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Amanda Snoke Dubbs, Esq. _i
Supreme Court Id: 202254 = c-j
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294 Dew Drop Road r.-) c3
York, PA 17402 C) `T'
Telephone: (717)430-6730
Email: mandasnokedubbsacomcast.net
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,PENNSYLVANIA
ORPHANS' COURT DIVISION
IN RE: NO. 21-15-0212
MARGARET L. WILKEMEYER,
An Incapacitated Person
PETITION TO INVADE PRINCIPAL
IN ACCORDANCE WITH 20 PA. CONS. STAT. ANN. §5536(a)
TO THE HONORABLE, THE JUDGES OF THE SAID COURT:
Good News Consulting, Inc., plenary guardian of the estate of Margaret L. Wilkemeyer,
by and through its counsel, Amanda Snoke Dubbs, Esq., respectfully states the following:
Tune-
1.
une1. Margaret L. Wilkemeyer ("Wilkemeyer") on J+47 4, 2015, was declared an incapacitated
person by this Honorable Court appointing Good News Consulting, Inc. as the plenary
guardian of her estate.
2. Wilkemeyer is 80 years of age and resides at Manor Care Carlisle, 940 Walnut Bottom
Road, Carlisle, Pennsylvania 17015.
UV
I The following individual would be entitled to take under the intestate laws:
Karen Lyons (Daughter) Patricia Putney (Daughter)
213 Glenwood Drive 1117 Cocklin Street
Dillsburg, PA 17019 Mechanicsburg, PA 17055
Frank Wilkemeyer(Son) Donna Renaut (Daughter)
438 Linden Street 29 Woodcrest Drive
Mechanicsburg, PA 17050 Carlisle, PA 17015
James Wilkemeyer(Son)
23 Deerfield Road
Mechanicsburg, PA 17050-1785
4. This petition has been sent by first class mail, postage prepaid, to the address as listed in
paragraph 3.
5. Wilkemeyer is the owner of a life insurance policy (Policy No. 0102626390) held with
Knights of Columbus, with a cash value of$3,492.79 as of August 7, 2015. (See Exhibit
A)
6. Wilkemeyer is the owner of a single premium whole life insurance policy (Policy No.
02627146) held with Knights of Columbus, with a cash value of$18,275.53 as of March
18, 2015. (See Exhibit B)
7. Petitioner is requesting to cash in these policies for the care and maintenance of
Wilkemeyer.
8. Cashing in the policies to pay for Wilkemeyer's care and maintenance was a
recommendation of Department of Human Services and County Assistance Office, so
that Wilkenmeyer will then qualify for Medical Assistance.
WHEREFORE, Petitioner respectfully requests that it, as Guardian of the Estate of
Margaret L. Wilkenmeyer, be authorized to cash in the life insurance policies held by Knights
of Columbus for the care and maintenance of Ms. Wilkemeyer.
Respectfully submitted,
Date: q`g 1015 By:
qZmanda Snoke Dubbs, Esq.
Supreme Court Id: 202254
294 Dew Drop Road
York, PA 17402
Telephone: (717)430-6730
Email: mandasnokedubbs@comcast.net
KNIGHTS OF COLUMBUS
MAKING A DIFFERENCE FOR LIFE
July 28,2015
CS: 12788
1117 Cocklin St
Mechanicsburg PA 17055-3959 s c ' ' SA
�4
Dear Policyholder:
This policy owner statement is in response to an inquily received on July 27,2015.
GENERAL INSURANCE INFORMATION
POLICY .........................................................................:........................................................................ 0102626390
INSURED ............................................................................................................................. Margaret L Wilkemeyer
ISSUEDATE .............................................................:.......................................................................... June 7,2003
CURRENT PREMIUM& MODE ..................................................................................................... 31.90 Monthly
PRIMARY PLAN OF INSURANCE&FACE AMOUNT:Whole Life $ 6,500.00
SUMMARY OF CASH VALUES
CASH VALUE OF BASIC POLICY .............................................................................................. $ 2,543.97
CASH VALUE OF PAID UP INSURANCE ADDITIONS, IF ANY ................................................ $ 948.82
(FACE AMOUNT OF PAID UP INSURANCE ADDITIONS) $ 1,287.04
DIVIDENDS ON DEPOSIT,IF ANY ............................................................................................ $ 0.00
CURRENT DIVIDEND(REDUCE PREMIUM) .........................i ............................... $ 0.00
HALF MATURITY DEPOSIT, IF ANY ......................:.....................................I............................ $ 0.00
DISCOUNTED PREMIUMS ON DEPOSIT, IF ANY:....:........................................:..........I.......... $ 0.00
PREMIUMS PAID IN ADVANCE, IF ANY .....................................................................:............. $ 0.00
LESS OUTSTANDING POLICY LOAN WITH INTEREST, IF ANY............................................. -. $ 0.00
TOTALCASH VALUE ................................................................................................................ $ 3,492.79
ALL VALUES SHOWN ARE AS OF 8/7/2015
Additional policy benefits and information are provided on the following pages, if requested.
If you do not know who your Knights of Columbus Field Agent is,we suggest that you contact your Knights of
Columbus General Agent Mr.John J Mitchell at(717)737-7808 for further information pertaining to your policy.
Sincerely,
Amanda Havens,Supervisor—Policy Document Change EXHIBIT
Certificate Service Department
CC:Agency 08283
1 COLUMBUS PLAZA • NEW HAVEN, CONNECTICUT 06510-3326 TEL. 203-752-4000 • WWW.KOFC.ORG
KNIGHTS OF COLUMBUS
MAKING A DIFFERENCE FOR LIFE
July 31, 2015'
Mrs.lvla�g ra eL:,, ilkeme .et `
1117 Co k^im S� '�
Mechanicsburg, PA 17055-3959
J
Dear Mrs. Wilkemeyer: °
This letter is in response to an inquiry received on July 29, 2015.
. . . . . . . . . . . . ... . . . . . . . . . GENERAL INSURANCE INFORMATION . . . . . . . . . . . . . . . . . . . . . . .
POLICY: 02627146
INSURED: Margaret L. Wilkemeyer
COUNCIL: 12788
ISSUE DATE: September 02, 2003
CURRENT PREMIUM AND MODE: $.00 J Paid Up
PRIMARY PLAN OF INSURANCE AND FACE AMOUNT: Single Premium Whole Life 1$20,231.40
• - • • • • • • SUMMARY OF CASH VALUES . . . . . . . . . . . . . . . . . . . . . . . . . .
CASH VALUE OF BASIC POLICY: $15,029.79
CASH VALUE OF PAID UP INSURANCE ADDITIONS, IF ANY: 3,245.74
(FACE AMOUNT OF PAID UP INSURANCE ADDITIONS$4,368.98 )
DIVIDENDS ON DEPOSIT, IF ANY: .00
CURRENT DIVIDEND(REDUCE PREMIUM): .00
HALF MATURITY DEPOSIT, IF ANY: ,00
DISCOUNTED PREMIUMS ON DEPOSIT, IF ANY: .00
PREMIUMS PAID IN ADVANCE, IF ANY: .00
LESS OUTSTANDING POLICY LOAN WITH INTEREST, IF ANY: - .00
TOTAL CASH VALUE: $18,275.53
ALL VALUES SHOWN ARE AS OF March 18, 2015
Additional policy benefits and information are provided on the following pages, if requested.
Sincerely yours,
Amanda Havens, Supervisor
Correspondence Division
Certificate Service Department
mbher EXHIBIT
cc: John J Mitchell,GA#8283
1 COLUMBUS PLAZA • NEW HAVEN, CONNECTICUT 06510-3326 • TEL. 203-752-4000 • WWW.KOFC.ORG
VERIFICATION
I verify that the statements made in this Petition are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.C.S. § 4904, relating to unsworn
falsification to authorities.
Date: 9/8/Z®l By:
Tina M. Hess
Good News Consulting, Inc.