HomeMy WebLinkAbout02-14-06
IN RE: LILLIAN G. HUNTZ
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
An alleged incapacitated person : NO.
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On the Petition of JACQUE BRINK and BERNETTE HUNTZ
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PETITION FOR APPOINTMENT OF CO-GUARDIANS OF THE
PERSON AND ESTATE OF AN ALLEGED INCAP ACIT A TED PERSON
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TO THE HONORABLE PRESIDENT JUDGE OF SAID COURT:
NOW COME, Petitioners, JACQUE BRINK and BERNETTE HUNTZ, by and through their
attorney, Marielle F. Hazen, Esquire, and file the within Petition for the Appointment of Co-
Guardians of the Person and Estate of an Alleged Incapacitated Person, and in support hereof, aver as
follows:
1. LILLIAN G. HUNTZ, the alleged incapacitated person, currently resides at 105
Valley Road, Summerdale, Pennsylvania 17093 . She is eighty-one (81) years old, her date of birth
being March 13, 1924.
2. Petitioners are two of LILLIAN G. HUNTZ's four children: JACQUE BRINK
(daughter), of 503 Schley Avenue, Frederick, Maryland 21702; and BERNETTE HUNTZ (daughter)
of 706 Linwood Street, New Cumberland, Pennsylvania 17070.
3. LILLIAN G. HUNTZ is not a patient in a mental hospital.
4. The names and addresses of those persons who would be the intestate heirs (or next of
kin) of LILLIAN G. HUNTZ are her four (4) children as follows: JACQUE BRINK, of 503 Schley
Avenue, Frederick, Maryland 21702; BERNETTE HUNTZ, of 706 Linwood Street, New
Cumberland, Pennsylvania 17070; SHIRLEY SURO, of 1214-F Cumberland Road, Harrisburg,
Pennsylvania 17103; and JAMES HUNTZ, of601 Rupley Road, Camp Hill, Pennsylvania 17011.
5. The name and address of the person or institution providing residential services to
LILLIAN G. HUNTZ are as follows: None. LILLIAN G. HUNTZ is currently residing at home.
She has a full-time caregiver in her home to provide care and Hospice of Central Pennsylvania
provides additional care services in the home.
6. The names and addresses of other service providers are as follows: Michael A.
Demichele, M.D, Associated Cardiologists, P.C, 856 Century Drive, Suite A, Mechanicsburg,
Pennsylvania 17055; (717) 697-3304.
7. LILLIAN G. HUNTZ was not a member ofthe Armed Services of the United States
nor is she receiving benefits from the United States Veterans Administration.
8. The Petitioners asks that they, JACQUE BRINK and BERNETTE HUNTZ, be
appointed as Co-Guardians, acting jointly and/or individually for the person and estate of LILLIAN
G. HUNTZ. The proposed guardians are the daughters of LILLIAN G. HUNTZ.
9. The proposed co-guardians have no interests that are adverse to the interests of
LILLIAN G. HUNTZ.
10. Petitioners believe, and therefore aver, that no Court has ever assumed jurisdiction in
a proceeding to determine whether LILLIAN G. HUNTZ is incapacitated.
11. Petitioners believe, and therefore aver, that LILLIAN G. HUNTZ has not previously
had a guardian appointed, nor is a guardianship hearing pending in any other jurisdiction.
12. The reasons why this guardianship is being sought are as follows: LILLIAN G.
HUNTZ is unable to manage her financial affairs or to make decisions regarding health care/medical
decisions, due to moderate state Alzheimer's type dementia which totally impairs her ability to
receive and evaluate information and to make and communicate decisions to safeguard her financial
and physical well-being.
13. LILLIAN G. HUNTZ currently has a full-time caregiver, however, Petitioners are
concerned about the quality of care being provided and believe LILLIAN G. HUNTZ's physical
well-being is at risk.
14. The functional limitations and physical and mental condition of LILLIAN G. HUNTZ
are: LILLIAN G. HUNTZ is not able to manage her financial affairs, nor is she able to make
competent decisions as far as her welfare is concerned. LILLIAN G. HUNTZ requires some level of
assistance with all of her activities of daily living.
15. The following steps have been taken, in order to find less restrictive alternative to the
appointment of a guardian: LILLIAN G. HUNTZ is not competent to execute a power of attorney.
No less restrictive alternatives are available to adequately provide for the physical and financial care
of LILLIAN G. HUNTZ
16. The Petitioners request that the co-guardians be granted powers to act for LILLIAN
G. HUNTZ in the following specific areas: financial management, and medical and health care
affairs including care and placement decisions, access to all medical records, including psychiatric
records, and the power to make all decisions regarding medical treatment and life support.
17. Petitioners also request that they, in their capacity as plenary Co-Guardians (jointly
and/or individually) of the Person and Estate of LILLIAN G. HUNTZ, have the power and authority
to serve as personal representatives (jointly and/or individually) for LILLIAN G. HUNTZ for all
purposes of the Health Insurance Portability and Accountability Act of 1996, (Pub.L.l 04-191), 45
CFR Sections 160 through 164, including but not limited to full authority to review her medical
records and to execute releases of confidential information from medical providers and insurers or
other third party payors.
18. The proposed co-guardians have the following qualifications: The proposed co-
guardians are the daughters of LILLIAN G. HUNTZ. The proposed co-guardians love and care for
LILLIAN G. HUNTZ.
19. LILLIAN G. HUNTZ's assets total approximately Two Hundred Eighty Thousand
Dollars ($280,000.00), including her residence and approximately One Hundred Thousand
($100,000.00) in savings and investments.
20. LILLIAN G. HUNTZ's net income from all sources totals approximately One
Thousand Five Hundred Seventy Dollars ($1,570.00) per month.
Petitioners respectfully request that the Court, under Section 5511 ofthe Probate, Estates and
Fiduciaries Code, issue a Citation to LILLIAN G. HUNTZ, LILLIAN G. HUNTZ's next of kin, and
to such other persons as the Court directs, to show cause why LILLIAN G. HUNTZ should not be
adjudged to be an incapacitated person and plenary co-guardians of her person and estate be
appointed.
Respectfully submitted,
Date: c;)..- \ oll oft,
01fk~qUire
Attorney for Petitioners
Court ID No. 68003
2000 Linglestown Road, Suite 202
Harrisburg, Pennsylvania 17110
(717)540-4332
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COMMONWEAL TH OF PENNSYLVANIA
SS:
COUNTY OF DAUPHIN
On this, the day of , 2006, before me, the undersigned officer,
personally appeared Jacque Brink who, being duly sworn according to law, does depose and say that
the facts set forth in the foregoing Petition are true and correct to the best of her knowledge,
information and belief.
IN WITNESS WHEREOF, I hereunder set my hand and official seal.
JACQUE BRINK
SWORN to and subscribed before me this
day of
, 2006.
Notary Public
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF DAUPHIN
On this, the 3cfh day of ~cVnua ref ' 2006, before me, the undersigned officer,
personally appeared Bernette Hunz who, being duly sworn according to law, does depose and say
that the facts set forth in the foregoing Petition are true and correct to the best of her knowledge,
information and belief.
IN WITNESS WHEREOF, I hereunder set my hand and official seal.
~~~
BERNETTE H Z
SWORN to and subscribed before me this
~ day of -1{/LlIU a rc.1
r
~%IV
, 2006.
NOTARIAL SEAL
SALLY B. McCOY, Notary Public
East Pennsboro Twp., Cumberland County
My Commission Expires May 20, 2007
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Ce>M~lur4WEAlTH OF PENNSYl '.'.A~l'nA
COUNTY OF DAUflIIH ~r eoi~vi' &'-
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On this, the ;? 7 day of tfL,- . , 2006, before me, the undersigned officer,
personally appeared JACQUE BRINK ho, being duly sworn according to law, does depose and say
that the facts set forth in the foregoing Petition are true and correct to the best of her knowledge,
information and belief.
IN WITNESS WHEREOF, I hereunder set my hand and official seal.
SS:
~r
SWORN to and subscribed before me this :J 7 day of J a-..... u~ ' 2006.
~~beA (J{y.~
Notary Public '(
~y Comm. EXPS.$,2009.
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF DAUPHIN
On this, the day of , 2004, before me, the undersigned officer,
personally appeared JACQUE BRINK who, being duly sworn according to law, does depose and say
that the facts set forth in the foregoing Petition are true and correct to the best of her knowledge,
information and belief.
IN WITNESS WHEREOF, I hereunder set my hand and official seal.
BERNETTE HUNTZ
SWORN to and subscribed before me this
day of
, 2006.
Notary Public
IN RE: LILLIAN G. HUNTZ : IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYL VANIA
: ORPHANS' COURT DIVISION
An alleged incapacitated person : NO.
On the Petition of JACQUE BRINK and BERNETTE HUNTZ
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 P A.C.S. ~ 4904, relating to unsworn
falsification to authorities.
~Qi!f~
BERNETTE HU
IN RE: LILLIAN G. HUNTZ : IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYL VANIA
: ORPHANS' COURT DIVISION
An alleged incapacitated person : NO.
On the Petition of JACQUE BRINK and BERNETTE HUNTZ
CONSENT TO APPOINTMENT AS GUARDIAN
1. The name of the proposed co-guardian of the person of LILLIAN G. HUNTZ is
JACQUE BRINK.
2. The name of the proposed co-guardian of the estate of LILLIAN G. HUNTZ is
JACQUE BRINK.
3. The proposed co-guardian speaks, reads and writes the English language.
4. The proposed co-guardian does not have an interest adverse to the alleged
incapacitated person.
5. The proposed co-guardian is self-employed as a Realtor.
6. The proposed co-guardian is not a fiduciary, or officer or employee of a corporate
fiduciary of an estate in which the alleged incapacitated person has an interest; and is not the surety,
or officer or employee of a corporate surety of such fiduciary.
Dated:
1-{:11~ tJ (p
~~
JA QU RIN~
IN RE: LILLIAN G. HUNTZ : IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYL VANIA
: ORPHANS' COURT DIVISION
An alleged incapacitated person : NO.
On the Petition of JACQUE BRINK and BERNETTE HUNTZ
CONSENT TO APPOINTMENT AS GUARDIAN
1. The name of the proposed co-guardian of the person of LILLIAN G. HUNTZ is
BERNETTE HUNTZ.
2. The name of the proposed co-guardian of the estate of LILLIAN G. HUNTZ is
BERNETTE HUNTZ.
3. The proposed co-guardian speaks, reads and writes the English language.
4. The proposed co-guardian does not have an interest adverse to the alleged
incapacitated person.
5. The proposed co-guardian is employed at Highmark Blue Shield.
6. The proposed co-guardian is not a fiduciary, or officer or employee of a corporate
fiduciary of an estate in which the alleged incapacitated person has an interest; and is not the surety,
or officer or employee of a corporate surety of such fiduciary.
Dated: / - ~O -O~
A3A/)!Oiff~
BERNETTE HU
IN RE: LILLIAN G. HUNTZ : IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
An alleged incapacitated person : NO.
On the Petition of JACQUE BRINK and BERNETTE HUNTZ
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 P A.C.S. ~ 4904, relating to unsworn
falsification to authorities.
~Q~~
BERNETTE HU
PRAECIPE/REQUEST In The Court of Common Pleas To be filed with the Clerk of the
FOR ASSIGNMENT Cumberland County Pennsylvania Orphans' Court
INRE:
LILLIAN G. HUNTZ, an alleged incapacitated person
DOCKET # Estimated Hearing/Conference Time: 1 Day(s) 1 Hour(s)
SPECIFIC MATTER TO BE ASSIGNED
(Check Only One Category)
Assignment Proceedings and Conferences
Adoptions Compel Accounting Sale of Real Estate
InvoluntaryNoluntary Termination Objections to Account Attorneys Fees
X Guardian of Incapacitated Person Proceedings Against Fiduciaries Status Conference
Discharge Guardian Will Contest Argument
Guardian of Minor Inheritance Tax Appeal Other (describe)
Minor Settlement Terminate Trust
Wrongful Death/Survival Dissolution of Corporation/Charity
Name(s) and Judge(s) of related case(s)
Docket number(s) of related case(s)
Date: 0"2- \o'-t \010 A~~J~ Re:ndent
NAMES, ADDRESSES, E-MAILS & TELEPHONE NUMBERS OF ALL COUNSEL INVOLVED
(use back of form for additional names and addresses)
For the Petitioner(s): Telephone No.
Marielle F. Hazen, Esq. 717 -540-4332
For the Respondent(s): Telephone No.
The Law Office of
MARIEI.u: F. HAzEN
Certified Elder Law Attorney*
An Estate Planning and Elder Law Firm
2000 Linglestown Road
Suite 202
Harrisburg, PA 17110
TEL: (717) 540-4332
FAX: (71 7) 540-4313
www.hazenelderlaw.com
Marlelle F. Hazen, JD, CELA *
Jeta C. Combs, Paralegal
Jessica A. Holland, Paralegal
Catherine M. Semon, Paralegal
Kim M. Smith, Office Administrator
February 13, 2006
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PAl 7013
Re: Lillian G. Huntz, an alleged incapacitated person
Petition for Guardianship
To the Register of Wills:
Enclosed for filing please find the original and one copy of the Petition for Guardianship of
the Person and Estate of Lillian G. Huntz. I am also enclosing a check in the amount of $50.00 for
the filing fee.
Please date-stamp the copy of the Petition and return it along with the signed Preliminary
Order of Court to me in the enclosed envelope.
Thank you for your time and assistance. Should you have any questions regarding the
enclosed document, please do not hesitate to contact our office.
Sincerely,
O~Vvi~~
Cathy Semon
Paralegal
ferns
Enclosures
ec: Jacque Brink
Bernette Huntz
..,.
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*Certified Elder Law Attorney by the National Elder Law Foundation as authorized by the Pennsylvania Supreme Court