HomeMy WebLinkAbout02-19-15 �
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COURT OF COMMON PLGAS OF � � �'�, " ,� � . i
CUMBF,RLAND COUNTY, PENNSYLVANIA � . � � `a - '
ORPHANS' COORT DNISION � �
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IN RE: . N0. 21-14-0878 �v � ` �'�
�
APPROVAL OF DISTRBUTION . � l�
OF PROPERTY BGI,ONGING TO .
MARY C. PELAIA, AN ADJUDICATF.D :
INCAPACITATED PF.RSON .
PETITION TO AUTHORIZE THE ll1S7'RIBUTION OF PROPERTY
BELONGING TO MARY C. PELAIA
TO THF: HONORA6LG, THE JUDGLS OF SAID COURT:
AND NOW, this [`t' � day uf ff��'�Ca�(� , 20I5, comes thc Petitione�,
�
Doneld P. Pelaia, Guardian of the Estate and Person ot Mary C. Nclaia, by a�d through his
counsel, David D. Nesbit of Kcystone Elder Law P.C., and files the following i� support of this
Petition to Authorize the Distribution of Property Belonging ro Mary C. Pelaia.
RH: JURISDICTION
l. Jurisdiction lics in the Orphans' Court Division unde� 20 Pa. C. S. §71 I(10), which states
that the administration and distribution of the real and perso�al property of the estates of
incapaeitated persons is [o be exercised through the Orphans' Court Division.
RE: PRIiV10US ADJUDICA"IION
2. Previously, hereto, upon petition and hearing, Mary C. Yelaia was adjudicated an
incapacitated person by an Order dated the sixth day of November, 20t4, signed by the
Honorable Judge Placey. 6y sa�ne Order, Donald P. Pelaia was appointed Plenary
Guardien of the �:state and of the Person of Mary C. Pelxix.
RE: PETI110NER
3. Petitioner, Donald P. Pclaia, residing at I16 I.ittleton Drive, Hanover, Yennsylvania,
17331, is an adult individual, having a birthdate of Nuvember 28, 1957, aged 57 ycars,
4
and is the namral born son of Mary C. Yelai� an adjudicated incapacitated person.
Petitioncr is also the Plenary Guardian of the said Mary C. Pelaia. Said Petitioner is a
United States citizen and is able m speak, read and write in thc English la�guage.
�,RyE: IN V F:NTORY
4. The inventory was filed on the �7�"� day of Pebrnary, 2015.
5. The inventory detailed Mary C. Pelaia's personal property totaling sixty two thousand
nine hundred and eighty six dollus- and scvenry nine cents ($62,98699) and real propeny
with a value of one hundred and eighry thousand(�I 8Q000)dollars.
RE: MARY C. P�LAIA
6. Mary C. Pelaia is an adult individual eighty-three (83) years of age, suffering from
Alzheimer's discase, which totally impairs her capacity to receive and evaluatc
information effectively, and to make and communicate decisions conceming management
of her financial affairs, or to meet essential requirements for her physical hcalth end
safety.
7. Mary C. Pelaia does not have an occupation, nor does she have any dependcnts.
8. Mnry C. Pelaia does not have any credirors known to Petitioner.
9. Mary C. Pelaia's to[al current monthly income is three thousand o�e hundred and four
dollars and fifty nine cents ($3,104.59) &om a retirement pensioq social security, and
survivors pension bcnefits from the Depurtment of Veterens Affaiis.
10. Currently, Mary C. Pelaia's assets consist of real estate ("family home") located at 116
Littleton llrive, Hanover, Pennsylvania, I7331, with an approximate value of one
hundred and eighty thousa�d ($180,000) dollars and liquid assets totali�g sixty two
thousand four hundred and eighty six dollars and seventy nine cents ($62,48679).
I 1. The [otal amou�t of liquid assets listed above includcs all of Mary C. Pelaia's income that
she is expected to �eceivc for the month of F'ebruary.
12. Mary C. Pelaia resides in a skilled nu�sing faciliry ("facility") in Cadisle and requires
assis[ance with her activities of daily living and eequires twenty-Tour (24) hour
supervision.
13. Mary C. Pelaia's cos[ of eare at the faeiliry is eight thousand nine hundred and Ihirty
thrce dollars ¢nd seventy five cents ($8,933J5) per month, which does not include
additional medical costs, such as for prescription drugs a�d services provided by a
Physician.
14. Mary C. Pelaia will quickty exhaust her assets iu o�dcr to pay for her care in the skilled
nursing facility, and thcrcfore, will need Medical Assistance to supplement her income in
paying for the cost of her care.
Rt: TRANSFER OP PAMILY HOME
15. Mary C. Pelaia, along with her deecased husband, Fred A. Pelaia, acyuired the family
home on July 3Q I980, and both of them resided therc until their medical conditions
required them to move into licensed care facilitics on separate dates beginning in Januazy
of 2013.
16. F�ed A. Pelaia was an immobile amputee with ehronic medical conditions including
kidney failum, which required dialysis regulxrly. Fred A. Pelaia not only needed help
with his own medical needs, but Fred A. Pelaia's condition eventually made it impossible
for him to carc for Mary C. Pelaia at the famity home without Petitioner's assistance.
1 Z Therefore, Petitioner, with the knowledge and appmcia[ion of his five siblings, moved
into tbe family home on September 2Q 2010 [o carc for Fred A. and Mary C. Pelaia; and
the family home has been Petitioncr's legal residence since that date.
I8. As Mazy's Alzheimer's disease progressed Gom 2010 to 2013, she became a security risk
Cor wandering because of the combina[ion of her physical mobility and hcr increasingly
diminished capacity. 'Chis caused a need fo� ncady constant (24/7) observation xnd
sapervision, which even[ually could no longer be provided salely a�d effectively by Fred
A. Pelaia and Petitioncr at the famity home.
19. In January of 2013, two years and four months aHer Petitione� moved into the family
home as his parents' caregiver, Mary C. Pelaia was placed in Emcri[us at Creekvicw
("Hmeritus"), a licensed Personal Caze Home, located at I100 Grando� Way,
Mechanicsburg, Pcnnsylvania.
20. Fred A. Pelaia remained at home with Petitioner until February 17, 2014 when, because
of sepsis and events �elated to his chronic medical eonditions, Fred A. Pelaia was
hospitalized until his discharge to Lmeritus on or about P'ebruary 19, 2014. Fred
subsequently died on April 30, 2014, approximately ten days aftcr bcing �e-hospitalized
for multiple chronic medical conditions.
21. Fred A. Pclaia was an honorably discharged veteran of the United Sta[es Nary, having
served in the Pacific Theater during World War II. Therelore, Frod A. Pelaia was
conditionally e��itled to thc Veterans Pension benefit program from the Departmcnt of
Vete�an Affairs (`VA'�, specifically the Aid and Attendance allowance (� the VA
Pensiod'), which he applied for in 2013 in order to help pay For Mary C. Pclaia's care at
Emeritus.
22. Iaw would have permitted Fred A. Pelaia to use the VA Pension benetit to pay Pctitioner
for the care that Petitione� providcd at the family home to both Fred A. and Mary C.
Pelaia prior to 2013, and thereafter to Fred A. Pelaia, but the Pelaias werc unaware of the
benefit and thus did not pursue that therefoce, the substantial care that Petitioner has
provided to Fred A. and Mary C. Pelaia since September 2Q 2010 has been
uncompensated.
23. A copy of a lette� written by Fred A. and Mary C. Pelaia's doctor, which further details
that Petitioner has been providi�g care to his parents, is attached as Exhibit A.
24. Medical Assistance regulations [55 Pa. Code § 178.104(e)Q)(iv)], known as the
"Caregiver Exception," permit the trensler of real property to a child who resided at the
real property for at least two years immediately before the date the parcnt(s) became an
instimtionalized individual, and who provided care to the parent(s), which permitted the
parent(s) to reside at home rather than in an institution or Lacility.
25. All parties in interest have conscnted to the proposed transfer of the family home ns
evidenced by the attached Exhibit B.
26. Yetitioner herein seeks permission to transfer ownaship of the family home, wherein he
is currently residing, to himself as consideration for his sacrificial caregiving as
permitted by federal and state regulations related to Medicaid and Medical Assistanec
and in accordance wilh[hc provisions of 20 Pa. C.S. § 5536 (b).
RF,: PREPAID FUNERAL
27. Petitioner herein seeks permission to establish a prepaid Cuneral account in the amount of
eleven thousand eight hundred ($71,800)dollars for the benefit of Mary C. Pelaia.
28. This amount is the average cost of a funeral in York Counry (as evidenced by the
attached Exhibit C), which is where the Pelaia farrtily intends to bury Mary C. Pelaia,
specifcally, in a cemetery plot adjacent to the pbt of her Iate husband, Fred A. Pelaia.
RF.: REIMBURSEMENT OF PEl'I"I'IONER
29. Because of her condition related to Alzheimer's disease, by the timc that the Pelaias
sought legal assistance, Mary C. Pelaia lacked capaciry to appoint an agent as her durablc
financial Power of Attomey (POA), which was not a probfem during Fred A. Pelaia's
lifetime because all of their assets wcre jointly owned.
30. Upon E�ed A. Pelaia's death on April 3Q 2014, Frcd A and Mary C. Pelaia's marital
assets were efPectively frozen until the appointment of Petitioner as Mary C. Pelaia's
Uuardia�i on November 6, 2014 (the time period of April 30, 2014 until November 6,
2014 hereinafter referred to as the "Gap'). Therefore, Mary C. PeLaia's funds were
unavailable after Fred A. Pelaia's death to pay fo� Fred A Pelaia's funeral and her own
care during the Gap.
31. On multiple occasions during a time period which coincided with the Gaq Petitioner
used his persona] funds to pay fur Frcd A. Pelaia's funeral and care expenses for Mary C.
Pelaia.
32. In addition, Petitioner used his personal funds to pay for legal fees associated with the
guardianship petition and heacing for Mary C. Pelaia, as well as the minimum �ecessary
expenses to responsibly muintain her rcal property
33. Petitionen c�ccin seeks pertnission to reimburse himself in thc amount of forty six
thousand eight hundred and forty one dollars and forly three ecnts ($46,841.43), from
Mary C. Pelaia's assets, fbr documented expenses paid from his pe�sonal funds for Fred
A. Pclaia's funeral, for legal fees associated with the g�ardianship petition and heazing
for Mary C. Pelaia, and fo� the care of Mary C. Pelaia, and for minimum necessary
espenscs to respo�sibly maintain her real proper[y from April 30, 2014, through
November 6, 2014.
WHB',REFORF., Netitioner respectfully rcquests that your Honorable Court gram the
following rcliefs:
(a) A Court Order be entered, approving that in accordance with the provisions of 20 Pa.
C.S. § 5536 (b); and with considcration to 55 Pa. C.S. § 178.104(c)(1)(iv), Donald P.
Pelaia, as Gua�dian of the Estate of Mary C. Yclaia, shall convey by recordable deed the
title to the property located at 116 Littleton Drive in Hanover, Pennsylvania Crom Mazy
C. Pelaia, who is the widow of Fccd A. Pelaia, to Donald P. Pelaia. Said property is
identified as Tax Parcel #44-000-14-008500-00000 as presently recorded in Deed Book
81-0 Page 809 of[he Recorder of Deeds uf York Co�nty, Pennsylvania. This order shall
be issued in a separate order, separate and distinet from the other items set forth hecein, in
order to facilitate ease of recording at the York County 2eco�der of Deeds.
(b) In accordanec with 20 Pa. C.S. § 5537, Donald P. Pelaia, as Guardian of the Estate of
Mary C. Pelaia, an irrevocable funeral tmst QFI�) in the amount of elevw thousand eight
hundred ($I 1,800) dollars may be established, with the cooperation of a licensed fu�cral
direcmr, for the benefit of Mery C. Pelaia.
(c) A Court Order be issued that authorizes Donald P. Pelaia, as Guardian of the Estate of
Mary C. Pelaix, to pay forty six thousand eight hundred and forty one dollars and tbrty
three cents ($46,841.43) from the funds of Mary C. Pelaia to cepay Donald P. Pelaia for
payments mxde for the funcral of Fred A. Pelaia, for Icgal fees associated with the
guardianship petition and hearing for Mary C. Pelaia, lor the carc of Mary C. Pelaia, and
for minimum necessary cxpcnses to responsibly maintain her real property, when the
funds of Mnry C Pelaia were inaccessible between the time of the dcath of Fred A. Pelaia
on April 3Q 2014 and this Court's appointment of Donald P. Pelaia as Plenary Guardian
of the Person and Estate of Mary C. Pelaia, an individual fou�d to be incapacitated by
this Coun on Novembcr 6, 2014.
Respectfully submitted, �,/�
'�!/�=,sG�������:✓`-C
David D. Nesbi[, Esquire
Pennsylvania Supreme Court ID No. 77411
Keystone tider Law P.C.
55� Gettysburg Pike, Suite C-100
Mechanicsburg, PA ]7055
(717)697-3223
Dave�ri.keystoneelderlaw.com
V BRIFICATION
The undersigned hereby certifies, subject to the penalties of 18 Pa. C. S. § 4904, relating
to unswom falsification to authorities, that I am the appoin[ed Guardian and son of the
adjudicated incapacita[ed person, and that the facts set fonh in the foregoing Petition are true and
correct to the best of my knowledge, information nnd belief.
Date:
147f'/5 BY: iB(Glit'��% " `"
�Donald P. Pelaia
EXHIIIIT A
A��
�
n n n..hannverfamilypmc(ire,anm
January 28.201 S
111 Yvm Strcc[
xe��.�.�,rn mii
pn�e3a-aaav To Whom It May Concem:
Jndrt C.f.ie6..KD_
Mnureen Ei.enM1erg,D_O-
���„i��,�ru�..ce.v e Mary Pelaia had been undec my care sinee beCore 2012, and was
ca,,�h�r���e��a��. c.w N.r �nflble[o manage her ae[ivities of daily living independen[ly. Her late
husband, Fred Petaia wa.a also under my can: until eazly 2014, shortly beTbre
wo F.ca�d�u Svrec, ��death on April 30th.
So�n zm
Hanovey PA 19131
("/i'�bi3-c09c
srepne�,rym.���.mPT 1 am aware[hat the Pelaia's soq Donald P. Velaia, has been living in
k'n.�-nn�eese.rza lhe family home foc the past several years in orde�to provide care tu his
.Neqan.Mnrrin.Y1A
a.�b�,�, K�,.���,.aaa parents, uud to assist with Mr. and Mrs. Pelaia's activi[ies of daily licing. He
wu also involved in wound care for Mc Pelaia. ]n my opinioq had i[ not
been for Ihe carc[ha[was provided by their son, Donald.over[he past severnl
usa s.o.a..ny ears. Mrs. Pelaia would t�ave needed to be movcd from her home sooner than
xanovee P4�]331 Y
01'p 5ax-vtNi she was in order to receive care from an ins[imtion or facility. Mc Pelaia,
n�b��.�✓tt�,�k�, v o. likewise, w'ould not have been ablc m remain at home,as he was also unable
Pmmru�U. Rnpp.ML.
lo perform his nc[ivi[ies of cleily livi�g, le[alone medical and wound care and
�viv196s3ass would have entered ui institution or faciliry to fulfill tivs need. at a much
k'rivtiv Wnde_/_C'S ff'.
earlier time.
t Iz cluver Lane
xono�er,r.n nJv �f I can rovide an further informa[ion m azdin Uonald's role in his
��n)csr-�au P Y B S
.�oe,� �e�<��„r.�C m�.r�. parents care for the past several yeacs.please do not hcsitate to contact me. �
Jnron Zirm, P�f..C.
("I1]�63]-5590 SIIICE�2�y,
Jen��(�A.Acin.MD. �� �
(91])bN&04J1 ��,� �� ',���
s�,«,n F���.�. Lrr
'Phomas D. Rapp. M.D.
]95 Chern Tree Cnurt
tiuite i
Henover,PAl]331
(717)630-8366
Canc�rine R. KirGr. .ND.
.hdre S�ro�rrhmgh Lixenharr_dGJ'P-OC
EXHIBIT B
CONSI�:NT TO TRANSFER OT ASSETS IN 1tELATION TO MARY C. PELAIA
I, �ra \_�,Z���e�,d ,am one of six(6)siblings who are[he biological children
of Mary C.Peleie and the late Fred A. Pelaia. I have secn a four page Memorandum m the Oiphans'
Conrt Division of the Court of Common Pleas of Cumbedand County, Pennsylvania,which presents
various fects related to my parents situation and the role my bro�her,Donald P. Pelaia,as their live-
in earegiver.To ihe best of my knowledge,the facis are eorrect as steted in that Memorandum.
I believe ihat�ny brother,Donald P. Pelaia,deserves to have ihe family home located at I 16 Litlleton
Drive in Hanover,Pennsylvania,tra��sfei'reA to his name at this time because of[he sacrisces he
mnde in relation ro the c�negiving of my parents. I realize that,oncc ihc family home is teansferred ro
my brother,Donald P. Pelaia,that it would be a pennanent n'ansfe��,and the family home would
�herefore not be pa�4 oC any cstate that might otheiwisc remain upon the death of my mother.
I encourage repayment to my brother,Donald,for$47,34726 in expenses which hc made on behalf
of our fnmily for my father's funeral and my mother's care,when my mother's asseis were no[
available before Donald was appointed ro bc hcr guardian.
i encow'age prepaymcn[of my mother's funcrnl in an nmount of up to$11,800.
1 support these actions because I believc thcy will result in good care for my mother,fair trcatment of
Donald, and circumstances[hat my siblings and I can manage so lhat,even if our parents'resouices
nre cxhaustcA by ihc cost of my mother's care,I hope to awid pe�sonal liability for her expenscs.
I cealize Iliat[he po[enlial consequenee of ac[ions I hereby endorse could be that no inheritance could
remain for me or my siblings aticr the eventual dea�h oC my mother.
I unde�stand lha[my statemenl as hereby provided may be submitted to various gowrmnental enti�ics
or pr �n �as e 'de� y�nce.�l �—
��
By: �i�' �Ct _ �- I°• �S _ _
(Sigoature Above) Date
STA7'HO� I��nnSy �v4ni G� __ _" •
SS:
COUN'fY OF �o r k �
ON THIS, [he �ntt day of F�hr t a�`� .20�5 befm•c mc,Ihe undersigned
officer,persunally appeaeed P�U � ���u �- Imown to ine or satisfac[orily proven
to be the person whose name is subscribed ro the within insu�ument,and acknmvledgcd that he/she
cxecuted the same for ihc pmposes Iherein conteined. M WITNESS WHEREOF,I hcreunto se[my
hand and no�arial seal. �
�
' � � :rn,�
N tary Pu�ic
COMh10NY/E4LiH OF FENNSYLVANIA
ito�anai Seai
Pmy C.iome.Notary Public
West MancM1ener TvD..Tod Counry
My Commiss��on&O��Flz July S,2DIi
nu� rv,,,ma.,�u�;smm��a irn.wes
EXHIBIT B
CONSENT TO TR/�ANSFER OF ASSETS IN RELATION TO MARY C. PELAIA
I, � v�0/nCeo' 1.1X'U-la. , am one of six(� siblings who are the biological children
of Mery C. Pelaia and thc la[e Fred A. Pelaia. I have seen a four page Memorandum to the Orphans'
Court Division of the Court of Common Pleas of Cumbcrland County, Pennsylvania, which presents
various Cacts rclated to my parents' situation and [he role my brother, Donald P. Pelaia, as their live-
in caregiver. To ihe best of my kno�v�ledge, the facts are wrrcet es stated in that Memorandum.
I bclicve that my brother, Donald P. Pelaia, deserves ro have the fxmily home located at I 16 Littleton
Drive in Hanover, Pennsylvania, tra�sCerred to his name at this time because of the sacrifices he
made in �etation to the carcgiving of my parents. I realize that, once the family home is transferrod ro
my bro[her, Donald P. Pelaia, [ha[ i[ would be a peRnanent ttansfor, and [he family home would
therefore not be part of any estate Iha[might otherwise remain upon the death oPmy mother.
I encourage repaymen[ to my brother, Donald, for$47,34726 in expenses which he made on behalf
of our fumily for my father's funeral and iny mother's care, when my mothe2s assets were not
available before Donald was appoin[ed to be her guardian.
I encourage prepaymenl of my mo[her's funeral in an amoun[ o(up [o $I I,800.
I support these actions because I believe they will result in good care for my mother, fair treatment of
Donald, and circumstances lhat my siblings and I can manage so tha[, even if our parents' msourees
are exhausted by [he cost of my mother's care, I hope [o avoid personal liability Tor her expenses.
I realize tha[the potential consequcnce ofactions I hereby endorse could be [hat no inheritxnce coulA
remain for me or my siblin�s after thc evenmel death of my mother.
I understand that my statement as hcreby provided may be submitted to various governmen[al enlities
or proceedin as evidenec.
By: 1 L� ZOi
(Signatu e Above) Date
STATEOFf�rrJ ,/r�eSP � �
SS:
COUNTYOF � S;ex .
ti
ON THIS, the �day of �2n u <=-"-y .Zo�5 before me, the undersigned
officer, personally appcared T/_o m�5 �`�'� known to me or satisCac[orily proven
[o be Ihe pe�son whose name is subscribed to thc wi[hin instmment, and acknowledged that he/she
executed the same for the purposcs thcrein contained. IN W ITNBSS Wl1EREOF, 1 hercun�o set my
hand and notarial seal.
� /1
�/ �� � ������
Notar Public
�OFEEN M 9UTLEN
Notuy PUEIic
Stete o1 New Jersey
My Commlesian ExDirec Jun 28,2019
EXHIBIT B
CONSENT TO TRANSFER OF ASSETS IN RELATION TO MARY C. PELAIA
I, ��``�h`I �"1 - �,2YL1 � , am one of six (6) siblings who are the biological children
of Mary C. Pelaia and [he late Fred A. Pelaia. 1 have seen a four page Memorandum [o the Orphans'
Court Division of the Court of Common Pleas of Cumberland Coun�y, Pennsylvania, which presents
various facts related to my parents' situation and the role my brother, Donald P. Pelaia, as [heir live-
in caregivec To the best of my knowledge,the fac[s a�e correct as stated in that Memorandum.
I believe that my brother, Donald P. Pelaia, deserves[o have[he family home located at I 16 Littleton
D�ive in Hanover, Pennsylvania,transferced to his name at this time because of the sacrifices he
made in relation to the caregiving of my paren[s. I realize that, once the family home is transferred [o
my brother, Donald P. Pelaia, [hat it would be a permanent transfer, and the family home would
therefo�e no[ be part of any es[ate that migh[o[he�wise remain upon the death of my mother.
�encourage repayment to my brother, Donald, for$47,34726 in expenses which he made on behalf
of our family for my ta[hcr's funeral and my mothcr's carc, whcn my mother s assets were not
available before Donald was appointed to be her guardian.
1 encou�age prepayment of my mother's funeral in an amount of up to $I 1,800.
I support[hese ac[ions because I believe [hey will resul[ in good care for my mother, fair[reatmen[of
Donald, and circumstances that my siblings and I can manage so that, even if our parents' resources
are exhausted by the cost oCmy mother's care, 1 hope to avuid personal liability for her expenses.
I realize diat the potential consequence of actions I hereby endorse could be that no inheritance could
remain for me or my siblings after the evenmal death of my mother.
I understand that my statement as hereby provided may be submitted to various governmental enticies
or proc�dings as evidence.
By: L�SI. , � �� ti �2- 5-� 5�
(Signatur �bove) Date
s��n�rEOH fl � i �
ss:
couN rv or ���_�h � rJ
ON THIS,the ,�day of dXXn�f0.FN�l , 2015 before me, the undccsigned
o�cer, personally Tppearcd ¢��I K- ��n � i'h known to me or satisfactorily proven
to bc the person whose name is subscribed to the within instrumen[, and acknowledged that he/she
executed the same for the purposes[hecein con[ained. IN W ITNESS W HEREOF, I hereun[o set my
hand and notarial seal.
70MMONWEALTN OF PENN6YWANIA
NOTAFIALSEPL NO[3I'VNu IiC
LYCIA F OAVIS �
Notary PUEIIc
y SWATAPA iWP,DAUPHIN COONTY 'm
9 My Commisslon Evpires Jan 2I,2�18
EXHIBIT B
CONSENT TO TRANSFER OF ASSETS IN RELATION TO MARY C.PELAIA
I, /N�l�//t N/ J � M CO Lf{ �one of six(6)siblings who are the biological children
of Mary C. Pelaia and the late Fred A. Pelaia l have seen a four page Memorandum to the Orphans'
Court Division of the Court of Common Pleas of Cumberland Co�nty,Pennsylvania,which presen�s
various facis related to my parenu' situation and the role my brother,Donald P. Pelaia,as their live-
in caregiver. To fhe best of my Imowledge,the facts are correct as stated in that Memorandwn.
I believe that my brother, Donald P. Pelaia, desecves to have ihe femily home locazed az 1 l6 Littleton
Drive in Hanover,Pennsylvania,transferted to his neme at tkus time because of the sacrifices he
made in relation ro the caregiving of my parenu. I realize that,once the family home is transferred to
my brothar,Donald P. Pelaia, that it would be a pecmanent transfer,and ihe family home would
therefore not be part of any estate that might othefwise remain upon ihe death of my motl�er.
I encourage rapayment to my brother, Donald,for$47,34716 in espenses which he made on behalf
of our family for rtry father's fwerai and my mother's care, when my mother's assets were not
available before Donald was appointed to be her guardien.
I encourage prepavmrnt of my mother's funeral in an amowt of up to$11,800.
I support ihese actions because 1 believe they will result in good carc for my mother, fair treahnent of
Donald,and circumstances that my siblings and[cen mensge so that,evrn if our pareats' resources
ere ezhausted by the cost of my mother's care, I hope to avoid personal liabiliry for her expenses.
I realize that the potential consequence of actions 1 hereby endorse could be that no inheritance could
remain for me or my siblings after Ihe eventual death of my mother.
I understand that my stazem�t as hereby provided may be submitted to various govemmental enlilies
or proceedings as evidence.
By: ��1'kF.tl-�-A-� �- �2�- l��
(Signature Abov Date
STA7'EOF �_J"$ , AW�cNMrywdherdficerewnpktingUis
ukfiah'rtrifiee WYtle iAen6ly of the indiviAml vAw
/�(//�-1/ . SS: +inpMlhedxumeMbxfii[hMisreNfi�ahisatla�hetl,
COlIN770F (J(jf'11�'(', , mdnd@ebNMu�ress,a�curacyorvalidqyoftlut
dxurenl
ON 7TiIS,the �day of_ f�N 2015 before me, the undcrsigned
officer,personally appeared �AQ�A�1 Imown to me or satisfactorily prove�
to be the person whose name is subscribed to the within instrument, and aclmowledged that hek�
eicecuted the same for the purposes therein contained. IN WiTNESS WHEREOF,I here�mw set my
l�az�d and notarial seal.
J.B. Swan III, Nolary PubLc
J.B. SWFN III Not9ry Pub�iC
Commission#2075057
< Notary Public-Czlifamia i
� n
� Orange Cranry
M Comm.ExVires Au 15,2012�
�
EXHIBIT B
CONSENT TO TRANSFER OF ASSETS IN RELATION TO MARY C. PELA►A
L I�'I(iRK � . ��L A "a , am one of six(6) siblings who are thc biological children
of Mary G Pelaia and the la[e Fred A. Pclaia. I have seen a four page Memorandum [o Ihe Orphans'
Court Division of the Co�rt of Common Pleas of Cumbedand County, Pcnnsylvania, which presents
various facts related to my parents' situatio�and the role my brother, Donald P. Pelaia, as theic live-
in caregiver. To the bes[oCmy knowledge,the facts are eorrect as stated in that Memorandum.
I believe[hat my brothcr, Donald P. Pelaia, deserves to have the family home located at 1 l6 Litticton
Drive in Hanover, Pennsylvania, transferred to his name a[[Ms time because of[he sacrifices he
made in rela[ion to the cazegiving oCmy parcn[s. I realize[hat, once the family home is transferred to
my brother, Donald P. Pelaia, Ihat it would be a permanen[transfer, and[he family home would
therefore not be part of any es[ate[hat migh[otherwise remain upon the dea[h of my mother.
] encourage repayme�[to my bro[her, Donald, for$47,34726 in expeuses which hc made ou behalf
ofour family for my fathers funeral and my mothers care, when my mothcr's assets were not
available before Donald was appointed[o be her guardian.
I encourage prepayinen[of my mo[her's funeral i�an amuunt of up[o 511,800.
I support these ac�ious because I believe[hey will result i�good care for my mothec, fai�treatment of
Donald, and circumstances tha[my siblings and I can mauage s-o that, even if our paren[s' resources
are exhausted by[he cos[of my mother's care, I hope to avoid personal liability for her expenses.
I realize that[he po[ential consequence of actions I hereby endorse could be that no inheritance could
remain for me or my siblings after[he even[ual death of my molher.
I understand that my statement as hereby provided may be s�bmi[ted[o various govcmmeutal entities
or proceedings as evidence.
BY:./' /p,i.� L .. <� � c� 8 LO r�
(SignaNre Above) Date
STATE OF I�`�� ,��� �
SS:
COUNTY OF�y'�- -��� .
yh
ON THIS, Ihe �� day uf \�x��4r, v-�� , 2015 before me, [he undersigued
officee persunally appeared N�a�-� t � I�e�ri,�� known to me or aa[isfactorily proven
ro be the person e�hose name is subscribed ro the within instrument, and acknowledged that he/she
executeA the same for lhe purposes therein contained. IN WITNESS WHEREOF, I hereunto set my
hand and notarial scal.
�
��iva. � t`:Ji ���
Notary Public
Donne M.Hoe�roMel
NpWy PubliC,CAuMy of Frederltll
Slate of Maryland
My Commiasiai Expires OS2Q2076
EXHIBIT C
2014 COUNTY BURIAL LIMITS
; 01-Adams } 8,000 � 10,000 �
02-Allegheny ; 12,400 �, 15500 �', .
_-__ ...... i ._._- _-_ ',, �..
i
03-Arms[ran6 .. � 8,600 �'., 31,OW ''�. ..
�. 04�Beaver �' 12SW ', 15,625 �
_ ......._ __ ___ I
_...__ ._.i, ,�..
�OS-Bedford 10,500_ .�!, 13,125 I �.
O6-.Berks . 10,000 . . 12500 __ _��li �
I I �
i 07-81air `�� 15,000 18,750 I
._.__ ___1-___--_�
, OS-Bradford ���� 12,500 � 15,625 �'
. ___ ._. . ...__.. . . __�__ ,.
�I 09-Bucks I 70,250 �� 12,812.50 '�
. .....__ __..... -____ . � �.
10-eutler : 10,600 .... -�-�13,250 _-� �'.
,..___. __. ___ r_. '�.
��, 11-Camhria 70,750 '� 13,43750 "
f____.. _.. .._ ,__ .
12-Cameron B4O00 " 10,000 ���
._..___ .._.._ . ...._._ ., .
13-Carbon 7,500 !. 9,375 ''�.
- __-____ .__._. _ �,
14-�Centre ; 9,000 '�, 11,250 �
,..___.- __.__ ""_..___ _.. .
i 15-chester � ia,o00 !. 12,500 -
__.. . _._ _.__- _.__ .._ ..
I 1G Clarion j 50,000 = 12,500
__- __ � ___ _.._ ..._.
17-Clearfield 8750 � 1093750 �
� _..._. *__ __-
�' 18-Cllnton � � j 10,000 ; 12,SW �
__.__._. __ ___.
19-Columbia ��� � � 12,000 j 15,000
...._ ._-__... _._ ..._.
20-Crawford �� � � 10,609 '�. 13,261
21-Cumberland � I9,345� � 11,681.25 � '�..
�, 22-Dauphin ...� i 9,000... 1�11,250 ��' .
� 23-Delaware ... i 12,500 '�, 15,625 '��
; 24-Elk j 10,000� �'. 12,500 '.. ...
�____.. __ ..._.
25 Ene 30,905 ��13,631 25 '�
.____-_ . .. .__ ',.
� 26=Fayette !� 8,891 '�, 11113.75 �'�,
......._"__ _._. .
27- Forest 30,000 � 12,500 �� ',
__ .
28 Franklin 10,020 '.� 12,525 �'�,
� _. ,
29-�FW[on . ... ; 9,000... ,"'�,,11250.""'_"'" .
__ _.... -- . .
30-Greene 9,807.11 12,25896 ......',
31 Hun[ingdon ___ i 30,000 ,�.12500 ��,�
, ._ ___ . .__�,
32-Indiana �I 9,200 ;_51500 ''�.
� 33-Jefferson i 10,000 �'- 12,500 � '�.
.... '_____'_ ._..._ _-:.-- _--,.
��� 34-Juniata j 10,000 �. 12,SW ��
...__.. . .._. . _._...__ ._ ,
35-Lackawanna 31,000 � �13]50 '�
..... . ._.. .__._ . .- ._. . . ._:
"i 36-Lanwster �I 9,874 : 12,34250 '
EXHIBIT C
2014 COUNTY BURIAL LIMITS
'�, 37-Lawrence ' 9,375 '! 31,71875 � �
..._._ _. ... _.._._ ..... ._;
'�. 38-Le6anon ' 10,000 �; 12,SW �
39-Lehlgh � �� ; 10,000 � ' 12,500 ��'�
.___ . ... . .. ____. ...... ...'�.
! 40-Luxeme i 11,500 �� 14,375 '�
. a1-Lycoming � �� ; 11,000 � !�13,750 �'��
, _ _.__. _-__ .,
i 42 MCKean 9400 ��11,750 '���
..'__ . ._.__. ._. .
I, 43-Merter i 30,000 �' 12,SW '
_._.. �_'_ ,
44-M�fflin � � 10,000� '�: 12500 �'-
-_. .._ `__ _ -
'�. 45-Monroe ... 'i 11,000 '��. 13,750 ���..
......_._. __-_._.. �.__ ..
46-Montgomery i 12,000 . 15,OW '
__ -
� 47- Montour . � 11,000 ��13,750 �'�
! 48-Northampton � 10,316 i 12,895 '
..__ - ___ ._.._ .._.__ .. ._ . :
j 49-Northum6erland i 11,500 � 14,375 ' '
_...." .__ .____ .,_..
So-Perry, __ 7,565 i945625 �
___._ ' "" -.<... __ .
51-Philadelph�a i 11,000 I 13,750 ; '
52-Pike 10,500 � 13,125 '
____ ..__ .... . .
53-Potter 9,500 � 11 H�5 I
......_ . ..__-._ -.--.... ..._.._._____y ... .
545chuyk�li B,500 .I.10,625
55-Snyder � � , 10,000 �. 12,500 '
, _.... .____ ..._.__.... ..._-'-' ..._.�.
�'�. 56-Somerset ��; 8,500 �I 10,615 '�
� 57-Sullrvan _.___ 11625� � �I 13750 ' '.
..._'__ -._-
! 58-Susquehanna I 11,000 �I 13,750 ��
59 Tioga ._ 11,000� �,� 13,750 '�
fi0- Union.__...... 1.30,400 _ �'�_33000 '� '�,
_ _ ;, _ '
61-Venango ..._. . 10,566 � 13,20750 ' '��.
�� 62-Warren ; 8,750 I 30,937.50 - �
,__.___ ._:
63-Washmgton �� � 12,000 �15,000
�'�, 64-Wayne -. . ���, 10,500� ;�13,125 �����
._ _.._.. . .'_' _-:
65-Westmoreland , 9,655 '. 12,Ofi875 �
66-Wyommg _ 11,000 i�13,750 �
'�� 67-Vork ; 11,800 � 14,750 '�