HomeMy WebLinkAbout07-20-06
IN RE: MYRTLE A. DRAWBAUGH
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. ,:{ J -- 0" ~ ciJ5b
An alleged incapacitated person
On the Petition of DANIEL D. DRAWBAUGH, SR. and
SHARON L. DRAWBAUGH
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PETITION FOR APPOINTMENT OF GUARDIAN OF THE
PERSON AND ESTATE OF AN ALLEGED INCAPACITATED PERSON--:.
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TO THE HONORABLE PRESIDENT JUDGE OF SAID COURT:
NOW COME, Petitioners, DANIEL D. DRA WBAUGH, SR. and SHARON L.
DRAWBAUGH, of 7353 Fishing Creek Valley Road, Harrisburg, Pennsylvania 17112, by and
through their attorney, Marielle F. Hazen, Esquire, and file the within Petition for the Appointment
of Guardian of the Person and Estate of an Alleged Incapacitated Person, and in support hereof, aver
as follows:
1. MYRTLE A. DRAWBAUGH, the alleged incapacitated person, currently resides at
Manor Care, a skilled nursing facility at 1700 Market Street, Camp Hill, Pennsylvania 17011. She
is ninety-five (95) years old, her date of birth being July 7, 1911.
2. MYRTLE A. DRAWBAUGH is a widow, her late husband having died in June of
1974. She has six (6) children: Dawn E. Viering (daughter) of Hershey Plaza Apartments, 215 W.
Chocolate Avenue, Apt. 2-P, Hershey, Pennsylvania 17033; Herbert V. Drawbaugh (son) of305 N.
28th Street, Harrisburg, Pennsylvania 17109; David R. Drawbaugh (son) of 2927 Williamsburg
Street, Sarasota, Florida 34231; Sharon L. Kimmel (daughter) of 2925 Wekiva Road, Tavares,
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Florida 32778; Elaine Osborn (daughter) of 1159 Loop Drive, Harrisburg, Pennsylvania 17112; and
Daniel D. Drawbaugh, Sr. (son) of 7353 Fishing Creek Valley Road, Harrisburg, Pennsylvania
17112.
3. MYRTLE A. DRAWBAUGH is not a patient in a mental hospital.
4. The Petitioners are is MYRTLE A. DRAWBAUGH's son and daughter-in-law,
DANIEL D. DRAWBAUGH, SR. and SHARON L. DRAWBAUGH, of7353 Fishing Creek Valley
Road, Harrisburg, Pennsylvania 17112.
5. The names and addresses of those persons who would be the intestate heirs (or next of
kin) of MYRTLE A. DRAWBAUGH are her six (6) children as follows: Dawn E. Viering
(daughter) of Hershey Plaza Apartments, 215 W. Chocolate Avenue, Apt. 2-P, Hershey,
Pennsylvania 17033; Herbert V. Drawbaugh (son) of305 N. 28th Street, Harrisburg, Pennsylvania
17109; David R. Drawbaugh (son) of2927 Williamsburg Street, Sarasota, Florida 34231; Sharon L.
Kimmel (daughter) of2925 Wekiva Road, Tavares, Florida 32778; Elaine Osborn (daughter) of 1159
Loop Drive, Harrisburg, Pennsylvania 17112; and Daniel D. Drawbaugh, Sr. (son) of7353 Fishing
Creek Valley Road, Harrisburg, Pennsylvania 17112.
6. The name and address of the person or institution providing residential services to
MYRTLE A. DRAWBAUGH are as follows: Manor Care (nursing home), of 1700 Market Street,
Camp Hill, Pennsylvania 17011.
7. The names and addresses of other service providers are as follows: None.
8. MYRTLE A. DRAWBAUGH's primary physician is: James Harty, M.D., 1609
Buckingham Road, Harrisburg, Pennsylvania 17111 (717) 761-8331.
9. MYRTLE A. DRAWBAUGH was not a member ofthe Armed Services of the United
States nor is she receiving benefits from the United States Veterans Administration.
10. The Petitioners asks that they, DANIEL D. DRAWBAUGH, SR. and SHARON L.
DRAWBAUGH, be appointed as Guardians of the person and estate of MYRTLE A.
DRAWBAUGH. The proposed guardians are the son and the daughter-in-law of MYRTLE A.
DRA WBAUGH.
11. The proposed guardians have no interests that are adverse to the interests of
MYRTLE A. DRAWBAUGH.
12. Petitioners believe, and therefore aver, that no Court has ever assumed jurisdiction in
a proceeding to determine whether MYRTLE A. DRAWBAUGH is incapacitated.
13. Petitioners believe, and therefore aver, that MYRTLE A. ORA WBAUGH has not
previously had a guardian appointed, nor is a guardianship hearing pending in any other jurisdiction.
14. The reasons why this guardianship is being sought are as follows: MYRTLE A.
DRA WBAUGH is unable to manage her financial affairs or to make decisions regarding health
care/medical decisions, due to dementia.
15. The functional limitations and physical and mental condition of MYRTLE A.
DRA WBAUGH are: MYRTLE A. DRAWBAUGH is not able to manage her financial affairs, nor
is she able to make competent decisions as far as her welfare is concerned. MYRTLE A.
DRA WBAUGH requires some level of assistance with all of her activities of daily living.
16. The following steps have been taken, in order to find less restrictive alternative to the
appointment of a guardian: MYRTLE A. DRAWBAUGH does not have a Power of Attorney and 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 MYRTLE A. DRAWBAUGH.
17. The Petitioners request that the guardians be granted powers to act for MYRTLE A.
DRA WBAUGH 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.
18. Petitioners also request that they, in their capacity as plenary Guardian of the Person
and Estate of MYRTLE A. DRAWBAUGH, have the power and authority to serve as personal
representatives for MYRTLE A. DRAWBAUGH for all purposes of the Health Insurance Portability
and Accountability Act of 1996, (Pub.L.1 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.
19. The proposed guardians have the following qualifications: The proposed guardians
are the son and the daughter-in-law of MYRTLE A. DRAWBAUGH. The proposed guardians love
and care for MYRTLE A. DRAWBAUGH.
20. MYRTLE A. DRAWBAUGH's assets total approximately Eighty-Four Thousand
Dollars ($ 84,000.00).
21. MYRTLE A. DRAWBAUGH's net income from all sources totals approximately
Twenty-One Thousand Five Hundred Forty-Four Dollars and 541100 ($ 1,795) per month.
WHEREFORE, Petitioners respectfully request that the Court, under Section 5511 of the
Probate, Estates and Fiduciaries Code, issue a Citation to MYRTLE A. DRAWBAUGH, MYRTLE
A. DRAWBAUGH's next of kin, and to such other persons as the Court directs, to show cause why
MYRTLE A. DRAWBAUGH should not be adjudged to be an incapacitated person and a plenary
guardians of her person and estate be appointed.
Respectfully submitted,
Date:
7 -I J -010
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gy: M~rielle . Hazen, Esquire
Attorney for Petitioner
Court ID No. 68003
2000 Linglestown Road, Suite 202
Harrisburg, Pennsylvania 17110
(717)540-4332
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
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On this, the I day of U \J l rJ- ' 2006, before me, the undersigned officer,
personally appeared SHARON L. DRAWBAUGH 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.
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SHARON L. DRAWBAUGH
SWORN to and subscribed before me this
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day of ,=y (j l ~ ,2006.
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Not ublic
:rH OF PENNSYLVANIA
Notarial Seal
J.t. C. Combs, Notary Public
SUI!:lu.hanna TWp., Dauphin County
My Commission Expires Oct. 21, 2008
IN RE: MYRTLE A. DRAWBAUGH
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
An alleged incapacitated person
:NO.
On the Petition of DANIEL D. DRAWBAUGH, SR. and
SHARON L. DRAWBAUGH
VERIFICA nON
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. 9 4904, relating to unsworn
falsification to authorities.
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SHARON L. DRAWBAUGH
IN RE: MYRTLE A. DRAWBAUGH
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
An alleged incapacitated person
:NO.
On the Petition of DANIEL D. DRAWBAUGH, SR. and
SHARON L. DRAWBAUGH
CONSENT TO APPOINTMENT AS GUARDIAN
1. The name ofthe proposed guardian of the person of MYRTLE A. DRAWBAUGH is
SHARON L. DRAWBAUGH.
2. The name of the proposed guardian of the estate of MYRTLE A. DRAWBAUGH is
SHARON L. DRAWBAUGH.
3. The proposed guardian speaks, reads and writes the English language.
4. The proposed guardian does not have an interest adverse to the alleged incapacitated
person.
5.
Manager.
The proposed guardian is employed at the Hershey Medical Center as a Billing
6. The proposed 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:
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SHARON L. DRAWBAUGH
IN RE: MYRTLE A. DRAWBAUGH
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
An alleged incapacitated person
:NO.
On the Petition of DANIEL D. DRAWBAUGH, SR. and
SHARON L. DRAWBAUGH
CONSENT TO APPOINTMENT AS GUARDIAN
1. The name of the proposed guardian of the person of MYRTLE A. DRAWBAUGH is
DANIEL D. DRAWBAUGH, SR.
2. The name of the proposed guardian of the estate of MYRTLE A. DRAWBAUGH is
DANIEL D. DRAWBAUGH, SR.
3. The proposed guardian speaks, reads and writes the English language.
4. The proposed guardian does not have an interest adverse to the alleged incapacitated
person.
5. The proposed guardian is not presently employed.
6. The proposed 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:
7 /tt' /0 (p
IN RE: MYRTLE A. DRAWBAUGH
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
An alleged incapacitated person
:NO.
On the Petition of DANIEL D. DRAWBAUGH, SR. and
SHARON L. DRAWBAUGH
CERTIFICATE OF SERVICE
I, Marielle F. Hazen, Esquire, certify that on J u 11 I ~
true and correct copy of the within Petition for Appointment of Guardian of the Person and
,2006, I served a
Estate of an Alleged Incapacitated Person on the parties named below, by depositing same in
the United States mail, certified mail, postage prepaid as follows:
Dawn E. Viering (daughter)
Hershey Plaza Apartments
215 W. Chocolate Avenue, Apt. 2-P
Hershey, Pennsylvania 17033
Sharon L. Kimmel (daughter)
2925 Wekiva Road
Tavares, Florida 32778
Herbert V. Drawbaugh (son)
305 N. 28th Street
Harrisburg, Pennsylvania 17109
Elaine Osborn (daughter)
1159 Loop Drive
Harrisburg, Pennsylvania 17112
David R. Drawbaugh (son)
2927 Williamsburg Street
Sarasota, Florida 34231
Manor Care
1700 Market Street
Camp Hill, P A 17011
Respectfully Submitted,
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Mari -lie F. Hien, Esq.
Court J.D. No. 68003
2000 Linglestown Road
Suite 202
Harrisburg, P A 17110
(717) 540-4332
Date
The Law Office of
MARIEILE 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: (717) 540-4313
www.hazenelderlaw.com
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July 19,2006
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Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
Re: Myrtle A. Drawbaugh, 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 Myrtle A. Drawbaugh along with a
Praecipe/Request for Assignment and a Notification of Mental Health Commitment form.
I am also enclosing addressed, stamped envelopes for service of the Order on all
interested parties and 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 documents, please do not hesitate to contact our office.
Sincerely,
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Melissa M. Kain
Paralegal
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Enclosures
cc: Daniel D. Drawbaugh, Sf. & Sharon L. Drawbaugh (w/enc.)
Dawn E. Viering (w/enc.) (via Certified Mail)
Sharon L. Kimmel (w/enc.) (via Certified Mail)
Herbert V. Drawbaugh (w/enc.) (via Certified Mail)
Elaine Osborn (w/enc.) (via Certified Mail)
David R. Drawbaugh (w/enc.) (via Certified Mail)
Manor Care (w/enc.) (via Certified Mail)
*Certified Elder Law Attorney by the National Elder Law Foundation as authorized by the Pennsylvania Supreme Court
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