HomeMy WebLinkAbout12-13-06
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IN THE MATTER OF:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
FILE NO. 21-05-0970
THE ESTATE OF JOHN A. YODERS
RE:
BRANDON J. POKRZYK ORPHANS' COURT DIVISION 0 ~
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PETITION FOR CONFIRMATION OF GUARDIANSHI~?~8 W CJ
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1. The parties are John A Pokrzyk, Jr. and Ann L. Pokrzyk whcfare marrisd adt:I1tr;:;)l
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individuals who reside together with their son, Brandon J. Pokrzyk at 627 Gutshall Road,
Boiling Springs, Cumberland County, Pennsylvania, 17007-9526.
2. Brandon Pokrzyk was named as an heir in the will of his grandfather, John
Yoders, deceased.
3. John A Pokrzyk, Jr. And Ann L. Pokrzyk are the natural parents of Brandon J.
Pokrzyk. See attached copy of birth certificate referred to as "Exhibit A"
4. Certain funds on deposit with John Hancock Life Insurance Company are to be
conveyed to Brandon Pokrzyk pursuant to the terms of John Yoder's will. See "Exhibit B."
5. John Hancock requires a court order confirming that John Pokrzyk and Ann
Pokrzyk are the guardians of Brandon Pokrzyk in order for the funds to be placed into an
account in the name of Brandon Pokrzyk.
WHEREFORE, John and Ann Pokrzyk respectfully request this Honorable Court enter
an order confirming that they are the guardians of the person and the estate of their natural
son, Brandon Pokrzyk.
Respectfully submitted,
O'BRIEN, BARIC & SCHERER
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Michael A. Scherer, Esquire
1.0. No. 61974
19 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
. . DEC-'12-2006 02: 54P FROM: STOTT & STOTT
717-243-1748
TO: 2495755
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; COMMONWEAl 1 H 01' f'ENNSVL V IINlA "llrPAh!lMENl or HEAL I H .'
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BRANDON JAV POKRZYK
cIa 627 GUTSHALL RD
BOILING SPRINGS PA 17007
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ExmIBIT "A"
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IN THE MATTER OF:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
BRANDONJ.POKRZYK
FILE NO. 21-05-0970
ORPHANS' COURT DIVISION
VERIFICATION
I verify that the statements made in the foregoing Stipulation for Guardianship are true
and correct. I understand that false statements herein are made subject to the penalties of 18
Pa. C.S.A. 94904, relating to unsworn falsification to authorities.
Date: December L, 2006
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John A. Pokrz I .
Date: December L\ ,2006
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Ann L. Pokrzyk
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John Hancock Life Insurance Company (U.S.A.)
Scudder Wealth mark Annuities
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601 Congress Street, Boston, MA 02210-2805
Mailing Address: P.O. Box 55066, Boston, MA 02205-5066
Phone: 800-493-8075
WQlU.oWlll1I S;ONSOR
October 27,2005
H.D. Vest Investment Services
Attn: Daniel W. Stott
157 S. Hanover St
Carlisle, PA 17013
Re: Venture Annuity # 55101303
Requirements for Death Benefit Settlement
Dear Sir or Madam:
,
We were recently notified of the death of John E. Y oders.
Enclosed are the death benefit settlement options available to Jane Yoders, John Yoders
and Brandon Pokrzyk, as death benefit recipients. Once Jane Yoders, John Yoders and
Brandon Pokrzyk have chosen an option, please submit the fomls indicated on the
enclosed check Jist. All original paperwork must be submitted by the designated
beneficiaries, as copies are not acceptable.
Please note that the automatic rebalancing program has been stopped.
We will promptly settle the claim upon receipt of all completed information. Should
you have any questions, please contact our Client Services Department at 1 ~800-493-
8075.
Sincerely,
Claims and Annuitization Department
Enclosures
John Hancock Life Insurance Company (U.S.A.)
ill) 2005 JOhn I-18ncoc:lc Lila Insurance Company (U. SA). A Manulife Financial Company All rights r...rvad.
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EXHIBIT "B"
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