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HomeMy WebLinkAbout07-10-14 cDmmanfU2a#tb of VanngpTbanta, - 4'; Camp of &ark, 06 : I, BRADLEY C. JACOBS, Register of Wills and Clerk of the Orphans' Court Division, i Court of Common Pleas in and for the County of York in the Commonwealth of Pennsylvania, the said Court being a. Court of record and law, and having a CIerk and seal, DO HEREBY CERTIFY that the following is a true and correct copy of the entire record for Frankie Lee Coleman, An Incapacitated Person, 6711-0588 in the herein stated case as the same remains filed and of record in said Court. In Testimony Whereof, I ereunto set my hp4 and affixed the seal of the said Office at York this 3m day o my,,2014. 0 Register of ill a oft e Orphans'Court commontuattb of VMnnp#banfa, Cauntp of fork so : I, John S. Kennedy, Judge of the Orphans' Court Division of the Nineteenth Judicial District of the Commonwealth of Pennsylvania,composed of the County of York in said State, DO HEREBY CERTIFY that the above named Bradley C. Jacobs, by whom the foregoing attestation was made, was, at the time of so making the same, and now is the Clerk of said Court, duly commissioned and qualified, to all whose acts as such full faith and credit are and ought to be given,as well as in courts of judicature elsewhere; that the seal thereto annexed is the seal of the said Court: and that the said attestation so made by him is in due form. In Testimony Whereof,I have hereunto/ e rn and this 3rd day of July, 2014, 1 --o John S.Kennedy, QCommantnealt#j a# �enn�p#battia, ��=._ �, . _� Countp of dark + I,BRADLEY C.JACOBS,CIerk of the Orphans' Court Division,CTOurt of Co on r'IeW of the County of York in the Commonwealth of Pennsylvania, DO HEREBS CERTIFY that the Honorable John S. Kennedy, by whom the foregoing attestation was made and _ whose name is thereto subscribed, was, at the time of making thereof, and is the Administrative Judge of the Orphans'Court Division, Court of Common Pleas for the County of York, composing the Nineteenth Judicial District of Pennsylvania, duly commissioned and qualified, and to all whose acts as such full faith and credit are and ought to be given,as well as in courts of judicature elsewhere. In Testimony Whereof,I have hereunto set my hand and affixed the seal of the said Court at York, this 3rd day of July,2014.. Cier o 2e Orphans'Court HF4L?'HS0[ITH Rehabddation Nosprtal ofYork viar:n 25, 201-1 c whorn it may coniern: This is to verify that Mr Frania- Coleman was admittec to Health5DUt.. Rehabilitation Hospital on 3%22!11 Based on Ivlr. Coieman's medical condition he is unable to zommunicaie o.handle his Personal affairs including his financial responsinii&es, His length of stay and duration o- his medical condition is undetermined at this time_. Mr. Coleman's daughters, Knitique Coleman and Bridgette Pierce, are the family member taking the responsibility to oversee his medical and financial needs. Si i -ereiy, - 1 c Bruce IJaskin, D.O. 7850 Normandie Drive• York, PA 77408. 717 767-6941 •Fax 717 764-1341 Patricia Carey Zucker, Esquire DALEY ZUCKER MEILTON MINER&GINGRICH. LLC 1035 Mumma Rd., Suite 101 Wonnleysburg, PA 17043 (717)724-9821 pzucker @dzmmglaw.com F-4 RE: GUARDIANSHIP OF : IN THE COURT OF COMMON PLF,AS OF FRANKIE LEE COLEMAN, : YORK COUNTY, PENNSYLVANIA AN ALLEGED INCAPACITATED ORPHANS' COURT DIVISION PERSON NO. CONSENT OF INDIVIDUAL TO APPOINTMENT AS EMERGENCY PLENARY GUARDIAN OF PERSON AND ESTATE I, Knitique S. Coleman, hereby consent to my appointment as emergency plenary guardian ofthe person and estate of Frankie Lee Coleman, an alleged incapacitated person, and certify that: I. I am 18 years of age or older. 2. 1 currently reside at 4063 Darius Drive. Enola, PA 17025. 3. My occupation is an Application Developer Lead at Highmark Blue Shield in Camp Hill, Pennsylvania. 4. I speak, read and write the English language. 5. 1 am a citizen of the United States. 6. 1 do not have any interest adverse to the alleged incapacitated person. 7. I am not a fiduciary, or an officer or employee of a corporate fiduciary, of an estate in which the alleged incapacitated person has an interest, or a surety, or an officer or employee of a corporate surety,of such a fiduciary. Datc: � � ;�P) I, 4nitji4ue S. man, P IN THE COURT OF COMMON PLEAS OF YORK COUNTY PENNSYLVA'.NIA, ORPHANS' COURT DIVISION In re: FRANKIE LEE COLEMAN, 6711-0588 an Alleged Incapacitated Person PRELIMINARY DECREE And now, upon consideration of the April 5, 2011 'Petition for Adjudication and Emergency Appointment of Plenary Guardian of Person and Estate" filed by Knitique S. Coleman, it is HEREBY ORDERED AND DECREED that: 1. A Citation be issued to Frankic Lee Coleman("Mr. Coleman"or"alleged i incapacitated person")to show cause, if there be any,why the relief requested in the Petition should not be granted specifically, that Mr. Coleman be adjudicated an incapacitated person and that Knitique S. Coleman be appointed emergency plenary guardian of the estate and person of Mr. Coleman pursuant to 20 Pa.C.S. § 5513. 2. The Citation shall be returnable on Tuesday, April 12,2011 from 1:00-2:30 pm in Courtroom Six of the York- County Judicial Center,45 N, George St. York,PA 17401, at which time a hearing will be held on whether the Court should grant the relief requested in the Petition. 3, Richard Konkel,Esq. of CGA Law Firm is appointed as counsel for Mr. Coleman. Attorney Konkcl is expressly authorized to meet with Mr. Coleman as deemed appropriate under the circumstances and be granted access to Mr. Coleman's medical i records. Attorney Konkel shall be compensated for his services to the alleged incapacitated person at the standard court-appointed rate and as provided by 20 Pa.C.S. § 5511(c). 4. Any physician who may testify to the alleged incapacitated person's incapacity and need for guardianship services may testify live at the hearing by speakerphone,if arrangements are made prior to the hearing,preferably in writing, with court staff. 5. Petitioner shall personally serve a copy of the Petition,Citation with Notice, and this Preliminary Decree upon the alleged incapacitated person, and those documents shall be explained in understandable terns to the maximum extent, at least 3 days before the hearing. 6. Petitioner shall personally serve the following persons and entities identified in the Petition with a copy of the Petition and this Preliminary Decree: Bridgette Pierce, Orian Coleman, Lillie Mae Hightower,Carmen Coleman, and York Hospital. 7. Petitioner shall make best efforts to locate Martha Anderson and give her notice of the scheduled hearing and a copy of the Petition and this Preliminary Decree as soon as possible. BY THE COURT: I E� BLACK �LL, Judg April 6,2011 IMPORTANT NOTICE CITATION WITH NOTICE COURT OF COMMON PLEAS OF YORK COUNTY,PENNSYLVANIA ORPHANS' COURT DIVISION To: Frankie Lee Coleman IMPORTANT NOTICE CITATION WITH NOTICE An Emergency Petition has been filed with this Court to have you declared an Incapacitated Person. If the Court finds you to be an Incapacitated Person, your 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 Knitique S. Coleman is attached. ��— You are hereby, ordered to appear at a hearing to be held in Courtroom No. Pennsylvania on t 2011 at . r}L) t�•m. to tell the ourt why i hould not find you to be 20 Incapacitated Person and appoint an emergency Guardian to a t 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 emergency 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 that will have either limited or full powers to act for you. To: Prankie Lee Coleman 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 appoint the Guardian requested. By: C 4C�k, rphans' Co REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF YORK COUNTY YORK COUNTY JUDICIAL CENTER BRADLEY C. JACOBS ARA KIMBERLY MCPHERSON Register of Wills Chief Deputy Clerk of Orphans'Courl Register of Wills JOHN C. HERROLD - BECKY K. FOUST Solicitor Chief Deputy Clerk of Orphans'Court Division 45 NORTH GEORGE S1 REET YORK,PA. 17401-1240 REGISTER OF WILLS(717)771-9607 • CLERK OF ORPHANS'COURT(717)771.9288 FAX:(717)771-4678 • www.york-county.org REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF YORK COUNTY YORK COUNTY JUDICIAL CENTER BRADLEY C. JACOBS ARA KIMBERLY McPHERSON Register of Wilts _ Chief Deputy Clerk of Orphans'Court *''l,.y. Register of Wills JOHN C. HERROLD ,.- BECKY K. FOUST Solicitor Chief Deputy Clerk of Orphans'Court Division I 45 NORTH GEORGE STREET YORK,PA. 17401-1240 REGISTER OF WILLS(717) 771.9607 • CLERK OF ORPHANS'COURT(717) 771-9288 FAX: (7171 771-U78 • www.york-county.org REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF YORK COUNTY YORK COUN-1Y JUDICIAL CENTER BRADLEY C. JACOBS ARA KIMBERLY McPHERSON Register of Wills Chief Deputy Clerk of Orphans'Court Register of Wills JOHN C. HERROLD ? BECKY K. FOUST Solicitor Chief Deputy Clerk of Orphans'Court Division 45 NORTH GEORGE S I REET YORK, PA.1 7401-1 2 40 REGISTER OF WILLS (717) 771-9607 • CLERK OF ORPHANS'COURT 1717) 771-9288 FAX:(717) 771-4678 • www.york-county.org REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF YORK COUNTY YORK COUNTY JUDICIAL CENTER BRADLEY C.JACO65 ARA KIMBERLY McPHERSON Register of Wills Chief Deputy Clerk of Orphans'Court _ p il Register of Wills JOHN C. HERROLD Solicitor BECKY K. FOUST Chief Deputy Clerk of Orphans'Court Dipision I 45 NORTH GEORGE SIREET YORK, PA. 17401.1240 REGISTER OF WILLS (717)771-9607 • CLERK OF ORPHANS'COURT(717) 771-9288 FAX: (717) 771-4678 • www.york-county.org REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF YORK COUNTY YORK COUNTY JUDICIAL CENTER BRADLEY C.JACOBS Register of Wills ARA KIMBERLY McPHERSON Clerk of Orphans'Court i.ei Chief Deputy Register of Wills JOHN C. HERROLD So/icifor "' :i ' ' BECKY K. FOUST Chief Deputy Clerk of Orphans,Court Division 45 NORTH GEORGE S3 REET YORK, PA. 1 7401-1 24 0 REGISTER OF WILLS 017) 771-9607 - CLERK OF ORPHANS'COURT(717) 771-9288 FAX:(717)771-4(,78 • www.york-county.org REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF YORK COUNTY YORK COUNTY JUDICIAL CENTER BRADLEY C.JACOBS Register of Wills ARA KIMBERLY MCPHERSON Clerk of Orphans'Court -,;4y_ Chief Deputy Register of Wills JOHN C. HERROLD Solicitor «' % BECKY K. FOUST Chief Deputy Clerk of Orphans'Court Division I 45 NORTH GEORGE STREET YORK,PA. 17401-1240 REGISTER OF WILLS p17) 771-9607 • CLERK OF ORPHANS'COURT(717)771-9288 FAX: (717) 771-4678 • www.york-county.org REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF YORK COUNTY YORK COUNTY JUDICIAL CENTER BRADLEY C.JACOBS Register of Wills ARA KIMBERLY MCPHERSON Clerk of Orphans'Court - Chief Deputy Register of Wills JOHN C. HERROLD Solicitor BECKY K. FOUST Chief Deputy Clerk of Orphans'Court Division 45 NORTH GEORGE S1 REET YORK, PA. 17401.1240 REGISTER OF WILLS(717)771-9607 • CLERK OF ORPHANS'COURT(717) 771-9280 FAX:(717) 771.4678 • www.york-county.org REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF YORK COUNTY YORK COUNTY JUDICIAL CENTER BRADLEY C. JACOBS Register of Wills ARA KIMBERLY McPHERSON Clerk of Orphans'Court �„ Chief Deputy "'� Register of Wills JOHN C. HERROLD Solicitor = _ ''� ° BECKY K. FOUST Chief Deputy Clerk of Orphans'Courf Division 45 NORTH GEORGE SI REET YORK, PA. 17401-1240 REGISTER OF WILLS(717)771-9607 - CLERK OF ORPHANS'COURT(717) 771.9288 FAX: (717) 771.4178 • www.york-county.org Patricia Carey Zucker,Esquire DALEY ZUCKER MEILTON MINER&GINGRICH, LLC 1035 Mumma Rd., Suite 101 Wormleysburg,PA 17043 (717)724-9821 pzucker@dzmmglaw.com IN RE: GUARDIANSHIP OF : IN THE COURT OF COMMON PLEASMF FRANKIE LEE COLEMAN, : YORK COUNTY,PENNSYLVANIA AN ALLEGED INCAPACITATED : ORPHANS' COURT DIVISION V ,' PERSON NO. 6711-0588 SUPPLEMENTAL EXHIBIT TO PETITION FOR ADJUDICATION OF INCAPACITY AND EMERGENCY APPOINTMENT OF PLENARY GUARDMA OF PERSON AND ESTATE TO THE HONORABLE PENNY L. BLACKWELL: AND NOW, comes Petitioner,Knitique S. Coleman, by and through her attorneys,Daley Zucker Meilton Miner &.Gingrich, LLC, pursuant to 20 Pa. C.S. §§5511 and 5513, to file a Supplemental Exhibit to Petition for Adjudication of Incapacity and Emergency Appointment of Plenary Guardian of the Person and Estate of Frankie Lee Coleman and in support thereof avers as follows: I. On or about April 5, 2011, Petitioner filed a Petition for Adjudication of Incapacity and Emergency Appointment of Plenary Guardian of Person and Estate ("Petition"), which is of record with the Court. 2. At the time of the filing of the Petition, Petitioner had not yet received the Deposition of the Attending Physician to Frankie Lee Coleman, Lee Maddox, M.D., at Weilspan Health York Hospital, which Deposition is attached hereto and incorporated herein by reference. 1 The medical information and opinion provided by Dr. Maddox alleges that the alleged incapacitated person, Frankie Lee Coleman, was in a more critical medical condition than originally thought when the Petition was filed on April 5, 2011 and therefore, Petitioner wishes to provide the Court with the Deposition of Dr. Maddox and with additional information as to why Petitioner seeks to obtain Emergency Plenary Guardianship of the person of the alleged incapacitated person, Frankie Lee Coleman. 4. The critical condition of the alleged incapacitated person, Frankie Lee Coleman, requires that Petitioner be appointed as Plenary Guardian of the person in order to establish her compliance with the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191) ("HIPAA"), which shields and protects Mr. Coleman's medical and health records from disclosure and which prohibits covered entities, such as hospitals and physicians from disclosing health information to unauthorized persons. An Order of Guardianship would give Petitioner the clear authority to obtain all medical and health records of Mr. Coleman and also to make essential medical decisions relative to his care and placement. 5. The authority being sought by Petitioner is in order to insure that the alleged incapacitated person; Frankie Lee Coleman, receives all the necessary emergency and critical care that is required, which may include the ability to transfer Mr. Coleman, if necessary, to another medical facility and/or make end of life decisions regarding Mr. Coleman. 6. Additionally, the alleged incapacitated person, Frankie Lee Coleman's, medical insurer(Cigna) and disability insurer (The Hartford) refuse to provide information to Petitioner since she is not in possession of a Power of Attorney, Court ordered Guardianship or any written authorization permitting her to access confidential information of Mr. Coleman, which includes his social security number and other medical information. 7. The ability to properly care for the alleged incapacitated person, Frankie Lee Coleman, and to provide for his medical treatment and rehabilitation necessitates written I authorization to oversee and direct critical medical treatment, which written authorization is not available, and therefore, requires an Emergency Guardianship so that Mr. Coleman's medical services and treatment will not be delayed, which could result in further devastating residual effects as a result of the stroke and other medical problems from which Mr. Coleman is suffering. WHEREFORE, pursuant to 20 Pa, C.S. §§551I and 5513, the Petition for Adjudication of Incapacity and Emergency Appointment of Plenary Guardian -of the Person and Estate of Frankie Lee Coleman, and related provisions of the Probate Estate and Fiduciaries Code, Petitioner respectfully requests this Honorable Court to enter an Order appointing Petitioner, Knitique S. Coleman, as Emergency Plenary Guardian of the Person and Estate of Frankie Lee Coleman, alleged incapacitated person. I Respectfully submitted, DALE;Y ZUCKER MEILTON MINE NGRICH, L.L.0 I Date; April 11, 2011 B cia C. Zucker, quire A orney LD.No. 3 334 1035 Mumma Ro ,S ' 101 Wormleysburg,Pe Sylvania 17043 Telephone: (717)724-9821 pzucker@dzinmglaw.com Atiorneyfor Petitioner VERIF�IC- litique S. Colem an, Petitioner, verify that the Exhibit to Petition are statements True and correct to the best of made in this Supplemental understand that false statements my knowledge, information herein are and belief. r made subject to the penalties of 18 Pa.C.S. 4904, that to unworn falsification to authorities. Section Date: 'ti� + iti c ofeni Petitioner ud(Ull U,7;il Yf} C1Jt1 Lv 5, 1�It 11.7bPM p�tfY, 1ut'Ktx � alnt�Kl� �u - /1/11519EtU% P 2110 APPEND&A IN THE COURT OF COMMON PLEAS OF YORK COUNTY,pENNBYLVANiA ORPHANS`COURT DIVISION !N RE, AMI 17ON OF INDIW(O VAf QlIA�lFIED TO FtENDLa 0��r..... This wditan depasttlon o/_ cL f>�' L4=19- , a wnaeas In thla Hater,le taken on the dayof.&err-- 707/ ISCt� Prmneylvente, 1, Fla'ase state yaw natr}s and your proresstana}sadrass. r g. on Ey�3 Ptaasa deadit}a your etb}cafton,bathing and oaekgrou�ufitn� ot}!ar aata our exparttsa in ev dedon oftndfvtduats a9$s Imapactftss OR attach to this written(fepomtdon your 1 3, In your professional CapaUfy,have ynu had the opportunity to meet with,examtns,speak with 13C Dhan+nso INOWme aaquafntod with F f l t�f �1�Ft )N ? (nema of Pa my If yes,please state the following, I first tomme acquainted wfth_ 1°1?4w a 2 on 2[[LL { 2011 when he/she was brought to my aflention by I York County Register of Wills & Clerk of Orphans' Court Date Printed: 07103/2014 DOCKET ENTRIES Page 1 of 1 CASE NUMBER: 6711-0588 CASE NAME: FRANKIE LEE COLEMAN DATE FILED # #Pages DOCKET AND RELEVANT INFORMATION 04/06/2011 1 13 PETITION TO ADJUDICATE INCAPACITATED AND APPOINT GRDN 04106/2011 2 3 ORDER and citation dated a dl 5, 2011 copy to P Zucker 04/06/2011 3 1 CERTIFICATION -OC 04/06/2011 4 1 CERTIFICATION -OC 04/06/2011 5 1 CERTIFICATION-OC 04/06/2011 6 1 CERTIFICATION-OC 04/06/2011 7 1 CERTIFICATION-OC 04/06/2011 8 1 CERTIFICATION-OC 04/06/2011 9 1 CERTIFICATION -OC 04/06/2011 10 1 CERTIFICATION -OC 04/11/2011 11 13 MISC TRANS-OC supplemental exhibit to petition 04/12/2011 12 1 INTERIM ORDER copy to counsel and guardian 0411212011 13 1 EXHIBIT-OC 1-2 04/14/2011 14 1 ORDER dated April 14, 2011 copy to Atty Zucker and Atty Konkel 04/14/2011 15 5 ORDER dated April 12, 2011 copy to P zucker, R Konkel and Kniti ue Coleman 06/13/2011 16 4 ORDER ADJUDICATING INCAPACITY-DATED May 17, 2011 copy to P Zucker, R Konkee and Kniti ue Coleman 07/19/2011 17 5 INVENTORY-OC 08/26/2011 18 4 PETITION FOR APPROV OF ATTY FEES 09/07/2011 19 1 ORDER FOR REIMBURSEMENT-County copy to Konkel and purchasing 02/14/2012 20 1 REMINDER LETTER FOR ANNUAL GUARDIANSHIP REPORT SENT 04/11/2012 21 9 ANNUAL REPORT OF GUARDIAN OF PERSON AND ESTATE 04/12/2012 22 1 CORRESPONDENCE -OC 02/1912013 23 1 REMINDER LETTER FOR ANNUAL GUARDIANSHIP REPORT SENT 04/12/2013 24 9 ANNUAL REPORT OF GUARDIAN OF PERSON AND ESTATE 04/16/2013 25 1 ORDER dated 04/16/2013 copy to: Kniti ue S Coleman 02/19/2014 26 1 REMINDER LETTER FOR ANNUAL GUARDIANSHIP REPORT SENT 04/14/2014 27 9 ANNUAL REPORT OF GUARDIAN OF PERSON AND ESTATE 06/27/2014 28 12 CORRESPONDENCE-OC letter and petition filed in Cumberland County re: transfer of incap. uardians!i R per request from Judge's order dated 04/16/2013 07/0212014 29 1 ORDER dated June 30, 2014 from Cumberland Co 07/03/2014 30 1 ORDER dated July 2, 2014 copoy to Adam Deluca, Esq and Kniti ue S Coleman END OF CASE INFORMATION ,cER i FIED from t; e ramrds of the Orphan, , Court Division of the Common Pte s Court or" York CnuP , Pennsylvania this , day of A.D.20 RADLEY C.JAC Clerk rphans'Court Patricia Carey Zucker, Esquire DALEY ZUCKER MEILTON MINER!$GINGRICH, LLC 1035 Mumma Rd., Suite 101 Worruleysburg,PA 17043 (717)724-4821 pzLicker@dzmmglaw.com dzmmglaw.com IN RE: GUARDIANSHIP OF : IN THE COURT OF COMMON PLEAS OF FRANKIE LEE COLEMAN, : YORK COUNTY,PENNSYLVANIA AN ALLEGED INCAPACITATED : ORPHANS' COURT DIVISION PERSON NO. PETITION FOR ADJUDICATION OF INCAPACITY AND EMERGENCY APPOINTMENT OF PLENARY GUARDIAN OF PERSON AND ESTATE TO THE HONORABLE ORPHAN'S COURT JUDGE: AND NOW, comes Petitioner. Knitique S. Coleman, by and through her attorneys, Daley Zucker Meilton Miner & Gingrich, LLC, pursuant to 20 Pa. C.S. §§5511 and 5513, to seek appointment as Emergency Plenary Guardian of the person and estate of Frankie Lee Coleman and in support thereof avers as follow=s: Part I General Inibrmation I. The name and address of the Petitioner and the Petitioner's relationship to the alleged incapacitated person, or, in the absence of relationship, the nature of the Petitioner's interest in the welfare of the alleged incapacitated person, are: r - Knitique S. Coleman—Daughter 4063 Darius Drive Enota,Pennsylvania 17025 I i e ! 2. The name, date of birth, residence, and post office address of the alleged incapacitated person, together with other vital information relating to the alleged incapacitated person, are: Name: Frankie Lee Coleman Maiden Name; NIA Date of Birth: July 5, 1950 Race: African American Residence: 489 W.Market Street Height: 5'9 (i York,PA 17402 I Post office address: same as above Weight: 200 lbs Ir Social Security Number: unknown Hair color: Grey Sex: Male Eye color: Brown Marital Status: Divorced 3. The names and addresses of the spouse, parents, and presumptive adult heirs of the alleged incapacitated person and their relationship to the alleged incapacitated person are: Knitique S. Coleman- Daughter Bridgette Pierce- Daughter 4063 Darius Drive 32 Kents Lane Enola,PA 17025 Wrightsville, GA 31096 Orian Coleman- Son Lillie Mae Hightower-Mother 201 Corbett Street,Lot 45 119 Martin Luther King Jr.Drive East Dublin, GA 31027 Wrightsville GA 31096 Carmen Coleman—Adopted Daughter(upon information and belief) 489 W. Market Street York, PA 17402 4. The names and addresses of the persons or institutions, if any, providing residential services to the alleged incapacitated person, (e.g., caregiver at his or her home, hospital,or nursing home) are: Lee Maddox, M.D.- Attending Physician Bruce Klaskin, D.O.-Previous Attending Wellspan Health Physician 2 l York Hospital (ICU/Room 3303) HealthSouth Rehabilitation Hospital of York 1001 South George Street 1850 Normandie Drive York, PA 17405 York, PA 17408 5. The names and addresses of the persons or entities,if any,providing other support services to the alleged incapacitated person (e.g., attending physician, agent under power of attorney,bookkeeper, etc.)are: Martha Anderson York, PA(exact address unknown) Purportedly paid cable bill for alleged incapacitated person, Frankie Lee Coleman, using debit card of Frankie Lee Coleman Carmen Coleman-Adopted Daughter(upon information and belief) 489 W. Market Street York, PA 17402 Purportedly paying bills for alleged incapacitated person,Frankie Lee Coleman, using debit card of Frankie Lee Coleman 6. The alleged incapacitated person suffers from the following conditions which necessitate the appointment of an emergency guardian: Stroke with complications and right side paralysis Pneumonia Diabetes Presently moved from HeahhSouth Rehabilitation Hospital of York to Wellspan Health, York Hospital, ICU/Room 3303 due to the severity of these health conditions, which include an inability of Frankie Lee Coleman, alleged incapacitated person, to effectively communicate in any way. Part 11 Request for Annaintmetu of Emer¢enev Guardian of Person and Estate 3 7. To the extent known by Petitioner, the alleged incapacitated person's assets and the approximate value of each asset and the alleged incapacitated person's sources of income and f� the estimated annual amount of income from each source are: Asset Approximate Value 1 Personal Property: Savings Account $(Upon information and belief, savings account maintains a significant , balance) Checking Account $(unknown amount) Total Personal Property $N/A Real Property: $N/A Total Real Property $N/A Source a£Income Estimated Annual Amount $ 46,000-$55,000(precise amount of salary unknown Total Estimated Amoral Income $46,000 to 55,000(precise amount of salary is unknown) 8. Because of the alleged incapacitated person's mental and/or physical condition. the alleged incapacitated person is unable to manage his financial affairs, unable to make and communicate responsible decisions relating to his financial affairs and unable to communicate his needs for assistance with regard to his financial affairs. 9. The alleged incapacitated person, Frar ie Lee Coleman, did not sign a power of attorney but, upon information and belief, verbally authorized Martha Anderson to pay his cable bill for the month of March 2011, with the use of his debit card from First Capital Credit Union 4 in York, Pennsylvania. Frankie Lee Coleman, an alleged incapacitated person, has worked for many years at BAE Systems in Spring Grove, Pennsylvania, and entered Wellspan Health on March 2, 2011 to have an abdominal aneurysm removed and only expected to be in the hospital for a short period of time. However, upon information and belief, complications from the I surgery caused Mr. Coleman to suffer a stroke and paralysis and have resulted in his incapacity and an extensive hospitalization and rehabilitation that was not originally anticipated. Upon information and belief, it is understood that Martha Anderson has given Mr. Coleman's debit card and wallet to Carmen Coleman, who presently lives with Mr. Coleman, but who, upon information and belief, is disabled and receives social security disability for schizophrenia. While Petitioner, Knitique S. Coleman, and her sister, Bridgette Pierce, approached Carmen Coleman and Martha Anderson and requested them to meet and overview what their Father, Frankie lee Coleman's, financial needs were and see that his funds were being properly allocated, both Carmen Coleman and Martha Anderson become irate and have refused to answer any financial questions regarding Mr. Coleman's finances or to cooperate with the family in any way. 10. Bridgette Pierce and Petitioner, Knitique S. Coleman, went to First Capital Credit Union on or about Thursday, March 24, 2011 and again Friday March 25, 2011 to ask First Capital Credit Union to freeze the checking and savings accounts of the alleged incapacitated person, Frankie Lee Coleman, and not pay any further amounts out which were being requested by either Carmen Coleman or Martha Anderson. 'The First Capital Credit Union required a written authorization that would state that Mr. Coleman wanted his account frozen. Knitique S. Coleman and her sister, Bridgette Pierce, then requested Dr. Bruce Klaskin, the Attending Physician at HealtbSouth Rehabilitation Hospital of York, who was treating their Father, Frankie 5 j Lee Coleman, for a letter which stated that Mr. Coleman was unable to communicate and that Knitique S. Coleman and Bridgette Pierce were handling the financial affairs for their Father. However, the First Capital Credit Union would not accept the letter from Dr. Klaskin, since they said it was not notarized, and would not freeze the accounts. The First Capital Credit Union holds a savings and checking account for Mr. Coleman and, upon information and belief, it is understood that Mr. Coleman's savings account holds a substantial amount of money, which can be accessed by either Carmen Coleman or Martha Anderson, who, upon information and belief, have made unauthorized withdrawals from Mr. Coleman's account which were for their own personal use and not for the benefit of Mr. Coleman, the alleged incapacitated person. 11. Undersigned counsel has requested that the Attending Physician at Wellspan Health, York Hospital, complete the "Deposition of Individual Qualified to Render Opinion as to Incapacitation" which will be provided to the Court upon receipt. Additionally, Dr. Bruce Klaskin of HealthSouth Rehabilitation Hospital of York, on March 25, 2011 did opine as to the incapacity of Frankie Lee Coleman while being treated at HealthSouth and stated Mr. Coleman was "unable to communicate or handle his personal affairs including his financial responsibilities". See letter attached as Exhibit"A". 12. The Petitioner, Knitique S. Coleman, believes that, in the event she is unable to obtain Emergency Guardianship of the finances and person of her Father, Mr. Coleman's finances will be dissipated and be used for unauthorized purposes which do not benefit him. Further, in the event Knitique S. Coleman is not able to obtain Emergency Guardianship of his person, she believes that Frankie Lee Coleman's present physical condition, which is tenuous, may deteriorate without the full authority to oversee his care. 6 13. No other Guardian of the Estate of the alleged incapacitated person has been appointed by any court. 14. All less restrictive altematives to the appointment of an Emergency Guardian of the Estate have been considered. The Petitioner believes that such alternatives will be ineffective. 15. The type of Guardian of the Person and Estate that the Petitioner asks be appointed is Emergency Plenary Guardian of the Person and Estate. 16. Petitioner, Knitique S. Coleman asks that she be appointed Emergency Plenary Guardian of the Person and Estate of Frankie Lee Coleman, the alleged incapacitated person. 17. The proposed Emergency Guardian of the Person and Estate of the alleged incapacitated person has no interest adverse to the alleged incapacitated person. 18. The consent of the proposed Emergency Guardian of the Person and Estate of the alleged incapacitated person is attached to this Petition as Exhibit"S"', WHEREFORE, pursuant to 24 Pa. C.S. §§5511 and 5513 and related provisions of the Probate Estate and Fiduciaries Code, Petitioner respectfully requests that this honorable Court award a citation directed to the alleged incapacitated person, and to such other persons as tine Court may direct, to show cause why the alleged incapacitated person should not be adjudicated an incapacitated person and why the proposed Emergency Guardian of the Person and Estate should not be appointed. 7 Respectfully submitted, DALEY ZUCKER WILTON MINER&GINGRICH, LLC Date: April 5, 2011 C tricia C. Zuck , Lsquir Attorney I.D. o. 3733 1035 Mumm Ro uite 101 Wonnleysburg, Pennsylvania 17043 Telephone: (717) 724-9821 pzucker @dzmmglaw.cotn AtForney,fi r Petitioner 8 1 VERIFICATION 1, Knitique S. Coleman, Petitioner, verify that the statements made in this Petition 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. Section 4904, relating to unswom falsification to authorities. Date: nit ue S Leman, Petitioner tiff-uo-turf us;rr rn nbIW naluu ti/ab14tSU/ P. 2110 Apr. 5, 2011 12:26PM DALEY, ZUMN !1 fiv. ,uU, . T APPMIX A IN THE COURT OF COMMON PLEAS OF YORK COUNTY,PENNSYLVANIA ORPHANS'COURT OMSION IN REt RLPOSITION OR INDWRIVAL QUALIFIED TTO�RENDER OPINION AS TO INCAPACITATION This written deposition of Lt d A 19+>atj + ,s wltnoss in MIS matter,is taken on the day of iarL- ?Wil at I.To{� Pannsylvenle. 1, Please state your name and your professional address. Y" � 4 E 57 lal >c �k- 171-143 2, Please describe youreducalfon,iralsing and background th paniautsr mphauts on your expartise in evaluedon of Individueis wNh Kroapecltles OR attach to this written deposftlon your cu"Whim vho. �G A 3. to yaur professional rapacity,have you had the opportunity to meet with,examins,speak with or fi othsw lco become mquahrtnd%*th;%oj1n Lds wm\j 7 (name of Patient) If yes,please state the ca fapovAng.' I first became acquainted wkh �i jG✓ 1(t t? —o' 2t` when he/she was brought to my atlention by 1+t>w''Ss r rJn-- ,� APR-05-2011 03:11 PM WCU MSICU 7178514807 P. 3110 Apr, 5. 2011 12;26PM DALEY, LUCM & tiulun!UH,` u+.. JVJ. i i i have since tvtatted sookep} xamin or trp1 himthar on ��} wher (circle applicable contacts) f occasions with an amege frequency of "Mal per � (daylwsewMonF"sr) P Sq + 4. Please evaluate the present oondMan of this patient with reapeet to fncapacftfes of the type alleged in the PaGdon for Adjudication of kicapacity, In particular,please comment on the nature and extent of the alleged inespecittes and disabilitles end also,ineofar an you are ebte,hfsnw mental,motional and physical oondhtOn,adaptive behavior,and social sidffs. Based upon my education,training and experlenc®,as weft as my acquaintance with this patient 4 t6 my opinion,to a reasonable degree of modest certainly,that blather fnoapacitles are as foR(nas Mental condition i Emotional condition I Physical condition/ Rau elo 114 a 6o 7 e-u- (7f,{tT ezl// jft AdsptAte behavior Sociatskitta S. aesed upon your education,trair>tng and experience,and your eontads with this pafiant,do you have an opinlan,to a reasonabta degree of medical certainty,whether he/she Is impaired in Most ability to effectively receive and evaluate informatfon and to make and communicate decisrans in any way? If yea,plasm explain your opinion, GY1 f GGlC31hSP5 (G j pct t aU rr to; odruut t5 175 r;,,)14t (s beAref /pryer JA) Ik ye . {1 e r 97' 11p 6 (et( r rV if J ., I APR-05-2011 03:11 PM MSiCU MSiCU 7178514607 ta, IU04 u P, 4/10 Apr, 5. 2011 12:26PM DALEY, WER A 01ORICK,, LM III tf you are of the opinion that helshe is Impaired In hwher ebluty to effectively receive and evomate information and to make and tommunteata decisions In only way,does such hhpeirrrrent ! render himlhor either partlratly or totally unable to manage his/her Anandal resources? I if yes.check whether such impairment renders h1wher, artlaW unable to menage his/her own finanoea. ?*fatly u»ebte to manage NOW own finances. pleas explsht YOUr oPlnicn• /' Nk l d / �tre 71 If you are of the opinion that he/she to Impaired in hi her abillty to effeotively receive and evaluate information and make and communicate deolslem,in any way,does such imiletmtent render h"unhter either partially or totally unable to meet the assentlal requirements for hlePoer physical health and safety? if yes,Cheek whether such impairment renders hk*er pa.Mally unable to meet essential requirements for his/her phyatdat health end safety, hr unsbta to most essential requirements far hielher physical health and safety. Pleas$explain your opinion. s APR-05-2011 133:11 PM MSICU MSICU 7178514807 P. 5110 Apr. 5. 2011 12:26PM DAEEY, PUCKER & (311161(1 0; LLG. NU, iuv't i S, Please provide an&$$segment of the severity of any Impairments of this patient. lmnedrment (Circle oneJ e) u{'e 6 . / Net r a t mild moderate C b) fiMD— 4e'{y u r mild moderate t�bhC tAaa mild moderate ere a} mild moderate severe + al mild moderate severe 0 -- mild moderate severe 91 mild moderate severe h} mdid moderate severe 0. is the ormds#tots of this ps&rtt such that because of owner condition, hatshe would be susceptible to undue influence by uneosvpuloue or designing persons? �stqperose� �c)nA#- C�� !�2 m —61 is ee44e 'j s rte+ (y l ,r b If so,what services or assistance would you recommend as necessary to aPP+ropdate e'L{r y t management of this pailenra tfnaness? „�"M42 ease -�D as 4 to, VoWaervioes oressietanoe would you nxommand as necessary to meeting the health and I safety needs of this Patent? rf,,t "62/ iCGC_ t r e ssrVIC taco mended s Least alt ve atremet°ves? J "r� .� 4.rr &41a-e 440 patient need the services of the gusrdlan to make decisions regardn9 the patient's r hqxftwre,so"and financial resources? In other wads,could the Patent evaluate. mmuniaate and make decisions regarding his/her health flnaneiei resources in important matters without the gvardlan? If not,please sxpiahr why less restrictive altemsttves are! APR-05-2011 03111 PM MSICU MSICU 7178514807 P, 6/10 Apr. 5. 2011 12:26PM DALEY, 2UCKER & 61NUICN; llC, so, luo4 12, Based upon your education, training,experience and familiarity with this patlent,what Is your opinlon as to the likelihood that the degree of incapnountion will sipnifloa�Chang? �I a2-- Fe Ala Fe SiS H�'� el I N��(f�-✓r?� Q 13. Would the physical or mantel condition of this patient be harmed by his/her presence In open court? NOTE: Ponnsylvents taw,20 pa.0.5.16611(a)(1), requires that the alleged Incapsolterwd person on testimony at the hearing stateiment,an or licensed hlemerpshysfwl or mental condition deposition,harmed would be harmed by his/her presence In court. if Yee,please exp sin, I �u r r t+tQ CPet Lre- �/,//,fM,V68tFJCaYItlN vertttythat the statements made in the for foregoing deposition are true and correct to the best of my knowledge,informstlon and belief. I understand that the statements heroin are subject to the penalties of 16 pa.C.S.$4004 raieting to unswom falsification to authorities. Slgneturs of Dap n Dated: APR-05-2011 03:11 I'll 11SIOU 11SIGt1 7178514807 P, 8110 i Lee A. Maddox,MD 2531 Donlenik Dr, York, Pennsylvania 17402 Home(717)741-0237 Office(717)851-2939 IMaddoxfjWe!IWW.org Current Position Medical Director of Pulmonary Services,Wellspan Health Medical Director Medical, Cardiac, Cardiovascular Surgical ICU's Wellspan Health Medical Program Director Select Specialty Hospital—York ChiegSite Director Wellspan Lung Sleep and Critical Core Clinical Assistant Professor of Medicine,Penn State College of Medicine Regional Tuberculosis Consultant—South Central Pennsylvania Hospital Aftlltations 'York Hospital,York Pennsylvania j Memorial Hospital,York Pennsylvania Select Specialty hospital,York Pennsylvania Gettysburg hospital, Gettysburg PA Medical' Training . Fellowship Duke University Medical Center , Pulmonary and Critical Care Medicine Durham,North Carolina July 2000—June 2003 Residency University of Texas Southwestern Medical Center Internal Medicine Dallas,Texas July 1998—June 2000 internship University of Texas Southwestern Medical Center Internal Medicine Dallas,Texas July 1997--Juno 1998 Education Medical School University of Maryland School of Medicine MD., Cum Laude Baltimore,Maryland August 1993 —May 1997 Undergraduate Pennsylvania State University B.S.,Biology State College,Pennsylvania August 1989—May 1993 APR-0's-2011 U3:12 P11 Ml GU NICU 7178514807 P. 9/10 Lee A. Maddox,MD Honors/Awards Medical School Alpha Omega Alpha—Beta Chapter 1,Earl Pass Memorial Award for Exceptional Proficiency In Internal Medicine [ Undergraduate Golden ICey Honor Society Hammond Scholarship Award Certifications Internal Medicine: October 2000,Diplomate Number 201431 Pulmonary Disease:November 2003,Dipiomate Number 201431 Critical Care Medicine:November 2004,Diplomate Number 201431 Sleep Medicine:November 2007,Diplomate Number 201431 Licenses Pennsylvania, December 2003—Present,NMD421102 North Carolina,June 2001 --September 2003,#1200100259 Texas,August 1999-August 2001,#K7450 Grant Support National Research Service Award: IF32-HL71406-01,June 2002-June 2004. NHLBI-NIH,S 102,200. Modulation of Airway Inflammation By Surfactant Proteins, Publications Maddox L,Long GD,Vredenburgh JJ,Folz RJ.Rhizopus presenting as an endobronchial obstruction following marrow transplant, Bone Marrow Transplant. 2001 28(6):634-636. Maddox L,Schwartz DA. The Pathophysiology of Asthma. Annu. Rev. Med.2002 53:477-498, I L.A.Maddox,J.1CL Walker,B.L.Lawson,W.M.Foster,T. ICorfhagen,D.A.Schwartz,J.R. Wright. Nitric Oxide mcdiates airway hypo-responsiveness in surfactant protein-A null mice. In publication American Journal ofRespiratoy and cellularBlology Abstracts Maddox L., Oldach D, et a1. Transplant esophagi#sr Microbiological, pathological, and clinical correlates in a series of 97 episodes in kidney and pancreas transplant reciplants, 16'Annual Meeting, American Society of Transplant Physicians,May 1997. Presentations Asthma In The New Millennium. Grand Rounds,York Hospital,York Pennsylvania, February 2004. Surfactant Prorein-A Null Mice Demonstrate Reduced Airway Hyperreactivity in Response to Aerosolized Lipopolysaccharide. American Thoracic Society Meeting,Mini-symposium, Seattle Washington,May 2003. AM-0-eUli UJ:1z rn nNIM msluu 7178bl480'1 P, 10/1D i Lee A. Maddox,MD -3- Anthrax. Grand Rounds,Environmental Proteetlon Agency,Chapel Hill,North Carolina,October 2001. Committees ICUSepsis CEr,Chairman. York Hospital,July 2009— Present. ICUCF.T andTCUExecutive CET,York Hospital,July 2009— Present Clinical Competence Committee,York Hospital,July 2003—Present Evaluates the clinical competence and abilities of Internal Medicine Residents at York Hospital. Other Experience Emergency Room Physician, Veterans Administration Health System VAMC,Durham,North Carolina,December 2000-2003 VAMC,Dallas,Texas, June 1999-June 2000 Instructor, Introduction to Clinical Practice for Medical Students Duke University Medical Center,2002 University of Texas Southwestern Medical Center, 1999 Emergency Room and Pediatric Student:Indian Health Services, T*aba City,Arizona, February 1997-April 1997 Professional Societies Society for Critical Care Medicine American College of Chest Physicians American Thoracic Society Professional Interests Cardiothoracie Critical Care, Sepsis,ARDS, Pulmonary Physiology, AsthmalCOPD, ICU Technology Integration t CERTIFICATE OF SERVICE I, Patricia Carey Zucker, Esquire, hereby certify that on April 11, 2011 indicated below I served a true and correct copy of the foregoing Supplemental Exhibit to Petition for Adjudication of Incapacity and Emergency Appointment of Plenary Guardian of the Person and Estate of Frankie Lee Coleman via the method stated below: Via Facsimile Via Email Ada Richardson Richard Konkel, Esquire Wellspan Health,York Hospital CGA Law Firm 1001 South George Street 135 North George Street, Suite 400 York,PA 17405 York, PA I7401 Via Overnight Mail Via Overnight Mail Carmen Coleman Bridgette Pierce 489 W. Market Street 32 Kents Lane York,PA 17402 Wrightsville, GA 31096 Y� tcia lZuer, ire ttom DALEY LTON MINERLLC 1035 Mu 01 Wormleysburg,PA 17043 (717)724-9821 pzucke dzmmglaw.com Attorneyfor Petitioner Petitioner will personally serve Orian Coleman and Lillie Mae Hightower on April 12,2011 with the Supplemental Exhibit to Petition for Adjudication of Incapacity and Emergency Appointment of Plenary Guardian of the Person and Estate of Frankie Lee Coleman prior to the Hearing scheduled for 1:00p.m. Patricia Carey Zucker,Esquire DALEY ZUCKER MEILTON MINER&GINGRICH, LLC 1035 Mumma Rd., Suite 101 Wormleysburg,PA 17043 (717)724-9821 pzucker@dzmmglaw.com IN RE: GUARDIANSHIP OF : IN THE COURT OF COMMON PLEAS OF FRANKIE LEE COLEMAN, YORK COUNTY, PENNSYLVANIA AN ALLEGED INCAPACITATED ORPHANS' COURT DIVISION PERSON NO. 6711-0588 VERIFICATION OF SERVICE ON FAMILY MEMBERS/130SPITAL 1,Knitique S. Coleman,hereby verify and state that: I. I am the undersigned Petitioner for Adjudication of Incapacity and Emergency Appointment of Plenary Guardian of Person and Estate of Frankie Lee Coleman, an alleged incapacitated person, and am therefore authorized the make this verification. 1 On April 6, 2011, I personally served a copy of the Petition for Adjudication of Incapacity and Emergency Appointment of Plenary Guardian of Person and Estate of Frankie Lee Coleman and Judge Blackwell's April 6, 2010 Preliminary Decree on the following interested parties: Bridgette Pierce, Orian Coleman and Lillie Mae Hightower. I also personally served Wellspan Health, York Hospital, by way of service to Ada Richardson, a social worker in the Care Management Department, familiar with the Petition for Adjudication of Incapacity and Emergency Appointment of Plenary Guardian of Person and Estate filed on behalf of Frankie Lee Coleman, an alleged incapacitated person. 3. On April 8, 2011, 1 personally served a copy of the Petitioner for Adjudication of Incapacity and Emergency Appointment of Plenary Guardian of Person and Estate of Frankie Lee Coleman and Judge Blackwell's April 6, 2011 Preliminary Decree on Carmen Coleman. EXHIBIT 4. I used my best efforts to give Martha Anderson a copy of the Petition for Adjudication of Incapacity and Emergency Appointment of Plenary Guardian of Person and Estate of Frankie Lee Coleman, as follows: A. On April 7, 2011, 1 notified Martha Anderson by telephone that I had Court papers to serve her with and was told by her that she would be at York Hospital later that day and that I would be able to serve her at the time. Ms. Anderson did not appear at York Hospital on April 7, 2011 while I or any of my family members were present. B. I then did a Google search for Ms. Anderson's address on April 7, 2011 and located her address as 444 Atlantic Avenue, York, Pennsylvania 17404. 1 went to the house at 444 Atlantic Avenue, York, Pennsylvania 17404 on April 8, 2011 to serve Ms. Anderson, however, the house was vacant. C. On April 8, 2011, 1 left a voicemail message for Ms. Anderson to call me back regarding service of the Petition but she has not returned my call. 5. The facts contained in this verification are true and correct to the best of my knowledge, information and belief. 6. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904,relating to unswom falsification to authorities. Date I itique S. man, Petitioner Sworn to and subscribed by me, the unders'gned officer, this I day of e 12011. star Public COM14ONWEALTH OF PENNSYLVANIA NOTARIAL SCAL Janet M. Fisher-Notary Public Lower Paxton Up.,Dauphin County MY COMMISSION EXPIRES OCT.19 2012 YORK COUNTY COURT OF COMMON PLEAS ORPHANS'COURT DIVISION IN RE: �t2 �o u _ l7 t�- w� No. 67- l' Q An Incapacitated Person INTERIM ORDER N � On this t 2 day of 201 1 f-24 11 r't-A- adjudicated incapacitated and n; 1 1 S (��.t?.,�� is/are appointed: ,'Plenary Guardian of the Person ❑ Limited Guardian of the Person �d Plenary Guardian of the Estate ❑ Limited Guardian of the Estate This Interim Order is being entered today so as to facilitate the Guardian in executing his/her responsibilities. This Interim Order shall expire in 14 days by which time a more detailed Guardianship Order{"Court Order")will be transcribed and filed. The Guardian is authorized to make decisions as set out in the Court Order with respect to the incapacitated person. The Guardian should not exceed the authority given to him/her in the Court Order. The Guardian or attorney of the Incapacitated Person should read the Court Order to the Incapacitated Person. The Guardian is directed to seek the Incapacitated person's input as much as possible before making decisions and to act in the best interest of the Incapacitated Person. The Guardian should read this Court's document, "Guidelines for Guardians of Incapacitated Persons." A Plenary Guardian is authorized to make all decisions with respect to the type of Guardianship of the Person or Estate or both of the incapacitated person. A Limited Guardian is only authorized to make decisions as specified in the forthcoming Court Order including Copies of this Order shall be given to Guardian(s), Incapacitated Person's attorney, Petitioner's attorney, and Petitioner. The Guardian is authorized to share copies of the Order with appropriate individuals or institutions. BY THE COURT: BLACKWEL , udge IN THE COURT OF COMMON PLEAS OF YORK COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: No. 6711-0588 -- FRANKIE LEE COLEMAN, an incapacitated person ORDER The Court reviewed the guardianship statute, more particularly 20 Pa.C.S.A. Section 5513 as to emergency guardianship. Given the statutory requirements, a Review Hearing is now set for May 17,201 ], at 10:00 a.m. in Courtroom 6. The guardian shall be prepared to present testimony from the treating physician, i testimony concerning the accounting of Mr. Coleman's funds and expenses, and the necessity for a guardian to continue to handle the estate and personal matters of Mr. Coleman. This Order supplements the Order issued April 12, 2011, and specifically changes the date for the Review Hearing. A copy of this Order shall go to Attorney Zucher and Attorney Konkel. Attorney Zucher shall be responsible for serving a copy of the Orders upon all the daughters, son, and girlfriend of Mr. Coleman. BY THE COURT: P �Le BEACKWELL, Judge IN THE COURT OF COMMON PLEAS OF YORK COUNTY, PENNSYLVANIA In Re: No. 6711-0588 FRANKIE LEE COLEMAN [Petition for Adjudication and Emergency Appointment of Plenary Guardian of Person and Estate] York, Pa. , Tuesday, April 12 , 2011 Before the Honorable PENNY L. BLACKWELL, Judge APPEARANCES: PATRICIA CAREY ZUCKER, Esquire For the Petitioner RICHARD KONKEL, Esquire For Frankie Lee Coleman O R D E R This is the time set for a hearing as to the alleged incapacitation of Frankie Lee Coleman , whose date of birth is July 5th, 1950. Knitique Coleman, one of his daughters, comes forth to propose that she become 1 the Guardian of the Estate and Person of her father. other relatives are present , as well as Martha Anderson, who has been the girlfriend of Mr. Coleman for a period of 10 years. Testimony by Dr. Maddox, as well as a review of the depositions that he filed in this proceeding, clearly and convincingly unfortunately establishes that Frankie Lee Coleman as of today's date is indeed incapacitated. He apparently in March underwent surgery and had a stroke on March 9th of this year. He was in the hospital until March 22 at which point he went to Healthsouth, then he returned to the hospital in ICU on April 4th. He has been in the ICU until the 9th of April and has remained unfortunately in the hospital since that time. He has had a stroke and an aneurism, as well as various other matters, including extraordinarily high salt levels. He appears at times to get better and then unfortunately once again decompensates. The Doctor opines that the prognosis appears that he gets better, but he continually has setbacks that challenge that prognosis. The last episode involved a gastrointestinal bleed that set him back once again and put him back in the hospital . Dr. Maddox is a licensed physician who 2 concentrates in critical care as well as pulmonary critical care. Given the testimony both of the Doctor as well as Ms. Coleman, Mr. Coleman is incapable at this time of handling his finances as well as his health matters. The Court notes that the Doctor did testify within a reasonable degree of medical certainty that at this point Mr. Coleman is incapable of receiving information, comprehending that information, and then being capable of making a reasonable decision as to complex matters. Apparently at times Mr. Coleman can indicate that he wishes to eat or is hungry but anything beyond that level is challenging to him. The Court will now appoint Knitique S . Coleman as Plenary Guardian of the Person and of the Estate of Mr. Coleman. However, it is directed that one of the responsibilities she shall have is to keep the family apprised of her father' s medical condition and of his financial affairs. This includes all members, the brother and sisters, as well as the mother Mrs. Coleman. She is authorized to receive financial information from banking institutions, savings institutions , any accounts that may be through BAE systems, as well as any savings and loans institutions. she is authorized to pay bills and to hopefully maintain 3 the residence in which Mr. Coleman might be able to return provided that he has regained the faculties to live independently. It is noted that Ms. Anderson has stated that Mr. Coleman has been in the area for over 10 years and that they've been involved with each other for over 10 years . It is hope that that can resume in the future. The Court will be scheduling a review hearing within the next 3 months and parties are i directed to appear at that time. j The Court does very specifically and clearly state that Mr. Coleman cannot be removed from the York county jurisdiction by prior Order of the Court. However, if he has to go to a nearby medical facility such as ]efferson Medical university and Hospital and/or university of Pennsylvania or Hershey or any nearby facilities, but he cannot leave the state. No compensation is being sought by Ms . Coleman for handling the guardianship. Copies of this order to be sent to counsel of record, and you' re asked to forward copies of this order to the various relatives and to Ms. Anderson. 4 IN THE COURT OF COMMON PLEAS OF YORK COUNTY, PENNSYLVANIA In the Interest of No. 6711-0588 FRANKIE LEE COLEMAN, Orphans ' Court Incapacitated Person Division York, Pa. , Tuesday, May 17, 2011 Before Honorable Penny Lee Blackwell, Judge N C� L C CJ 3] APPEARANCES : PATRICIA ZUCKER, Esquire (,� c _.. For Knitque Coleman „ CID RICHARD KONKEL, Esquire For Frankie Lee Coleman O R D E R This is the time set by the Court for a review hearing as well as a hearing to confirm the permanency of the appointment of Knitique Coleman. She testified as to what she has undertaken since the date of April 12th, 2011, on behalf of her father, Frankie Lee Coleman. 1 The Court in the April 12th, 2011, Order had adjudicated Mr. Coleman as being incapacitated totally as to person and estate. Dr. Mann testified today within a reasonable degree of medical certainty that unfortunately Mr. Coleman has improved somewhat but not to the level of regaining his competency and capacity. He is in a nursing home called Golden Living, which is located in Camp Hill, Pennsylvania. Mr. Coleman is suffering, unfortunately, from partial paralysis and has other complicating matters that were set forth in the April 12th Order. He is at a high risk of complications and infections and has to receive 24/7 care. The physician testified that he is uncertain as to whether Mr. Coleman will be able to regain his capacity, and it may take up to one year to be able to ascertain whether Mr. Coleman, indeed, can handle his own affairs . The Court reaffirms the April 12th, 2011, finding of incapacitation, and the Court finds that his incapacitation is total as to both estate and person. He is unable to receive, evaluate, and 2 communicate information so as to have the ability to make decisions both as to his person and estate. Knitique Coleman testified that she has undertaken contacting all of the various creditors, utilities, and banks so as to be able to ascertain his true financial status and to garner all resources for the benefit of her father. The physician, the Court notes, testified that he believes Ms . Coleman has acted appropriately and has undertaken a full involvement with her father' s recovery as well as any and all medical decisions . She has also cooperated with Golden Living so as to have the appropriate paperwork filed so as to hopefully have Mr. Coleman receive medical i assistance and/or any other monies that may be available for his care . Given that Ms. Coleman indicated under oath that she is willing to remain the guardian for her father, the Court does reaffirm her appointment as plenary guardian of the person and of the estate of Frankie Lee Coleman. once again, she is reminded to file the 3 iappropriate reports through the Orphans ' Court Division of the Courts, and those forms are available on the I Orphans ' Clerk website. ' She has not sought any compensation for being the guardian for her father, and, therefore, none is given to her. The Court at this time will waive the bond requirement given the estate . Copies of this Order are to be sent to counsel of record as well as to Ns. Coleman at 4063 Darius Drive, Enola, Pennsylvania 17025 . BY THE COURT: G Pe y Lee Blac cwel l Judge kmf 06/01/11 4 f GUARDIAN'S INVENTORY COURT OF COMMON PLEAS OF York COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of Frankie Lee Coleman x®an Incapacitated Person ❑a Minor No.6711-0588 1. Real Estate:(Location,by whom occupied and rental Estimated Value:. ' terms,if applicable) None. c:- Sub-Total for Real Estate: 0.00 2. Personal Property: Estimated Value: 1994 Buick Century automobile 1,425.00 2000 Mercury Sable automobile 2,225.00 Household furniture and household items 2,550.00 Savinp Account-First Capital Credit Union 2,540.48 Chceking Accounts-First Capital Credit Union 2,09057 Money Market-First Capital Credit Union- we exhibit A,B,C 5,962.34 Restricted Stock-BAE Systems PLC 11,452.19 3. Jointly Held Property: Estimated Value: l3etforth real and personal peDperty ow wd by the 1r¢apacimttd Prr J01N?ZY with any othespersrm(s). State whether held as nnants by the emredes;tj'nor,whemerthe nghr of survivonMp e:isv.) JaWy Held Properly None. Form 0.04 rev.10.1106 Page 1 of 2 Estate of Frankie Lee Coleman l[Zan Incapacitated Person ❑a Minor 4. Anticipated Assets: Estimated Value: (Selfwlh property ofany kind erpeetedio be acquired hereafter,tagetherwith anticipated date of acquisition) Prap-v Aaaelpmed Dame ofAcgai don Weekly Short-term disability to 12/05/11 before taxes 9,300.00 Sub-Total for Personal Estate. 27,545.58 (Attach additional sheets if necessary) TOTAL OF ITEMS 1,2,3,and 4: . . . . . . . . . . . . . . . . . .. . . . . . . . . . 27,545.58 Commonwealth of Pennsylvania : : ss. County of York Knitique S. Coleman says that the foregoing is a full, Guardian true and complete Inventory of the Estate of Frankie lee Coleman the aforesaid Incapacitated Person or Minor;and that all of the information set forth herein is true and correct to the best of the Guardian's knowledge and belief. i I verify that the statements made in this } Inventory are true and correct. I under- ) stand that false statements herein are ) made subject to the penalties of ) 18 Pa.C.S. §4904 relating to unswom ) Luir falsification to authorities. ) Attorney for Guardian: Supreme Court I.D.No.: Address: Telephone: Form G-04 rev, 10.7306 Page 2 of 2 Exk bt July I2,2011 Clerk of Orphan's Court RE: Frankic Coleman#3000328 ` To Whom It May Concert: Frankic Coleman maintains an account#3000328 with First Capital FCU which is currently being managed by Knitique Coleman in the capacity of Plenary Guardian for Frankic Coleman.The account consists of a Primary Share (savings)with a balance of$2540.48,Share Draft#0400(checking)with a balance of$909.96,Share Draft#0401 (checking)with a balance of$1180.61,a Money Market Share Savings#0700 with a balance of$16894.61 but at) available balance of$5962.34,and a Share Secured loan with a balance of$10932.27 and monthly payment of $151.01. The Share Secured loan is collateralized with the funds in the Money Market Share Savings account.Thus reflects the difference in the balance and the available balance in the Money Market Share Savings.The loan was originated 12/8/2010 for approximately 24 months. Included with this letter are a copy of the Disbursement Receipt for the loan and a print screen of the account relationship as it is reflected in our system. If you have any other questions or need clarification on the contents of this letter,please contact me at 717-767-5551 ext. 1151. Respectfully yours Shawn L Miller Branch Manager First Capital FCU }littt l"rroxtlt koad N)R<w 7';tip . Yo A;. Knills•Iv:mi:z ?"^(Pl .t) •F(. %171;'!: -!r'S' 1 i13{'f1jftA; `):Tlf: 1,'A {I3i 70'/ i:�V7 ww rt.{= 7ut.oli`C al.i't q 'I 1601 8 7746 Road rsOEKAt GRFOtT UNION YMk,lift 17404-0748 Fm9r ax inam.FPS rl@ry@ut (717)767,(1551 Open-End Disbursement Receipt Plus BORROWER INFORMATION eamovaR I HAKE 489 west Market street AceOHn FNEfNA GATE FRANKEE L COLEMAN York, PA 17401 0003000328 .0001 12/08/2010 peOtOWfR 2NAK4E P BILL CONSOLIDATION SECURITY OFFERED CONSUMERS' CLAIMS AND DEFENSES F CHECKED SEE NOTICE BELOW j TXEAWANDE tS AOtFgEatt YIXKt STrA@fi.AIt PADRRTY SFL31R0E0OTNER]rANAb/ANtE3 AND LOAM RNCOVED INTra 9A5TOa IN THE AITUat AND'INE fOLEONWD n0 may. NOPL@TYHADOft YEAR to WORKER VALUE KEY NUMBER t N/A s � s PIEDDE Ai SNARES NNE PEEDDE OF nrARE5 ACr-0rNr Axaoaaifo5lis 614377 17 4 0003000328-0700 Ax@roPOH05trs 1 NIIRr[0. i REPAYMENT TERMS DRAY rE1eWK;sATF ANNUAL pERCENTAGE RATE NETEAESERATE dz. R11AfiM On[a RES EAataEnr+d wcnD+HAt PAEVgtS aEi ltEnE 0.014 5.000% 5.000% f 10.00 114,277.17 TRiW KAIfRF[TX6 SUe0.GTAUM AMDVNr A0VAr10ED PAYRFOt AROINTr DATE DUE PAYMOTT f@EDNEAT=Y LINE OF"FOR I,wr RERNe1WO4s� S14,377.17 31+1,377.1? $151.01 01/06120_22 Meekly 10.00 t24,37?.27 Projected Loan Term: Rate Discount\(n` Approxirnat01V 24 months By endorsing ft proceeds chacR for the advance described above,or by having the ban proceeds deposited into your share/Share draft account or paid to a third party,you again:(1)that the property described In the Security Offered section above(`Property')Is security under the terms of the LOANLINER Credit and Security Agreement(the"Plan")for ali ammmts you owe under the Plan and that the property description Is Incorporated Into and a part of the Plan: (2)that the Property Is also Security for any other loans, Including but not flneted W. any credit card loan that you have Win the credit union now or in the future: and(3) to make payments as disclosed above and in accordance with the turns of the Plan. CONSUME—RSO CLAM AND DEFENSES NOTICE The foUowhg paragraph applies W the Advance only Ir the bok Is Checked NOTICE: ANY HOLDER OF THIS CONSUMER CREDIT CONTRACT 15 SUBJECT TO ALL CLAIMS AND DEFENSES WHICH THE DEBTOR COULD ASSERT AGAINST THE SELLER OF GOODS OR SERVICES OBTAINED PURSUANT HFRETO OR WITH THE PROCEEDS HEREOF, RECOVERY HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUNTS PAID BY THE DEBTOR HEREUNDER. FOR CREDIT UNIQMSE ONLY REMOVED MIARER PAYS U Smgie LlfefjoiN Lye mcxtdAM PRAME3I NUFMEW. 2 PIa,AIJFr rOR Olvehit fUkE3USACCOrAn ND.: PETE DAN OrtCrRCOMStrH1S. LOXf Dff I]re @1]010 _ IMTrAtS 1SSs G S CAAr'° t)L� D cONA RVruunemn,lash w.ZDOT.as AV.RKans aESERVED CREDIT UNION COPY V00167 eAM 4 - A A,..wt mmDmne -cmwn��: ao+laaksPmOmMlars O4m '> ';-Iaohp 9T. aoetaeleo a906sse wrsmlD Wdvy DO: 1omM :'..trCpmrrteemstH: —P LEASE SEE TE gmIKk CDEMiKELI Mv 9/ADAN FOR - t.cwomA: MIME COIflNN 1 PMlamaem. Er:�dr.PlardMOde,AudoVAtldraeek - Tradi910: Wen End Phn 1 Traddmm: Wad, - Nate: O Nat. - m 5lssepml0: PRIMRYSHAW 2.50.60'`�: CTf 2.V OMm: 9YdIE0MAFT[8391285) 983.96:_ O Stwom all SNAAEDAA'T[II401000Dmal) 1,160.61;+- fp, w 100700: PIPST MOtEY MAI 91G0E 16,891.61 EIAMODm01: "RE SECT 10.942.21'. P6,lp: 9wesxvad0O=D MS07C0 Im.DOl1K.'; Tra:nfal Palnwltha OWSDDmMS0010 Mook T,.fts1: f EIADal, -able: am" f leM 100010: PAMPFASOM Cbud. i _ired8961: Msc ElAO . C L0 MODll: MM HA881A15 TA C6.d�,- I 7redbq Sl: we"Cetd Trad*V= Y*Ade EFT: ACHD C.W 000000 tosmlo HIM El Card IS: 4 M1600m2180W Ceplueb:- AMM: UkmlreMeles o0m300mMS09m Amss: SwmI,.dA leem911ms28Sm10 El Card IS: aYd760mm127t1 Cap08M� i-Ama: Sav mlraMWes to OOmOm3?BSen10 �A. Ck1DDansl s o00P40m'mSaMm i � o :a In re: FRANKIE LEE COLEMAN, IN THE COURT OF COMMON PLEAS ? An Alleged Incapacitated Person OF YORK COUNTY, PENNSYLVANIA' NO,6711-0588 PETITION FOR APPROVAL AND PAYMENT OF COURT APPOINTED ATTORNEY'S FEES AND NOW, comes the Petitioner, Richard K. Konkel, Esquire, and files this Petition for Approval and Payment of Court Appointed Attorney's Fees,of which the following is a statement: 1. Your Petitioner was appointed to represent Frankie Lee Coleman by the Honorable Penny L. Blackwell by Order of Court dated April 5, 2011. 2. This is a non-complex case and all anticipated legal services have been concluded,for which a final bill is attached hereto. 3. A bill was sent to the Guardian Knitque Coleman. She informed us that all of Mr. Coleman's funds have been expended on his care. They are awaiting medical assistance. Therefore, there are no funds to pay for court appointed counsel, Therefore,we arc asking that the County of York pay our fee for billing in this matter. 3. Petitioner has expended 89 hours at S75.00 per hour representing the interest of his client as set forth in the attached bills marked Exhibit"A." WHEREFORE Petitioner requests this Honorable Court to approve and direct the County of York reimburse Petitioner's fees at a fair and reasonable rate. Respectfully submitted, CGA Law Firm By: Richard K. Konkel,Esquire Supreme Court No. 77953 135 North George Street York,Pennsylvania 17401 Tel.: (717) 848-4900 2 CGA LAW FIRM, PC CGA Professional Center 135 N George Street York; Pennsylvania 17401-1132 i Tel:717-8484900 www.cgalaw,com Fax:717.843-9039 Tax 10:232628089 Court Appointed Guardianship May 23, 2011 PP P c/o Richard K. Konkel Billed Through 05/23/11 Bill Number 019515-00033-89798 RKK Frankie Lee Coleman, incapacitated person Balance forward as of bill number 0 dated 12130/99 $0,00 04/07/11 Court Appointed Frankie Lee Coleman: Reviewed 2.00 hrs 150.00 Preliminary Decree and Petition for Adjudication and Emergency Appointment of Plenary Guardian of Person and Estate; Telephone conference with Attorney Patricia Zucker regarding the case; 04/12/11 Visited client at York Hospital and had opportunity to 2.50 hrs 187.50 speak with client, his family and health care professionals: reviewed file in preparation for hearing; 04/12/11 Attended Guardianship hearing before the Honorable 2.00 hrs 150,00 Judge Blackwell; 04/25/11 Telephone conference with Leon Butler, brother of 0.20 hrs 15.00 Frankie Coleman regarding telephone conference with family members; 04125/11 Conference call with family members; 0.50 hrs 37.50 05113/11 Reviewed message from Attorney Zucker's office 0.20 hrs 15.00 regarding Frankie Coleman having been moved to Cumberland County; 05/17/11 Reviewed file to prepare for hearing; attended review 1.50 hrs 112.50 hearing before the Honorable Judge Blackwell confirming daughter Knitique Coleman as plenary guardian of i person and estate; Total fees 8.90 $667.50 Client: Court Appointed Guardianship May 23, 2011 Matter: 00033- Frankie Lee Coleman, incapacitated person Page 2 BILLING SUMMARY Total fees 667.50 Total Disbursements 0.00 CURRENT BILL TOTAL AMOUNT DUE $ 667.50 Balance Forward: 0.00 Payments &Adjustments: -0.00 Total Due: $ 667.50 In re: FRANKIE LEE COLEMAN, : IN THE COURT OF COMMON PLEAS An Alleged Incapacitated Person : OF YORK COUNTY,PENNSYLVANIA : NO. 6711-0588 Order AND NOW, TO WIT, this �_day of ':-;, 4�,—� , 2011, upon consideration of the foregoing Petition, it is hereby ORDERED that the County of York shall reimburse the Petitioner,Richard K.Konkel,Esquire,for 8.9 hours spent in representing the interests of his client at a rate of$75.00 per hour, for a total of$667.50. BY THE COURT: J. i i i REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF YORK COUNTY York County Judicial Center BRADLEY C.JAC}BS ARA KIMBERLY McPHERSON Register of Wilts Chief Deputy Clerk ofOrphans'Court Register of Wills JOHN C.HERROLD ? BECKY K.FOUST Solicitor Chief Deputy= Clerk of Orphans'Court Division February 14, 2012 KNITIQUE S COLEMAN 4063 DARIUS DRIVE ENOLA PA 17025 Incapacitated: FRANIGE LEE COLEMAN CFile Number: 6711-0568 Guardian: COLEMAN KNITIQUE S Counsel: PATRICIA C ZUCKER Guardian Report needed by: 04/12/2012 Dear Sir/Madam: It has tome to my attention that you have not filed a Guardian Report in the above Incapacitated estate. As per Purdons 20 Pa. C.S.A s5521,the guardian or their counsel shall file with the Clerk of the Orphans' Court his/her Guardian Report. The filing will become delinquent on 04/12/2012. Your prompt attention to this matter will be appreciated. Sincerel�y,Qe Bradley C. Jacobs Clerk of Orphans' Court CC: File 45 NORTH GEORGE STREET - YORK, PA 17401-1240 REGISTER OF WLLS(717)771-9607 - CLERK OF ORPHANS`COURT(717)771-9288 FAX-(717)771-4678-www.york-rounty.org ANNUAL REPORT OFu "? GUARDIAN OF THE PERSON ;u ; COURT OF COMMON PLEAS OF lark —COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of 1 it CxA ki 6 Lee, &Aex an an Incapacitated Person No. 4 7N- 05-$8' I. INTRODU�CCTIOyN was appointed tn Linutcd Guardian ofthe Person by Decree of %nn' L. Mack 1G) I., dated �0_ I-i. 2G1 [gl�. This i the Annual Report for the period from 14(Jr i �'- _ _2_0--'-L to rt , Z Oi 2 (the"Report Period");or ❑ B. This is the Final Report for the period from to (the"Report Period"),and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: 2. The Guardianship was terminated by the Court by Decree of I.,dated For a Final Report,omit Sections Htkrougk 1Y. " t I- q' Fo m c-03 rev.10 13,06 Page 1 of 4 Estate of Trankie, Lea t o rtct o an Incapacitated Person II. PERSONAL DATA Age of the Incapacitated Person: Date of Birth: G5D III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: OrWen Livirr-4 benior- 1-1D -P0pLLtarJ01"rch Rd car~,p 1-blk I-�R I1 B. The Incapacitated Person's residence is: E]own home f apartment GKUrsing home ©boarding home 1 personal care home Guardian's home/apartment ❑hospital or medical facility ❑relative's home(name, relationship and address) [3other: C. The Incapacitated Person has been in the present residence since_i 4 cm If the Incapacitated Person`has moved within the past year„state prior residencc and reason(s) for move: No+ c Cpl Kabie� Fa+n"3 ran. 10.13.06 Page 2 of 4 Estate of �ranIC18 �P e C.ola„ar� an Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: Knl+que S Colerr,,an 40(03 Dar;us 6r- E nolct., p A 1-11)45 IV. MEDICAL INFORMATION A. lI/l-+_e major medical or mental problems of the Incapacitated Person are as follows: Cerr-b�roVaScu(ar o cCi Llen+ uji' I'� herni po.re�s and 0.PhaSICt/ S / !" 4-fipit- AAA KPalrl "Per-}ens+on, h Per' T"de,•,+a. C 0-1-'10, uri r y&v-j re erNi-iori cLna �icebetc5 l S u ,cable -(-D Wal k o-na M& al, ; cal exprrss+n9 h;s +►,ouyh+s. B. Specify what, if any,social,medical,psychological and support services the Incapacitated Person is receiving: Golder L ;VInU Cen4er 4-kemPy llr`� h �rovt�s SPe�`� Occu�a+�oi,�l a+-1.1 Physlc&t +4-cra N b 0. reyul�r �jctia" Cam 4-1 i+ 1s 4,z; o� Wcck. Speeds �i7,e In '� C In+niCC ropm Wig U�¢v �cS+dcnf5. pe Lbw G,.rncl. �reyun+ visrls �'ro.,, cQauy�ls, ►c l gua,A,a+.. Visms am CO—w^orkersar�d 140 m, I, mem�ee . V. GUARDIAN'S OPINION A. It is the opinion of the Guardian of the Person that the guardianship should: [Qcontinue ❑be modified ❑be terminated Form"3 rev.10.13.06 Page 3 of 4 Estate of_�rox%kle Lee Cdcrr-eL,- an Incapacitated Person t 1 The reasons for the foregoing opinion are: rye- 'is S4-i 41 uvtctble. }u C'a.re. iF X ku-n5el� k is I i s4d ccs 2y/7 hour CA re-, I+e, 15 Llr,gl,>le i-o vr`al<e A-ec.is�es� rCCtcerd.r�c' lootfi h;s rned;c<<I Gnd rst�+ l ar'�ki-s . ' B. During the past year,the Guardian of the Person has visited the Incapacitated Person 2-e inL times with the average visit lasting 2 hours, 15 _minutes. 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 he 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. §4904 relative to unsworn falsification to authorities. S opt S V an of Me Perron Coletm,3 Nmne ofC'Wr& o lt&Person(OW o Pnnt) 4NO3 Darkys fir. Address Enolct, 'PA 17025 Ctry.Score,71p 1� 11�) �2TJ -1-1 Qj TetepMn Fo C-03 ree 10.13.06 Pagc 4 of 4 ANNUAL REPORT OF GUARDIAN OF THE ESTATE yCOURT OF COMMON PLEAS OF r)r k COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of �7rckn k,e e (�I Cr ya n an Incapacitated Person No. (- 711 'CF5 8PS L INTRODU TION 5 A was appointed r.Wlenary ❑Limited Guardian of the Estate by Decree of Penn.l _%{aCK We•l I J., dated Q I 2 p { M"'A. This i�the Aonoal Report for the period from i Z 2U{ to r i rj 12 of (the"Report Period");or ❑ B. This is the Final Report for the period from to (the"Report Period"),and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: Name of Personal Representative: 2. The Guardianship was terminated by the Court by Decree of J.,dated Form G-02 rev.10.13.06 Page I of 5 Estate of t"r0.h R I e Le P CC I EvrYt An Incapacitated Person 11. SUMMARY A. State the value of the estate reported on the Inventory $ 27,545.5e) B. State the value(s)of principal assets at the beginning of the Report Period. (Same as Inventory if first Report, otherwise, ending balance from last Report.) $ Zvi 545-5B C. What is the total amount of income earned during the Report Period? $ Z 3 y D. What is the total amount of income and principal spent for all purposes during the Report Period? $ E. What are the balances remaining at the end of the Report Period? 1. Principal $ 11 3- q7-096 2. income $ 5 3. Total of Principal and Income $ 153 36-2z III. ADDITIONAL INFORMATION (If more space is needed,please attach additional pages.) A. Principal 1. How is the principal balance listed above currently invested? (Please specify, e.g.,real estate, certificates of deposit,restricted bank accounts,etc.): � L �U1� Res4Ti(-W knrkaeco�,N+s - Chec.4c. I`forcy T, gs. 2. Have there been any expenditures from the principal during the Report Period? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes ❑No If yes: a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? . . . . . . . . Wes ❑No Fm c-02 rev.10./3.06 Page 2 of 5 Estate of �-r C-L nk,P. Lee CIeltyy\ An Incapacitated Person b. List purpose and amount of expenditures: es4 C xp;W R-tk-LcrLn $ $.(oDT OD GoAenL'ivi (:e ow $ I'�t312.0O ;{, T-Ndo� Crtdk�j�banh�res. $3 z 32.93 C.d.icc�l Experti rs $ 3.4�cf7.oO c. Was Court approval received prior to expending the principal? . . . . . . . . . . . . . . . . . . . . . . . YYcs ❑No pPir co"r+ OrAp, doaWY-eyr�- 3. Were additional principal assets received during the Report Period which were not included in the I vegto, or a prior Report filed for the Estate? . . . . . .. . . . . [fYes ❑No W- WJ pri ru ; (kz1 . If yes: a. Was Court approval requested prior to Tthe additional principal?. . . . . . . . . . . . . . . . U"Yes D No Near Cowr-F e;)rd.e r a-oc u ww'^+- b. State the sources and amounts of the additional principal received: Loan. pvoiec4icn $ 9), G 4+vrom CO '�3 $ 5 loto•DO &nk acc.+. do deaos-15 $ k3.8 f�ed.,raj c rn;scellttnrus re4..i+.r15 $ (o0�.(pO B. Income 1. State sources and amounts of income received during the Report Period (e.g., Social Security, pension,rents,etc.): �1E S�bkms-ShortTerrn Dis 1, $ Z3 $ $ $ $ $ Total income received during Report Period: $ 0.00 Fora c-02 rev.10.13.06 Page 3 of 5 Estate of Vf6Lr\k%e, Lce,- (ema✓1 An Incapacitated Person 2. How is income currently invested? (Please specify,e.g.,restricted bank accounts,client care account,etc.): Re-<4r;cked b-znk am)kc A-{ -Gav 1 ngS ,Check�.tq C. Expenses for Care and Maintenance Specify what expenditures were made from the principal and income for the care and maintenance of the Incapacitated Person(e.g., clothing,nursing home,medicine, support,etc.): �� r�SC�.tX -r (C j044)�r\t and 60,p . 2)"1`I 12 00 y�r R + ho1�+16� Covered b� 1'�Sv✓anCQ 3)'136) q7.60 fvr, medAc-d Ser v,coS no+ C-.erect 1"'4 1 1S4 ra nc¢ . D. Other Expenditures Specify what other expenditures were made during the Report Period. (Do not include any items stated in response to question C above.) 1) pa.ny, fees Fay 6, 11 pack E. Guardian's Commissions ND-4 a.ppi�c&b)e,. List amounts of compensation paid as Guardian's commission and state how amount was determined: Court Amount Method of Determination Approval Obtained ❑Yes []No ❑Yes ❑No Farm G-02 .¢°. 10.13.06 Page 4 of 5 Estate of Frank)e, Lee. W(emaL-, An Incapacitated Person F. Counsel Fee Na4- a ppl4c,tble. List amounts paid as counsel fee,and indicate whether Court approval was obtained. Court Amount Approval Obtained ❑Yes [:]No ❑Yes ❑No 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. § 4904 relative to unsworn falsification to authorities_ 0,a—ul V ZD12 t w. ate S j'{fore of o the 6e11e Nome of Guar&ah ofthe Sataro(type gprin# 4o�o3 Darin Ls Dr Address Enulr.,. PA 1-iOZS City,Smote,Zip Telephone Fw G-oz rev.10.13.66 Page 5 of 5 COURT OF COMMON PLEAS NINETEENTH JUDICIAL DISTRICT YORK COUNTY, PENNSYLVANIA 45 North George Street Bala Jamison York,Pennsylvania 17401 Nancy Burls District Court Administrator 717 771-234 Court Audit Clerk FAX 717 771-9911 April 11, 2012 N G' Ms. Knitique S. Coleman 4063 Darius Drive -- Enola, PA 17025 Re: Frankie Lee Coleman, Case#6711-588 L , Dear Ms. Coleman, Thank you for filing the annual reports regarding your father. There are some discrepancies on the form which need to be addressed. On page 2 under II. Summary the starting value plus the income minus the expenses does not equal the ending balance you report. Also, although item II C. states total income earned, this line must included all money that came in to Mr. Coleman's accounts. Therefore according to the amounts on page 3 this total is actually$34,407.36. The expenses listed on pages 3 and 4 total$30,098.93 plus bank fees, which did not have a dollar amount listed. With a starting amount of $27,545.58, $34,407.36 into the account, and $30,098.93 paid out of the account,there would be a balance remaining of$31,854.01. Please review this report and re-submit it with the appropriate changes. I have enclosed a copy for your convenience. Feel free to contact me with any questions, I will be happy to help you. Sincerely, Nancy B s Court Aud Clerk i REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF YORK COUNTY York County Judicial Center BRADLEY C.JACOBS �l ARA KIMBERLY McPHERSON Register of Wills { , Chief Deputy Clerk of Orphans'Court Register of Wills JOHN C. HERROLDLS BECKY K.FOUST Solicitor Chief Deputy 'Y Clerk ofOrphuns'Court Division February 19, 2013 KNITIQUE S COLEMAN 4063 DARIUS DRIVE ENOLA PA 17025 Incapacitated: FRANKIE LEE COLEMAN File Number: 6711-0588 Guardian: COLEMAN KNITIQUE S Counsel: PATRICIA C ZUCKER Guardian Report needed by: 04/12/2013 Dear Sir/Madam: It has come to my attention that you have not filed a Guardian Report in the above Incapacitated estate. As per Purdons 20 Pa. C.S.A s5521, the guardian or their counsel shall file with the Clerk of the Orphans' Court his/her Guardian Report. The filing will become delinquent on 04/12/2013. Your prompt attention to this matter will be appreciated. Sincerely, Bradley C.Jacobs Clerk of Orphans' Court CC: File 45 NORTH GEORGE STREET — YORK, PA 17401-1240 REGISTER OF WILLS(717)771-9607 — CLERK OF ORPHANS COURT(717)771-9288 FAX: (717)771-4678—www.yorkrountypa.gov ANNUAL REPORT OF _ GUARDIAN OF THE PERSON W a A� �r N ` COURT OF COMMON PLEAS OF YO r k COUNTY, PENNSYLVANIA r ". ORPHANS' COURT DIVISION Estate of Franki L= ( Dl I o-n an Incapacitated Person No. 611) -05861 I. INTRODUCTION l li yiQLAC C--5 rm r\ ��II was appointed [IPlenary[:]Limited Guardian of the Person by Decree of Ha�ttade. Pennq L BID Ckwg1,J., datedHaLl"i3 2D11 ErA. This is the Annual Report for the period from A Pf I �P ZDl y to Aor� 1 }I I , 2-03 (the "Report Period"); or © B. This is the Final Report for the period from to (the "Report Period"), and is filed for the following reason: I. The death of the Incapacitated Person. Date of death: 2. The Guardianship was terminated by the Court by Decree of J., dated For a Final Report, omit Sections II through IV. Fom c-03 rev.1013.06 Page 1 of 4� Estate of rank c an Incapacitated Person II. PERSONAL DATA tt Age of the Incapacitated Person:—6 2 Date of Birth: J� qrJ C� III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: Golden f iviny cenaev- I 1 1a popul21, Chun-ch P.d, C=amp F611 PA B. The Incapacitated Person's residence is: 0 own home/apartment r2inursing home 0 boarding home/personal care home []Guardian's home/apartment hospital or medical facility 0 relative's home(name,relationship and address) j 0 other: C. The Incapacitated Person has been in the present residence since Ha If the Incapacitated Person has moved within the past year, state prior residence and reason(s)for move: Na' app 1" Ca1*. Form G-03 rev.10,1106 Page 2 of 4 Estate of Parkte, CA£1W n ,an Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: Vnt6gae S. Calerran 90 + 3 Da(ta5 Dr. E r)u)o-, P A 1-lo25 IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: Cerebrovasular cxecide✓\+ Wig hern�(�rxre515 and aphaeaia 5/P 4 * Pie AAArerr Mr�p rrsiorl hjPenlemia (ppD urir+ar ream{t �reyucll Lfr15. CA 1,�.,9 �,,1a1 vn2to- 5rs k�arr, = 7v�on Crcui, radi&---7— S u.nab'E }D Ik OLnA has di41 c� �1� 14u PYp �. his W ns B. Specify what, if any,social, medical, psychological and support services the Incapacitated Person is receiving: iQotkq�,ne Iherap+� assessme� . U,B }� from dQtC�h r/Ic t3LW-Ln., or ' re Lehr " e. I� mem4�ss a� eo-r orkers wlo, V. GUARDIAN'S OPINION A. It is the opinion of the Guardian of the Person that the guardianship should: Q'continue Q be modified 0 be terminated F.s c-03 .x.10.13.06 Page 3 of 4 Estate of _T YRr\K.i e, Lee- l.f))C r\ an Incapacitated Person The reasons for the foregoing opinion are: B. During the past year, the Guardian of the Person has visited the Incapacitated Person 326 times with the average visit lasting_L hours,.—0 minutes. 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 IS Pa. C.S.A. § 4904 relative to uunswolm falsification to authorities. 2 013 Date ,a ve of Gi di an of a Person { knA["3Slr S CC {�rrKty1 Name ofGvardi n of Be Perron frype or pnn9 -4063 Qar tus @r. Addresr Enc)la- -P A nwuy city,Some.Zip 1 -717) 128-g1 q1 Felepho e Form G-03 rev. 10.13.06 Page 4 of 4 ANNUAL REPORT OF GUARDIAN OF THE ESTATE <rj O— COURT OF COMMON PLEAS OF A. O r COUNTY,PENNSYLVANIA - ORPHANS' COURT DIVISION Estate of }Yay.�l�r Le (n' tWtyl an Incapacitated Person No. – 05 I. INTRODUCTION �_1Y11�-;r111P S G�I° yj ' , was appointed IGPlenary ❑Limited Guardian of the Estate b y of Decree dated 1�fnHr �ry tt J _ 1 A. This is the Annual Report for the period from Apri (� to AtXi I Z —�----1� 2D13 the "Report Period"); or ❑ B. This is the Final Report for the period from to (the "Report Period"), and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: Name of Personal Representative: 2. The Guardianship was terminated by the Court by Decree of J., dated Form G-07 rev./0.73.06 ' Page 1 of 5 Estate of ran kt 6 Lee° Uetrar\ An Incapacitated Person II. SUMMARY A. State the value of the estate reported on the Inventory $ 21�ys • 5a B. State the value(s)of principal assets at the beginning of the Report Period. (Same as Inventory if first Report, otherwise,ending balance from last Report.) S C, What is the total amount of income earned during the 2� �S Report Period? $_� D. What is the total amount of income and principal spent for all purposes during the Report Period? $ 312), Ewi - 2D E. What are the balances remaining at the end of the Report Period? 1. Principal $ 2. Income $ 3. Total of Principal and Income $ 2 1. 5 Z. 1II. 'ADDITIONAL INFORMATION (If more space is needed,please ) �e attach additional pages A. Principal SP[�l Y v c) - CL w CC-uc 1. How is the principal balance listed above currently invested? (Please specify, e.g.,real estate, certificates of deposit, restricted bank accounts, etc.): 2. Have there been any expenditures from the principal during the Report Period? . . . . . . . . . . . . . . . . . . . . . . . . . . . . El Yes ©No If yes: a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? . . . . . . . . ❑ Yes 0 No Form G-02 rev. 10.13.06 Page 2 of 5 t . t Estate of 1;an k,C Lee Chen cen _, An Incapacitated Person b. List purpose and amount of expenditures: c. Was Court approval received prior to expending the principal? . . . . . . . . . . . . . . . . . . . . . . . ❑ Yes ❑No 3. Were additional principal assets received during the Report Period which were not included in the Inventory or a prior Report filed for the Estate? . . . . . . . . . . . M Yes ❑No If yes: a. Was Court approval requested prior to receiving the additional principal? . . . . . .. . . .. . . . . . ❑Yes ❑No j b. State the sources and amounts of the additional principal received: $ $ $ B. Income L State sources and amounts of income received during the Report Period(e.g., Social Security, pension,rants, etc.): �! L �crn t�u rC}tramra! l ��1�`siwss� $_�S5.y5 r�tfo rY�-q,�_v�,y{1 chrck rcI*.rd c $ `tr'},PA •O� $ Total income received during Report Period: $_!7 3 .?l 'w Fo,m c-oz m.10.13.06 Page 3 of 5 t Estate of _ r I.t)klt, Lee- CJIew)an An Incapacitated Person 2. How is income currently invested? (Please specify, e.g.,restricted hank accounts, client care account,etc.): Checkv-15l Gavin, Y) t`(ont y ttlarkt , C. Expenses for Care and Maintenance Specify what expenditures were made from the principal and income for the care and maintenance of the Incapacitated Person (e.g.,clothing, nursing home,medicine, support, etc.): 9 1, 001 3131 300.!�n D. Other Expenditures Specify what other expenditures were made during the Report Period. (Do rot include any items stated in response to q ytion C above.) -J-) Cable (19(dq % kI r L.195- 71 yff 1i-IQrCNr 1j �22.! aD iqa. e'el's T ca ticho rea Cc, r '� ty Via 4C gWry lLkJo ins. airiat.ta.+tPL- 2-� E. Guardian's Commissions NON- ckppl«Cuter, j� T t� ( - 7 List amounts of compensation paid as Guardian"s common and state how amount was determined: Court Amount Method ofDetermination Approval Obtained MYes ©No _.T []Yes ©No Form C-02 rm 10.13.06 Page 4 of 5 Estate of t f Let . COI V\ An Incapacitated Person F. Counsel Fee Nat applicable, List arnounts paid as counsel fee,and indicate whether Court approval was obtained. Court Amount Approval Obtained []Yes D No DYcs DNo 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. § 4904 relative to unswom falsification to authorities. - Dote i a rte of G. dian aJihe Estate 1 Nome of Guardian of the Estate(type or print) 40i Cr�r.uc Dt Address Enjq, PA 1—i025 err, state.Zfp (711) g48-g-19-i Telephone Farm G-02 rcv.10.13.06 Page 5 of 5 IN THE COURT OF COMMON PLEAS OF YORK COUNTY, PENNSYLVANIA 0 C - In Re: No. 67-11-588 °- o FRANKIE LEE COLEMAN VK _ An incapacitated person Orphans' Court Division y• , ORDER The Court has been advised that Frankie Lee Coleman, and incapacitated person, is now residing in Cumberland County, Pennsylvania, Knitique Coleman, guardian of the person and estate of Frankie Coleman, also resides in Cumberland County, Pennsylvania. The guardian is now directed to file a petition in the county in which they both reside in which the petition requests that county accept jurisdiction of Mr. Coleman's case and that York County transfer the case to that county. Notice is to be given to the Orphans' Court of York County that the petition has been filed. A copy of this Order shall be sent to Knitique S. Coleman,4063 Darius Drive, Enola, Pennsylvania 17025. BY THE COURT: sJ . Blackwell Judge W Dated this I(o day of April,2013 REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF YORK COUNTY York County Judicial Center BRADLEY C.JACOBS y ARA KIMBERLY MCPHERSON Register of Hills Chief Dep1N Clerk of Orphans'Court Register of;Vills JOHN C.HERROLD BECKY K. FOUST Solicitor Chief Deputy Clerk of Orphans'Court Division February 18, 2014 KNITIQUE 5 COLEMAN 4063 DARIUS DRIVE ENOLA PA 17025 Incapacitated: FRANKIE LEE COLEMAN File Number: 6711-0588 Guardian: COLEMAN KNITIQUE S Counsel: PATRICIA C ZUCKER Guardian Report needed by: 04/12/2014 Dear Sir/Madam: It has come to my attention that you have not filed a Guardian Report!n the above Incapacitated estate. As per Purdons 20 Pa. C.S.A s5521, the guardian or their counsel shall Me with the Clerk of the Orphans' Court his/her Guardian Report. The filing will become delinquent on 04/12/2014. Your prompt attention to this matter will be appreciated. Sincerely, alp, T Bradley C. Jacobs Clerk of Orphans'Court CC: File 45 NORTH GEORGE STREET - YORK,PA 17401-1240 REGISTER OF WILLS(717h 771.9607 - CLERK OF ORPHANS'COURT(7171 771-9288 FAX {717}771-4678-v .yorkcountypa.gov ANNUAL, REPORT OF 0 GUARDIAN OF THE PERSON -- xr - C vr^. COURT OF COMMON PLEAS OF `{or k COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of ran kk e, Lee CyI e man an Incapacitated Person No. 0 f 1-v5sg I. INTRODUCTION r fltli�-aue was appointed Plenary ELimited Guardian of the Person by Decree of RVrzrade. kenN L. 111arkwi I ,J., dated M -7, 2A11 n [U4. This is the Annual Report for the period from April r i D1 to A it i ilia 2014 (the° eport Period"); or © B. This is the Final Report for the period from to (the"Report Period"), and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: 2. The Guardianship was terminated by the Court by Decree of 1., dated For a Final Report, omit Sections 11 through/V. Form 0-03 rev. 10 1106 Page I of 4 A Estate of r Tkl �e 2 �0�Can an Incapacitated Person II. PERSONAL DATA Age of the Incapacitated Person: (V3 Date of Birth: Q-7,425h Sd III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: GclAen Uvir\5 Cfrtk - 1-70 ►�Pwta. Church Rd Cctmlp Hill, pA B. The Incapacitated Person's residence is: I3 own home/apartment G; fiursing home ©boarding home/personal care home [:3 Guardian's home/apartment ❑hospital or medical facility ❑relative's home(name,relationship and address) ©other: C. The Incapacitated Person has been in the present residence since M a Zoo . If the Incapacitated Person has moved within the past year, state prior residence and reason(s)for move: Fo G-03 rev.io.i3.0e Page 2 of 1 Estate of �rankte, L CO�P.rnCLn an Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: Knl �Rut S Werna.n 40(o3 Danws Dr',vc� EhDIat PA I'102-5 IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: L'A D-P Iung��} Uc 14) (n f-4 +a brace,, Ctanior>�,y arl& M14'1+6n 0'0 lungs, CVA rQh+ rlemi ffr-s.s3 .1-riple AAA rcPR`;ttTN) 14pCA Uph4see I up[), urirwj �r-�4-iun , b M, CT bleej . 13. Specify what,if any,social,medical,psychological and support services the Incapacitated Person is receiving: RDJi'r\e, � e_rgM 4S`�e55meAi5 and Gt�s51DnS . V I5i--15 'Crorn d� / btsi V i s tk -Poyn CF4w- - -G i y rrMernbe'm CO-\ A CrlEry When 44A,� ct.ne. ekb1e, V. GUARDIAN'S OPINION A. It is the opinion of the Guardian of the Person that the guardianship should: >rcontinue ©be modified 0 be terminated Form G-03 rev./0.!3.06 Page 3 of 4 L Estate of Fromktit Les Cade an Incapacitated Person The reasons for the foregoing opinion are: B. During the past year,the Guardian of the Person has visited the Incapacitated Person _?_3-_times with the average visit lasting I hours, 2 D minutes. The report of 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. § 4904 relative to unswom falsification to authorities. ) Date pe"On Siburr oJGu diu thce 'I// No''m11e ofCuord naflFe Person Oype orpeinl) �1Db3 Darw QriVG Addrsr Enola PA 17025 Gry.9mr (_-III) 12.8-q-1c1 j Telephone Form G-03 m.10.13.06 Page 4 of 4 , t ANNUAL REPORT OF GUARDIAN OF THE ESTATE AL " COURT OF COMMON PLEAS OF 7 COUNTY,PENNSYLVANIA ORPHANS' COURT DIVISION r Estate of Fran tf Lec, Calfma.n an Incapacitated Person Nn.-4 I. INTRODUCTION / K h=a e— S bl erna- l pp , was appointed denary 0 Limited Guardian of the Estate by Decree of HLnQL4ie IYnrt[l Blnrkwc(I J., dated Ha Zp� &KA. This is the Annual Report for the period fromApr, j 11 201 a to j. 2DI+) (the "Report Period"); or © B. This is the Final Report for the period from to (the"Report Period"), and is filed for the following reason: I. The death of the Incapacitated Person. Date of death: Name of Personal Representative: _ 2. The Guardianship was terminated by the Court by Decree of J.,dated Fos c-02 r¢v.10.13.06 Page 1 of 5 Estate of Vrankl e. Lee Coierria n An Incapacitated Person II. SUMMARY A. State the value of the estate reported on the Inventory $ 221 53 4 5_$ B. State the value(s)of principal assets at the beginning of the Report Period. (Same as Inventory if first Report, otherwise, ending balance from last Report.) 1 ,41 .52 C. What is the total amount of income earned during the Report Period? $ 507. 59 D. What is the total amount of income and principal �I spent for all purposes during the Report Period? $ 2 2 q2. tPo E. What are the balances remaining at the end of the Report Period? 1. Principal $ 2. Income $ 3. Total of Principal and Income $ 3,51P. 73 III. ADDITIONAL INFORMATION (7f more space is needed,please attach additional pages) A. Principal NA applicable. 1. How is the principal balance listed above currently invested? (Please specify,e.g.,real estate, certificates of deposit,restricted bank accounts,etc.): 2. Have there been any expenditures from the principal during the Report Period? . . . . . . . . . .. . . . . . . . . . . . . . . . . . Q Yes No If yes: a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? . . . . . . . . Q Yes Q No Farm G-02 rev. 10.13.06 Page 2 of 5 . l Estate of Vrahhke Lfe An Incapacitated Person b. List purpose and amount of expenditures: c. Was Court approval received prior to expending the principal? . . . . . . . . . . . 0 Yes ❑No 3. Were additional principal assets received during the Report Period which were not included in the Inventory or a prior Report filed for the Estate? . . . . . . . . . . . ©Yes ©No If yes: a. Was Court approval requested prior to receiving the additional principal? . . . . . . . . . . . . . . . . El Yes ❑No b. State the sources and amounts of the additional principal received: B. Income 1. State sources and amounts of income received during the Report Period(e.g., Social Security, pension, rents, etc.): Pen('re.aEd: 1.ln16„ $_ $ Total income received during Report Period: $ (oi 507j Form c-02 rev.10.13.06 Page 3 of 5 Estate of t rar-,kt e, Lee. W erna n An Incapacitated Person 2, How is income currently invested? (Please specify, e.g.,restricted bank accounts,client care account,etc.): �ef)lficke� bw is 0LccoLLrX45- Chrcktr,9 .XLvlr 5 WAuney 4a.r 4, C. Expenses for Care and Maintenance Specify what expenditures were made from the principal and income for the care and maintenance of the Incapacitated Person(e.g., clothing,nursing home,medicine, support, etc.): \\ c� � GaXACry L�vinr, NLtr5ina (Prmtl UjLCCh ] =. 91a11. 61 M, cal I-V r _ ac 64s I s. Fib �ood� clo�►,� � misc�llar, s i +�,s � �oo•oa D. Other Expenditures Specify what other expenditures were made during the Report Period. (Do not include any items stated in response to question C above.) _lncme- 4 t �c 10poo Loss 0� be-d Jrun:4u rc Ax -6 -�{oal: b 25• vo JJ I . E. Guardian's Commissions N [n- 0.�plicA.b�a, •005 oa List amounts of compensation paid as Guardian's commission and state how amount was determined: Court Amount Method of Determination Approval Obtained Yes ©No []Yes E]No Form c-02 rev.10.13.06 Page 4 of 5 Estate of vrQ/1 k 1 t Lee (bl C t,1 An Incapacitated Person F. Counsel Fee Nc� 0.p pl iC(Lbie. . List amounts paid as counsel fee,and indicate whether Court approval was obtained. Court Amount Approval Obtained ©Yes ©No 0 Yes ©No 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. § 4904 relative to unswom falsification to authorities. G1 e, I I -4c�_ zai4 G&I Dote Sipanve ofG dian ofth rmm Kr)1bgUf s coken'O-r) Name ofGuardjah ofihe Fsmre Type orprint) 40 (03 Dar'lus Dr( VC_ Address Cnola, , FAA I-IoZ cry.sure.zip ( If-1) 12.S-9-19-7 reiephane ' Form G-02 rev.10.13.06 Page 5 of 5 ALLIED ATTORNEYS OF CENTRAL PENNSYLVANIA,L.L.C. 61 West Louther Street Carlisle, Pennsylvania 17013 (717)249-1177 (717)249-4514 Fax (877) 882-8904 Toll Free Stephanie E.Chertok,R.N., Esquire Adam R. Deluca, Esquire June 26, 2014 York County Judicial Center Bradley C. Jacobs, Clerk of Orphans' Court Second Floor 45 North George Street York, PA 17401 RE: Frankie Lee Coleman,An Incapacitated Person York County No. 67-11-0588; Cumberland County No. 21-14-0608 SENT VIA USPS FIRST CLASS MAIL Dear Mr. Jacobs: Enclosed, please find a copy of the Petition for Acceptance of Jurisdiction and Transfer of Guardianship in the above captioned matter, pursuant to a Court of Common Pleas of York County, Orphans' Court Division order dated April 16, 2013 requesting the aforesaid action. I have also enclosed a Certificate of Service for your records. Should you have any questions,please do not hesitate to contact me. Thank you for your time and cooperation in this matter. Sincerely, i Adam R. Deluca Enclosures: Petition Certificate of Service I RFCOr,!.0 C I ..E OF Adam R. Deluca, Esquire 2;11 iUN L 6 PM 1 ';4 PA Supreme Court ID#; 311738 Allied Attorneys of Central Pennsylvania, LLC 61 West Louther Street Carlisle,PA 17013 C C' ":' P.1 (717)249-1177 (717)249-4514 Fax adeluca@keystonehearin sg com IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,PENNSYLVANIA FRANKIE LEE COLEMAN ORPHANS' COURT DIVISION AN INCAPACITATED PERSON NO. CERTIFICATE OF SERVICE I,Adam R. Deluca, Esquire,do hereby certify that a true and correct copy of Petitioner's Petition for Acceptance of Jurisdiction and Transfer of Guardianship has been served upon the following persons on the �day of_ nom, 2014, by forwarding the same via first-class U.S. Mail, postage prepaid to: York County Judicial Center Knitique S. Coleman Bradley C. Jacobs Guardian of Fankie Lee Coleman Clerk of Orphans' Court 4063 Darius Drive Second Floor Enola, PA 17025 45 North George Street York, PA 17401 ADAM R. ELUCA,ESQUIRE PA Supreme Court ID#: 311738 Allied Attorneys of Central Pennsylvania,L.L.C. 61 West Louther St. Carlisle, PA 17013 (717)249-1177 (717)249-4514 Fax Attorney for Petitioner nr_"� ^FF�CE OF " LLS Adam R. Deluca, Esquire PA Supreme Court 1D#: 311738 % 'y JUN 2 b GM 1 33 Allied Attorneys of Central Pennsylvania, LLC 61 West Louther Street Carlisle,PA 17013 (717)249-1177 (717)249-4514 Fax adelucana keystonehearings.com IN RE: IN THE COURT OF COMMON PLEAS OF FRANHIE LEE COLEMAN CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION AN INCAPACITATED PERSON fi(R I NO. � E — ILl ` d Qg PETITION FOR ACCEPTANCE OF JURISDICTION AND TRANSFER OF GUARDIANSHIP AND NOW comes Petitioner, Knitique S. Coleman, Guardian of Frankie Lee Coleman,an incapacitated person, by and through her attorneys,Adam R. Deluca, Esquire and Allied Attorneys of Central Pennsylvania, LLC, and files the instant petition seeking Cumberland County to accept jurisdiction of the above-captioned Guardianship matter from York County, and as such,that York County transfer the case to Cumberland County. PART I:ACCEPTANCE OF JURISDICTION AND TRANSFER OF GUARDIANSHIP 1. Petitioner is Knitique S. Coleman,an adult individual, with a present address of 4063 Darius Drive, Enola, Cumberland County,Pennsylvania 17025. 2. Frankie Lee Coleman, an adult incapacitated person, has a present address of Golden Living Community, 770 Poplar Church Road, Camp Hill, Cumberland County, Pennsylvania 17011. I 3. Petitioner is the daughter and appointed guardian of the person and estate of Frankie Lee Coleman,the incapacitated adult in this transfer request,pursuant to a Court of Common Pleas of York County,Orphans' Court Division Order dated June 13,2011,at Docket No. 67.11-0588,attached hereto as"Exhibit A". 4. Petitioner has resided in Cumberland County at the above listed address since August 31, 2001, 51 Frankie Lee Coleman,an incapacitated person,has resided in Cumberland County at the above listed address since May 2011. I 6. Both Petitioner and Frankie Lee Coleman, an incapacitated person,having moved from York County to Cumberland County, now seek to have Cumberland County accept jurisdiction of this guardianship matter,and that York County transfer the case to Cumberland County,pursuant to a Court of Common Pleas of York County, Orphans' Court Division Order dated April 16, 2013, at Docket No. 67-11-0588,attached hereto as"Exhibit B.". WHEREFORE,Petitioner respectfully requests that this Honorable Court accept jurisdiction of the above referenced guardianship matter from York County,and that York County transfer the case to Cumberland County. Respeetfully submitted, ADAM R. DELUCA, ESQUIRE PA Supreme Court 11)4: 311738 Allied Attorneys of Central Pennsylvania,L.L.C. 61 West Louther St. Carlisle, PA 17013 (717)249-1177 (717)249-4514 Fax Attorney for Petitioner VERIFICATION I, KNITIQUE S. COLEMAN, verify that the statements made in this Petition 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 unworn falsifications to authorities. Date: ' 25 �� Knitiq . Coleman, Petitioner