANT TO 20 Pa. C.S.A. 5513 , respectfully represents: Your . Petitioner is ~,~k 0-o~<~557~9_ (' domiciled having been bom on ~q3~~ ~M, ICD~ ~a_~~a~ (' ~ marital is currently receiving care at at years of age status is Those persons, if any, who are {"f'¥~tXX[ 0,,_~\-~5>%.~ 2 %-. next-of- kin and their relationship to same, of whom your Petitioner has knowledge are as follows: ~X~(~' e'O %~.'~%%'"'tgL4 No other Court within the Commonwealth of which Petitioner has knowledge has appointed a guardian for ~'~(~)~-0-,D~i~.ZX'xiLA ~'X,Q ~9~,.rc,~z%/x,~ is mentally retarded. Because of mental deficiency, x/'~(X,Q,.C 0,,.D~\'x,v_~ lacks 10. 11. sufficient capacity to make or communicate responsible decisions conce~!ng his/her person~ as set forth in the attached Affidavit prepared by ,4~,~ m~ked as Exhibit A and made a pa~ hereof. ~~~ is in need of residential ~ se~ices. ~ ~~ has been accepted for placement at ~q~ ~~Q~ ~ Q~ ~ upon 12. the condition that a guardian of the person be appointed to consent to said placement on his/her behalf· ~L'('~.'~ ~X~c~,~ , ~ffxVq. o~(~having no interest adverse to ~(x~(kk~_Q~::~x'~/,, , has agreed to act as Temporary Guardian of the Person of' '{"~(~.~ ~x(x.¢.4 if this Honorable Court shall so appoint. WHEREFORE, Petitioner under the temporary guardianship of~\~ prays this Court place , pursuant to 20 Pa. C.S.A. § 5513 and empower said temporary guardian to provide substitute consent for such community-based or institutional services as may be necessary to provide for his/her needs. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLtC WELFARE OFFICE OF MENTAL RETARD~'TioN .. Central Region "' ' ' Willow Oak Building, Room 430 P.O. Box 2675 Harrisburg, Pennsylvania ~'~05-2675 September 30, 2004 Nh'. Mark W. Glcssner C/O Beverly Health Care Camp Hill 46 Erford Road Camp Hill. Pennsylvania 17011 Dear Mr. Glessner: In 1987, Congress enacted major nursing facility, reform legislation that mandated a Preadmission Screening Program for individuals sec -king admission to any nursing facility participating in the Medical Assistance Program. Thc purpose of the screening is to determine whether individuals who may be mentally retarded need nursing facilities and if they also need specialized services to treat their condition. The DeparUnent of Public Welfare has completed its review of your application for admission to a nursing facility. The attaclxment (Appendix I) contains our final determination regarding the above- mentioned needs. Further information on available services for persons with mental retardation may be obtained by contacting the followIng agencies: County. Mental Health/ Mental Retardation Office: Cumberland/Perry. MHJMK Address: 16 West High Street Carlisle, PA 17013 Phone #: (717) 240-6325 Local Advocacy Agency: ARC, Cumberland/Perry Address: P.O. Box 386 117 N. Hanover Street Carlisle, PA 17013 Phone#: (717) 249-2611 Sincerely, ,w~ - Attachment - Appendix I c: Cumberland Count>.' Assistance Office Cumberland Count' AAA Cumberland/Peru.' MI-t/MR Program Ms. Stephame L. K/rk~patnck. BSW File APPENDIX I NOTIFICATION OF PREADMISSION SCREENING I CONTROL NUMBER: 166-52-1360 DETERMINATION The Department has completed its review of your application for admission to a nursing facilib'. The evaluation and review has been conducted in order to assist you ,,,,5th the determination of the most approphate level and type of care for your current condition. The Department is required to determine whether you need the leveI of services provided by a nursing facili¢' and, if you do, whether you need specialized services for either mental illness, mental retardation, or other related conditions The Department has determined that You require the level ofservices [/x~ You need specialized serw'ices. provided by a nursing facility, and as desired may be admitted to a nursing facili~ enrolled with the Department ] 180 d%,s or less [] More than 180 days You do not need specialized services ] You do not require the level of ~] Other as explained in our services provided by a nursing facility attached letter an:d may not be admitted to a nursing facility enrolled with the Department IF YOU NEED MORE INFOR~ML4TION ABOUT THE EVALUATION OR DETER~MINATION PROCESS, YOU MAY CALL: (717) 772 -6507 RIGHT TO APPEAL AND FAIR HEARING If you have been determined not to require a lexel of service provided by a nursing facili~' and/or mental retardation specialiked services, you may appeal that determination by filing an appeal Mth: Bureau of Hearings and Appeals Department of Public Welfare P.O. Box 2675 Harrisburg, Pennsylvama 17105-2675 Ixfforrnation concerning the filing of appeals can be obtained by calling the Bureau of Heanngs and Appeals at an)' of the follo~mg telephone numbers: Harrisburg (717) 783-3950 Pittsburgh Reading (610) 378-4189 Erie Philadelpb. ia (215) 560-2385 Wilkes Barre (412) 565-5213 (814) 871-4433 (717) 820-4904 --- P~tLacM OFFICER ~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUlVlBERLAND AFFIDAVIT z:~)i'-~"'""'d' ,,"?""5~'~'-'~ "'~';~'/~'~'" '~/~-/"~"rM,'~ZPetitioner in this matter, being duly sworn according to law, do depose and state that I am of , and that the facts set forth in the foregoing Petition are tree and correct to the best of my knowledge, information, and belief. Petitioner SWORN TO AND SUBSCRIBED BEFORE ME, THIS DAY OF ,20 NOTARY PUBLIC IN RE: Mark Glessner an Alleged Incapacitated Person : IN THE COURT OF COMMON PLEAS COUNTY, PA : ORPHANS' COURT DIVISION · NO. 21-04- ~'£~ · GUARDIANSHIP ORDER OFCOURT AND NOW, this ~ ~ day of O(-/~ ,2004, upon review of the attached Petition, and pursuant to 20 PA. C.S.A. § 5513, this Court appoints Dennis Marion, Emergency Guardian of the Estate and Person of Mark Glessner, an alleged incapacitated person. ITIS FURTHER ORDERED THAT: The Guardianship shall appointment shall terminate at on November 18,2004, and no ~epor[ by the Guardian shall be required. BY THE COURT, Ir~ RE: Mark Glessner an Alleged Incapacitated Person · IN THE COURT OF COMMON PLEAS · OF CUMBERLAND COUNTY, PA : ORPHANS' COURT DIVISION NO. 21-04- GUARDIANSHIP TO MARK GLESSNER IMPORTANT NOTICE CITATION WITH NOTICE A petition has been filed with this Court to have you declared an Ihcapacitated Person. If the Court finds you to be an Incapacitated Person, your ghts will be affected, including your right to manage money and property and to aka decisions. A copy of the Petition which has been filed by Robert L. O'Brien is attached. You are hereby ordered to appear at a hearing to be held in Courtroom No. i~/ , Courthouse, Carlisle, Pennsylvania, on 2004,, at//..~ .~_.M. to tell the Court why it should not find you to be an Ihcapacitated 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 be conducted 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 rbpresenting you) the Court will still hold the hearing in your absence and may appoint the Guardian requested. / IN An Cour mar Cu~ E: MARK GLESSNER leged incapacitated person IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-2004-0969 IMPORTANT NOTICE CITATION WITH NOTICE A petition has been filed with the Court to have you declared an Incapacitated Person. If the finds you to bc an Incapacitated Person, your rights will bc affected, including yonr right to ge money and property and to make decisions. A copy of the petition which bas been filed by ~erland/Perry MHMR Office is attached. You are hereby ordered to appear at a hearing to be held in Court Room No. 4, Cumberland  ounly Courthouse, Carlisle, Pennsylvania, on Novem~ber 2~3 _, 200~4, at ~11:30 A..M. to tell the Comrl why is should not lind you to be an incapacitated Person and appoint a Guardian to act on your bch~I[: To be an incapacitated Person means that you are not able to receive and efl'ectively evaluate information and communicate decisions and that you arc 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 ajury trial. If you do not have an attorney, you have thc right to requcst thc Court to appoint an attorney to represent you and to have the attorney's fees paid fbr you if you cannot aflbrd to pay them yourself. You also have the right to request that thc 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 ?' ~Z884 IN RE: Mark Glessner an Alleged Incapacitated Person · IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, PA · ORPHANS' COURT DIVISION · NO. 21-04- · GUARDIANSHIP TO MARK GLESSNER IMPORTANT NOTICE CITATION WITH NOTICE A petition has been filed with this Court to have you declared an I Incapacitated Person. If the Court finds you to be an Incapacitated Person, youri 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 Robert L. O'Brien is attached. You are hereby ordered to appear at a hear~ipg to be held in Courtroom Noi ~/ , Courthouse, Carlisle, Pennsylvania, on ~/~'¢~) , the,.2~¢~day 2004, at / . ,~ ~F_.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 l 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 be conducted 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 add your capacity to make and communicate decisions. The Guardian will be of yot~r 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 and may appointl the Guardian requested. By: iN RE: MARK GLESSNER An alleged incapacitated person : IN THE COURT OF COMMON PLEAS OF 1 CUMBERLAND COUNTY, PENNSYLVANIP4 : ORPIIANS' COURT DIVISION : NO. 21-2004-0969 IMPORTANT NOTICE CITATION WITH NOTICE A petition has been filed xvith the Court to have you declared an Incapacitated Person. Il' thi Court finds you to be an Incapacitated Persou, your rights will be affected, including your right to / manage mouey and property and to make decisions. A copy of the petition which has been filed by Cumberland/Pe~T¥ MHMR Office is attached. Yon are hereby ordered to appear at a hearing to be held in Court Room No. _4, Cumberland / County Courthouse, Carlisle, Pennsylvania, on November 23 ,2004, at 11:30 A..M. to teII the Court why is should not find you to be an incapacitated Person and appoint a Guardian to act on yot! bchalt~ 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 bc spent. At the hearing, you have the right to appear, to be represented by an attorucy, 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. Thc Guardian will be of your person and/or your money and other property and will have either limited of full poxvers to act for you. lfthc court finds you are totally incapacitated, your legal rights will be affected and you wilI 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 lcgaI 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 ,,'ill still hold the hearing in your absence.~ a~d may appoint the G,u. ardian requcsteO./~, Date:10-29-04 By:. ~ttC¢r~ 'L~ C* ~ . Clerk, Orphans' Court Division ~Dt A"~/~, Cumberland County, Carlisle, PA !/s~ ~ , My Commission Expires 1~' Monday,' January, 2006 IN RE: MARK GLESSNER an ALLEGED INCAPACITATED PERSON IN RE: PETITION GUARDIAN IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-969 GUARDIANSHIP FOR AN APPOINTMENT OF A PURSUANT TO 20 PA.C.S.A. 5511 ORDER OF COURT AND NOW, this 23rd day of November, 2004, this matter having been called for hearing, the parties hereto being in agreement that Mark Glessner is in fact an incapacitated person and is in need of a guardian, the court appoints Dennis Marion as plenary guardian of the person of Mark Glessner, the incapacitated person. By the Court, Kev~A. Hess, J. Robert L. O'Brien, Esquire ~ / .... For Petitioner ~ ~--' ~ ~ ~ David H. Martineau, Esquire '---~n For Mrs. Glessner (~'-% {q.~)~., : Jacqueline M. Verney, Esquire ~[kx*~ ~ Court-appointed for Mark Gless~O~ ' , i:., Marjorie A Wevodau First Deputy One Courthouse Square Carlisle, Pa 17013 ___'__.__'_ ,_...__.. 0'_,._~'__ ...c._ '-.;llGlluCl rClIII~! .:JLi Q~UClU:-!11 Register of Wills & Clerk of the Orphans' Court (717) 240-6345 FAX (717) 240-7797 KIrk S. Sohonage, Esquire Solicitor OFFICES OF Register of Wins anb 'lClerk of tbe ~rpfJans' ([ourt <!Count)) of QSumbl'rlanb December 1, 2005 Dennis Manon One Courthouse Square CarlIsle, PA 17013 IN RE: Estate of Mark Glessner, an incapacitated person File No. 21-04-0969 Dear Sir/Madam: It has come to my attention that you have not filed the guardian reports required by 20 Pa.C.S.A. 95521(c) in the above captioned guardianship. Enclosed you will find the suggested fonn(s). Please mail those reports, along with a check for the filing fee which is $15 for each report filed, payable to the Clerk of Orphans' Court, to the following address wi thin (30) days: Clerk of Orphans' C0U11 One Courthouse Square Carlisle, P A 17013 If you have any questions, please contact your attomey. Respectfully, Glenda FameI' Strasbaugh Cierk of the Orphans' Coun CC: Robert L. O'Brien, Esquire .. ~ . Clerk of Orphans' Court of Cumberland County INRE: [rTl&--FZ .d~ /"'1~' W-t-f'/V61/. Docket No, C?I-c:J-o-OY - 0967' An Incapacitated Person ANNUAL REPORT OF GUARDIAN OF THE PERSON I, pf/l//I//f ~/tt;.A,) ~ ~#/1,e 4:>""'/"/1 r~~ , was /VV'et'e""appointed plenary guardian(s) of the person of ~/?A:/C ~.j#~ by Decree of the Honorable Judge lCe,,!I.,! ~,( , dated / / bJ' h'tM,/ . This is my annual report for the period from 1'O'~/~r' t:'7~? ~~s:1'The Report Period"). 1. Present age of the incapacitated person: fd-.- Yrs. 2. Current address of the incapacitated person /.j>Y ~.-v/~ J?- ~d2-4- / ~ /:7 i1 ..;L S-- 3. The incapacitated person's residence is: o own home/apartment o nursing home " j o boarding home/personal care home o guardian's home/apartment -) ;~ . "'t o hospital or medical facility f" '\ ~ relative's home ~,J)E7"-/ ~J/1/~ "",~ c, (Name and relationship) o other: (describe) 4. The incapacitated person has been in the present residence since (l;,eT1'f- //,b#f'7 . If / , the incapacitated person has moved within the past year, state change and reason(s) for .~~ change: 5. Name and address of the incapacitated person's primary care giver: ~2/~~ ~.r~~ ~ ~ 4T.r/..rpt)N~ ~/k,. ) q. ~ k ~/JvP.J d:Trt7v/4-7-rT ,/ Y' ;r-. 4 ~.,~ ~vm ~ ~v/u'..yL../ ~dI-/?- . ~ /7t?";' (---- / 6. The major medical or mental problems of the incapacitated person are as follows: ~hV".N'V .fifE~ ~.7">?wOAh70.J tf/<P- d- ) ./ 7. Specify what, if any, social, medical, psychological and support services the incapacitated person IS receIvmg: 8. ft~ ~7Jf- ~ ,,' ~~~ ~JO ~/h-r:J . ~~ t4-0~~.;1L~/.r"C- ~w/t..--t- ~t/Jir^//~ / J'ff~ C~~/.-../.-(J.-r7Q..rJ,,) t::~<!~14-'--' -~J-~ ~#-~ It is our opinion as guardian of the person that the guardianship should: (check one) ~ continue, 0 be modified, 0 be terminated. (Briefly explain your response) 9. 4~.~..o/.,.. //"'C~~ fop .s'/?.Mf d~;' ~G-v-o,~, c -" .ZJ/,Aoo€-'A/n~ CO v'/~ W/ ~ /7z~~ ~771- f"//'h c.-/IC- /""1~':" r ~ #<t/bl 70 7t ~ , During the past year, I have visited the incapacitated person'.;2.... times with the 4r~M4-1,"(:- average visit lastirrg j')E C4V'/OJ'-:j ~~Ks j.-th~ . /S- ~ v~- ~,-- /J ~./CJ J~ .11'/ (State nu~ber of hours 1m in utes, etc.) ~.A/~ J;-~~ . ~ . I 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. 94904 relative to unsworn falsification to authorities. ~ -JtD -. oS-- Date ~ ~ .A't'./'J,A.../' Signature of Guardian ~/.NJ/:n.~~ * FILING FEE $15 MUST ACCOMPANY THIS FILING.