HomeMy WebLinkAbout02-08-05
INRE:
AN ALLEGED INCAPACITATED
PERSON, ELIZABETH ANN ELLIS
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYL VANIA
ORPHAN'S COURT DIVISION
NO. ) 5 - I ^ d-
PETITION FOR ADJUDICATION OF INCAPACITY AND
APPOINTMENT OF PLENARY GUARDIAN OF THE ESTATE
AND PERSON IN ACCORDANCE WITH 20 Pa.C.S.A. ~ 5511
The petitioner, JACQUELINE A. ELLIS. by and through her attorneys. Salzmann
Hughes, pc, respectfully represents the following:
1. Petitioner, JACQUELINE A. ELLIS, is an adult individual whose principal
residence is 1924 Esther Drive. Carlisle, Pennsylvania 17013.
2. Petitioner is the mother of ELIZABETH ANN ELLIS (hereinafter the "alleged
incapacitated person").
3. The alleged incapacitated person was born on October 27. 1986. is 18 years of
age. unmarried, and currently resides at Health South Rehabilitation of Mcchanicsburg. located
in Cumberland County. Pennsylvania.
4. The alleged incapacitated person was transferred to said facility on or about
January 14. 2005. following a motor vehicle accident occurring on December 18. 2004. Prior to
that time she resided at home with her mother. Jacqueline A. Ellis. at 1924 Esther Qrive.
Carlisle. Pennsylvania 17013.
5. To the best of Petitioner's knowledge. information and belief.' the alleged
incapacitated person is not survived by a spouse or children.
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6. To the best of Petitioner's knowledge, information and bclicf. thc only living
ncxt-of-kin of the allcged incapacitated person is:
Jacquelinc A. Ellis (mother)
1924 Esther Drivc
Carlisle. PA 17013
7. The only institution currently providing residential serVIces for the alleged
incapacitated person is Health50uth Rehabilitation of Mechanicsburg, located at 4950 Wilson
Lane, Mechanicsburg, Pennsylvania 17055.
8. To thc best of Petitioner's knowledge, information and belief: the alleged
incapacitated person has a savings account with a balance of approximately $267.00.
9. Petitioner estimatcs the alleged incapacitated person's monthly income to be
$267.00, an 551 survivor bcnefit set to discontinue on June 3, 2005.
10. The alleged incapacitated person is prcsently in an unresponsive state resulting
from the injuries she sustained in the motor vchicle accident. A true and corrcct copy of a lcttcr
dated Fcbruary 4, 2005, from the alleged incapacitatcd person's treating physician, Peter Brier,
M.D.. of Internists of Central Pennsylvania is attached hereto and incorporated herein as Exhibit
"A."
11. As stated by Dr. Brier in Exhibit "N', because of her impaircd physical and
mental condition. the alleged incapacitated pcrson lacks the ability to care for herselL to
efTectively receive and evaluate information. As such. shc lacks the ability to make responsible
decisions concerning hcr care and meet essential requircments for her physical health and safety.
12. As stated by Dr. Brier. in Exhibit "A:' the alleged incapacitated person is "totally
dependent upon nursing and other caregivers. and completely unable to care for herself for her
activities of daily living:'
13. Dr. Brier also stated in Exhibit "A" tbat he does not expect the alleged
incapacitated person's condition to change in the near future.
14. Because she is unresponsive. the alleged incapacitated pcrson is totally unable to
managc her financial affairs and resources, and is totally unable to make and communicate
responsible decisions rclating thcreto.
15. The scverity of the alleged incapacitated person's physical condition neccssitates
that a plenary guardian of her person be appointed to handle all issues rclating to the alleged
incapacitated person. specifically including, but not limited to: her living arrangements. hcr
medical care. the administration of medication to her. and the employment and discharge of
physicians, dentists, nurses, therapists and other professionals for her physical and mental
treatment and care.
16. The severity of the alleged incapacitated pcrson's physical condition necessitates
that a plenary guardian of her estate be appointed to handle all aspects of the alleged
incapacitated person's estate. specifically including. but not limited to: all issues rclating to her
cash. checks, and any bank or savings accounts hcld in her name. her personal property. her
cntitlemcnt to any governmental and nongovcrnmental bcnefit plans. federal. state. and local
taxes. claims made or to be made on behalf of her or against her. the exccution of any documents
necessary and related to the above, and the entry into contracts affecting her as wcll as the
payment of reasonable compensation or costs to provide services to hcr.
17. The proposed plenary guardian ofthe person and ofthe estate of the alleged
incapacitated pcrson is Petitioner. JACQUELINE A. ELLIS. whose principal residence is 1924
Esther Drive. Carlisle. Pennsylvania 17013.
18. Petitioner. the proposed plenary guardian of the person and of the estate of the
alleged incapacitated person is her mother and has no interest adverse to the alleged
incapacitated person.
19. The consent or the Petitioner as the proposed plenary guardian is attached hereto
and incorporated herein as Exhibit "B"
20. No other court has ever assumed jurisdiction in any proceeding to determine the
capacity of the alleged incapacitated person.
WHEREFORE, Petitioner respectfully requests that this Court award a citation directed
to ELIZABETH ANN ELLIS. the alleged incapacitated person and to such other persons as this
Court may direct. to show cause why ELIZABETH ANN ELLIS should not be adjudged a fully
incapacitated person. and Petitioner appointed plenary guardian of both her person and her
estate.
Respectfully Submitted.
SALZMAN'N HUGHES PC
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Dated: 'J---./ t/O~
J~Jj~ D,~
Susann B. Morrison. Esquire
Supreme Court I.D. # 77041
95 Alexander Spring Road. Suite 3
Carlisle. l' A 17013
(717) 249-6333
Attorney for Petitioner
CONSENT OF GUARDIAN TO APPOINTMENT
I, JACQUELINE A. ELLIS, hereby consent to act as the Guardian of the Estate and
Person of ELIZABETH A. ELLIS.
I reside at 1924 Esther Drive, Carlisle, Cumberland County, Pennsylvania, and am the
mother of ELIZABETH A. ELLIS. I am a citizen of the United States of America and can speak,
read and write the English language.
I have no interest adverse to ELIZABETH A. ELLIS, the alleged incapacitated person.
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7l0~tN'A/Y)-P (/ ~ ~
. .,IA ELINE A. ELLIS
Date: January 28, 2005
VERI FICA nON
The foregoing document is based upon infom1ation that has been gathered by my counsel
and myselfin the preparation of this action. I have read the statements made in this document
and they are true and correct to the best of my knowledge, information and belief I understand
that false statements herein made are subject to the penalties of 18 Pa.C.S.A. S 4904, relating to
unsworn falsification to authorities.
<--~. ;'J . .k."-/YJ
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( acqueline A. Ellis
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Date: .:) - 7- ()!..J