HomeMy WebLinkAboutOC1968-1579 - ESTATE OF FLETCHER••
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ni THE COUR'I,' OF COMMON PLEAS OF WASHING.TON COUNTY. PENNA.
ORPHANS' COURT DIVISION. . '~ · ·
IN RE:
ESTATE OF
LEROY FLETCHER,
::!: an alleged incompetent.
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No .. 1579 of 1968
'• Ill z z HEARING ON PETITION FOR APPOINTMENT OF
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GUARDIAN
X BEFORE: Ill
THE HONORABLE P. VINCENT MARINO,
President Judge of the said Court. o( '
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t; APPEARANCES: WRAY G. ZELT, III. ESQ .• of Washington~ Pa .•
r:epresenting the Petitioner . Q
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Monday. January 27. 1969, at 10:00 o'clock A. M •
EST.
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Now we will proceed with the Fletcher. inco~pete 1cy.
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Mr. Zelt?
~ MR. ZELT.: May it please the Court, we. presented a Petition
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at Number 157.9 of 1968, Orphans' Court.number and term. I represent
the petitioner, who we also wish to have appointed as the guardian
of Leroy Fletcher. Would the proper procedure be to question the
petitioner on the stand at this time?
THE COURT: .Yes. After we are certain that we have service
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made on the proper partie~ in accorda~ce1'~ith'·the Courys 'Inter-
. iocutory ·0rder ~(December 161 196,8..
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' MR ... ZELT: . In. accordance, ~ith:the Order of Court1 : -~e had
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". ~a .copy of the paper~ including' the Citation~· served personai~y o~
Leroy Fletcher~ who, i's ·and has been in the Washington County Hom
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and I offer into e'videnc·e .the Affidavit of Service. ·' f .
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Who ar'e the next of kin? Personal service or
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service by registered .or ~~rtified ~ail was to have been made on th m.
C) z MR. ZELT: The 'next· of kin include four grandchil?ren.
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'An~ that is the .extent <?f. the next ofkin. And we made service by
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. registered m~.'ill· ~ letter I ·~return receipt requested. ·In the case
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• of Sandra L. Caffrey1 : the orie granddaughter~ the lette'r was receive
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at her home by her husb,and. In the case of Diane Stanley~ the .
letter was rec.eiyed and signed by Dian~ S~anley herself. In the· case .
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' . . of Mr. James Fl~tcher, who is our prop().sed guardian~ the letter . . .
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was rec:eived and gigned by him himself. And in the case s:>f--no1 e cuse ':'
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me. · In the case of James •Fletcher. the letter wa~ originally sent
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to New Je.rsey and '·was not received, and then it was sent to an
address at Boulder~ Colorado, ·where it was received and signed.
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for by him. 1 of{er these receipts attached to the photocopies of
. ' ' . th.e letters ~nto the evidence, . to show that seryice was made in
accordance with the Court order. ~ .. -..
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THE COURT:· · · The Affidavit of Service showing service on the·
·· alld' ed·inc6·m' etent having been made on December 191 1968, the
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said Affidavit of Service having complie~ with statutory requirement~
and the rules of this Court;·is received in evidence and made part
of the record .. we· will likewise make part of the record and receive
in evidence the various letters showing service by certified mail
on the proper parties. You may callyour witnesses.
~JEROME P. FLETCHER IS CALLED' AND SWORN .
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0 ... o DIRECT EXAMINATION BY MR. ZELT: z
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<( Q ~ Would you state your name please?
..: u A 0: _Jerome P. Fletcher. ... U)
Ci Q .J And where do you live. Mr. Fletcher?·
~ u Ci A :J 290 East Wheeling Street, Washington, Pa. ..,
:t 1-,... Q N What is your age? ·
IIi a: ... A" ... 29 . a: 0 a. ... Q a: And where are you employed? .. ... a: :J 0 A u Pennsylvania Transformer.
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u Q ii: And what relation if any areyou to Leroy Fletcher?
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A He's my grandfather .
Q Where does your grandfather Leroy Fletcher reside at the present
time?
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A At the \\Washington County Home.:· · · · -. I
Q And how long has he been there?
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A The exact time 1 couldn't tell you. I'd ~ay·apprqximately five montl: s.
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Where did he live before he went to the Washington County Home?
. ~ . At 290 East Wheelmg Street.
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That is the same address where you live?
Yes .
Who else lives there with you?
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:: A z My wife and two children. '. .. .
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z What were youf living arrangements before your grandfather went
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i to the Washington-County Home?
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1-0 . z A 1 rented the upstairs from my grandfather .
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~ Q And h~w long d~d you people live there in the same home as your
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:I ., Q Were you in a positi_on to observe his behavior and the way he
J: .. .... N handled hims~lf during those two years?
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1&1 .... 0: A Yes .
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.... Q Incidentally, are there any other near relatives besides the ones,
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besides you, Mrs. Caffrey, your brother James and your sister
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A Pardon me?
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Q Is your grandfather's mother living?
A No. ..
Q Is his father living?
A No.
Q Is he married ?
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A No. '
Q Does he hav·e any living children?
A No1 he doesn't.
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Does he have any other grandchildren besides you and Diane, Sandra
and James?
No.
Under what circumstances did your grandfat.Q.er go to the Washington
County Home?
He was taken sick· and they took him to the Washington Hospital and
' at the hospital when he didn't recover to a certains tate,· the doctor .
recommended that he go to the ~ounty Home.
Do you know why the doctor di~ make that recommendation?
~·Because he was unable to take c·are of himself.
Now before your grandfather took sick' and went to the Washington
Hospital and eventually to the Washington County Home, was he able
to get around physically?
Yes, he g~t around the house .
Could he go up and down stairs?
Very little. He would go up occasionally to see our children.
Q At about this time,· what age was he?
A 85 years old.
Q Did your grandfather make an attempt to handle his business affairs?
A Yes.
Q Was he capable of handling them?
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At that time, yes, he was.
And what means of subsistence did he. have?
You mean income?
Yes •.
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~ocial Security and t~e rent that I was paying him upstairs.
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Did ·he haye any" other income whatsoever?
No, he didn't.
Did he have any likelihood or was' there any ap.ticipation of any other ·
income?
·No,. there wasn't.
Now when. you say he could handle his business affairs, was he able
to do his banking and endorse his checks and pay his rent and other
bills as an ordinary man would?
Yes. Then he could handle all that at that time.
Has this ·changed since then?
Yes, it has.
w.ould you describe for .the, <;:ourt what change has taken place?
Now he's, I'd say, barely able to sig~ his name on the check and.
he gets confused mentally,. forgets, and I believe just unable to hand e
·his personal affairs now.
Is he able to take care of his bodily needs arid clothing and health
and care of his daily habits ?
No, he isn't.
Q And at about what time or: what date did this' begin? That is to say,
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when you begc:-n to·notice his inability to take care of.himselL
A To give Y?U an exact time, I c;wldn't do that. .I'd S!lY it would be.:. __
Q You don't need to give an 'exact time. Give an approxim,ate month
. or time qf the year . • A I w.ould. say in the fall of last year .
. ~ z Q That is fo say_ the fall of 19?8·.
< > .J >-Ill A Yes. z z 1&1 II.
i Q Can you recall any particular things that your grandfather. did to
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your knowledge that indic~ted' an -1nability to haridle his affairs?
Ill . < ~ A Well, he would actually forget my name at times, forget my wife's
...: u a: 1-name at times, associate-me with his son a good bit.
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.J Q < Do you know how long your grandfather has b:e~n a resident or was
u 0 :J .., a resi9ent of ~ashington County': before he went into the County Home or
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IIi a: 1&1 A 1-a: It would be over ~0 years, but .I 'wouldn't know exactly.
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So he-has resided at East Wheelin_g Street f?r a number of years.
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.J Yes, he has.
< u ii: Q ... Do you yourself _have any adverse interests to your grandfather
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Leroy Fletcher ?
A No, I don't-.
Q Do you know of any reason why' you~ gr~~df~th~r ~h-~uld ri~t b~ .,·-
adjudged an incom-petent?
A No, I don't.
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Q Have any other proceedings been started· against or to affect an
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adjudication of incompetency'for your grandfather?
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Has your grandfather ever been a member of the Armed Forces?
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Is he receiving any Veterans' benefits?.-.'·; 1
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None.
If your grandfather were left to take care of his own property such
as his Social Securi~y <Z1he'ccks and his home, do you feel that he would
be able to do so competently?
No, I don't.
Can: you give .us your estimate of the value of your grandfather's
. . house and lot at ?90 East Wheeling St:reet, Washington, Pa.?
Approximately $15, oo'o •.
And is this· house and lot owned solely and alone by your grandfather
Leroy Fletcher"? · ·
Yes .
Do you know t.he ;a mount of the Social Security check received by
your grandfather?
lt"s; $91.00, I believe, sixty cents a month.
Q I believe you stated that your grandfather receives nothing else and
has no other assets in this world~
A· No, he doesn't.
Q We have no further questions, Your Honor.
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EXAMINATION BY THE COURT:
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Q Mr. Fletcher, you are a grandson of Leroy Fletcher?
A Yes.
Q What was your father's name?
A Adrian Fletcher.
Is he deceased? ·.
Yes.-he. is.
·Did you have a,ny; brothers or sisters?
Yes. I do. _I have One brother ar1d.two sisters.·
And who are they?-
..: 0 ~ A _My older brother; James Fletch~r; one sister. Sandra Fletcher, anc
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Diane Fletcher .
; MR. ZELT: If the Court please. those are the four-:-""-
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THE COURT:· The others .a-re .brothers and sisters of his.
Ill li: MR. ZELT: There are no children of the alleged incompetent
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THE COURT: We are getting to that. Are there· any children
of Leroy Fletcher living at the present time?
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No.
Q And are. there any deceased children other than your father? In othe
words, did Leroy Fletcher have more than one child, that is your
father?
A .Yes, he did.
-Q How many children did he have?
·A They had one other child that died. I believe. in infancy.
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So that' that child would have no children.
Correct •
Leroy Fletcher's wife, that is your mother, is she deceased?
.No, that is your grandmother .
0 he is also' deceased.
Would you know whether Leroy Fletcher, you~ grandfather, had beer
married more than once?
No, he was marri~d just once.
So that the only livirig heirs of your grandfather now are yourself
and the other three children.
That is correct.·
Did your· fat her marry more than once? .
No .
Only once?
Yes.
Mr. Fletcher, what has· been ~he extent of your education?
I graduated from. high school, senior high school.
In Washington?'
Yes1 Washington ~figh School.
_And where haveyou been employed since. then?
·Do you want my last job?
Y,ou are employed now where?
I work now at _McGraw-;-Edison, Transformer.
How long ha veyou been with that firm?
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A Three years.
Q Where· did you work .prior to that?
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A I worked at Canonsburg Metal here in Washington for .one year and
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before that I worked at Brockway Glass for seven years .
Now you are living in your grandfather's home at 290 East Whee lin~
Street, _Washington, Pa.
That is· correct.
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And your grandfather had been living there at the same home prior
to ent_ering the hos pita!.
A Yes.
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What arrangements have ·been made between you andyour grandfather
' as to rents for the premises which you are occupying? .
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I have taken and done some repairs on the house and 'I. have an apart
-~ m(mt up_stairs which I am renting out now, and there's a .woman·.that ~tays
in the b?-s ement apaj:,:tment. _f\rid this money is be~ng used to help
kee·p my _gran~father. alo'ng witn his ,social Secl,lri~y at t~e County
Home.
Does your grandfather ha~e a·hy 'checking account now at any bank? ..
' He has a small checking,accmint at Pittsburgh Bank. . . . ~ .
Are any deposits cu;·rently rjl_ad.e· in t!;Iat account?
We deposit his Social Security check in ther_e ;and we will pay the
/ county home through deductions therel. · · •
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How are checks writtmon that· account?: :c:3:n M;r\: Fletcher write
checks now?
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A He is still able to scratch· out lfis ria me, ,·but'it~s getting worse each
time:
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·Do you feel, sir. that if he would be per'mttted to con~i~~e tq 'look
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after his own financial affairs that he might become the victim of ~ ~ ;,. • • Jl • ~ • ' •
designing individuals.who would ·get to his money irl; some way or
other?
I don't understand what you mean.
Well, if he were permitted to keep on handling his own financial
affairs and were not declared to be inc.om petent by this Court, then
he would have charge of an his financial affairs. If that be the
case, do you think that he could become the victim of some individua that
had improper ideas about it?
!.imagine he could be.
But he still today continues to sign these checks on.his account.
Yes.
And would the checks be prepared by y~u before he signs them?
By myself or by my wife, yes.
Now what de:> you ·contemplate in the future if he remains where he's
at. what do you contemplate about the manner of handling his·.
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expenses and whatn_ot? .Are you going· to keep on renting this property
_and would you secure enough money from thatto take care of his
expenses?
A Yes, I believe I would. With the income from the rent and his
Social Se~urity, there would be enough to take care of my grandfathEr
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and to maintain. the house and keep the house which he always· wantec . .
us to do.
Or did you possibly have in mind selling the ?ouse?
Not while my grandfather is ;;-1~ive, no.
• Now do you understand, sir, that if the Court appoints you as a
guardian in this estate that you will have to keep strict account of all
the monies that yo_u receive in his behalf and hhall&the monies that
are expended for him and thatyou will have to file an accounting
with this Court when you are required to do so.
Yes, I understand.
Do you understsnd that you cannot mingle his funds with-your own?
Yes, I db.
You would have to keep. everything separate. Do you understand that?
Yes, I do.
How many rooms doyou and your family occupy?
We have five rooms and bath.
What' WJUld you say would be the. fair rental value per: month of the
five rooms and bath that you occupy?
I'd say $75 to $100 a month.
What do you get for the other room.s that you are renting out? What
rooms are being rented now?
A There's an upstairs apartment.
Q How many rooms ?
·A Five rooms and bath.
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Q How· much do you get .for that?
A I get $130. 00 and that's everything included, use of the laundry also.
Q What other rents do you have?
A And the basement, there 1 s a basement apartment, more or less • an effiCiency room, and. ~.we get $30.00 a month out of that..
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Are all yo.ur utilities and heat .and soforth, are they all together
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z Ill a. A i Yes, they are.
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Do you have gas heat?
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:= A Gas, that is correct .
...: u a: Q .... And the electricity is all together.
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u Ci :J Q .., How much does your electric run a month?
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N A Well, with just my farpily in there it was roughly $20.00 a montl).
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Ill .... 0: The past month is the first month that I had the :UpS3tairs rented
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.... out, so I don't have any idea what it will g.o to with two families.
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' .J My gas bill goes $~i. 00 a month on the bl,ldget.
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separate accounts for all tJ::te monies that you· receive and expend
for this· in~ompetent? ·
A Yes, I do .
. Q Will you keep 'them in such a way that they can be filed with the Cou t
. when you are required to do so?
A Yes. I will. ·
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'EXAMINATION OF MR. FLETCHER. BY MR .. ZELT:
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. Mr. Fletcher, the income.and the Soci~l' Security and everyth:ing
is probably not going to be· enough to pay for your grandfather withou
you advancing some of your own money, is it?·
I have had to spend some money on the home and. on different things
that have come up.
Do you.feel that in thefuture you are going·to have to kee·p the house
going and to keep· your payme~ts made, whatever they are at the
Washington County Home that you ar!2 going to have to a.dvance(,your
own money?
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Yes, I have already _invested some money in ·the house. I put anew
furnace in ..
Is it your present intent to let that become an indebtedness against
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your grandfather's estate or if it becomes large enough to perhaps
mortgage the h?me or .make ·some. other provision?
As of right now, I'll pay for the expense myself. -• • • ~ !
Did your· grandfath~r ·sign the last Social Security check that you
offered to him to sign?
' ,~ Yes. .. ·"'
Willingly?
Sometimes. Well,. h.e doesn't give me too much of~ hard time but
if someone else tries to get him to sign,it he's tlOt too crazy-about it. . . . . . , .
THE COURT: Which might b.e a good idea.
Q ·We have no further questions.
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THE COURT: That will be all, ·Sir. Thank~ ·you .
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CALLED AND SWORN.·. DIANE STANLEY IS • ' . .
EXAMINATION \BY MR. ZELT:
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z Q What is your name? -
< . > ' . .J >-A . Diane Stanley.· . Ul
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i Q What was your maiden name ?
0 1-C) ' z A Diane Fletcher. I X I. Ul
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I ... < 3 Q How old are you, Mrs. Stanley?
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.J Q Are you any relation to Leroy Fletcher, the alleged incompeter1;t? ~
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:J A He's my grandfather. ..,
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"" N Have you been sitting here·while I and Judge _Marino questioned and .. Q
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1-received answers from your brother Jexo:IJ:18:'Elet.cher? a: 0 Q. ' • Ill a: A .Yes. 1-a: ' :J . 0 u Q And do you have any disagreement with any of the answers that you .J <
0 . ii: heard given by your brother? II.
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e A No, I don't.
Q Were yo~ in a positionto obs'erve yo11r·._grandfather recently?
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A Yes, on visits.
Q And do you or do you not agree .th<l:t he is unable to handle his own I
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affairs? .. .
A T think hP i~ unable to handle his affairs.
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Q We have no further questions.
EXAMINATION BY THE COURT: • Q Mrs. Stanley, do you feel that your brother Jerome is a proper
~ z person to be appointed guardian in this estate and he will handle the
o( > .J )o• Ill z . same competently?
z Ill D. A i Yes, I do.
0 .... C) Q ~ What does your husband do?
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~-A My husband is a body man at Hagan1s Oarage .
.,: u a: Q .... Do you have any children? .
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0 :I Q .., Has your grandfather ever lived with you?
X ... I' N A No. he hasn1t.
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0:: Ill Q .... 0:: How long has your grandmother been deceased, approximately?
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Maybe 12 or 15 years ..
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A Yes.
Q _ Areyou satisfied that the Court appointt -~Jerome as th~ guardian. t
in this estate ?
A Yes, lam.
Q Do you understand that if he is appointed the guardian by this Court
that he will have the s'Ole decision to make, he himself can make
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decisions as to what expenditures to make for your grandfather?
A ·Yes.
Q And that. it may become necessary to sell your grandfather's home
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on East Wheeling $tr.eet for his support. It could become necessary . -
if th-~re ish' t enough income from the .property to pay his expenses at d
maintenance.· Do you understand that?
.Yes.
Do you think that Jerome is the proper individual to look after that?
Yes, I do.
That's all I have. Thank you;
18
t-= u ~ MR. ZELT: lf the Court please, we have the proposed guardic n's
Ill
0
~ · wife here as well as the other sister. We feel their testimony would
0
0 ~ be repetitious but ifthe Court wishes, we will put them on the stand.
X 1-,..
"' THE COURT: _ Icbn'.t think we will need them ..
IIi a: Ill li: MR. ZELT:
0 II. Ill
: THE COURT: a:
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in Court.
THE COURT:·
We have nothing further to offer, Your H0nor.
·Very w:ell. ·
I don't believe the alleged incompetent is present
Do you· have a doctor's statement that you wish·~
to offer iri evidence?
MR. ZELT: No. !believe the Court instructed me· to have
the doctor here himself and I called him and he stated tha:t he w'ould
,j '!, • •
try. to be here. I called then last week to remind them at his office
; .
•.
. ..
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· : arid they were so reminded. We called. this morning before _coming
\, . . ~
o.ve.r here ·and w_e were told' that' the doctor· has· been· at 'M~-nongahela
"1 ·-~ ~ : . ~t; ,
· _Hospital all morning. . • ..
. '
( .
. ..
THE CQURT: • . · .. What doCtor i
. '
MR~·ZELT: ... ; . . . . ~alph Blas'iole, who is one of, I think, 'two d9ctor
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that ·aJtends .people at the Washington.County Home. The other is .
. ' ~ ' t . l ., . ~ . f . .
Dr. J:,_,arge who'hi.mself \vas iri the ho~ pit;:tl f~r;a· ·:mimberof days: . . . '. \ . . ~ '' . . .
r • • > • ' ~ " • • : • ' • : i "'
:THE COURT: . ,· W.e will permit you -to call Dr:-.··Blasiol~ at a . . ~· . .. . ' ..
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later time.·
; MR. ·ZELT: Cou.ld we sUbmit his statement and his. ~igned
ui a:
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affidavit in lieu of ~alli9-g him ? . . .. : . ..
No. You will h~v~'to c~lk him personally .
. That will complete tl:lis hearing .
. '
.. •,
.<
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It
: .
(On Thu.rsday, February 20, 1969, at:2: 30 P. M., the following occurre ):
l-It :J 0 u . -~ DR:· FRED LAR_GE IS CALLED AND DULY t)W.ORN·. -.
.•I· . ' 0 ii: II. o .EXAMINATION BY MR. ZELT: ..
Q Your f.uli name please?
A' Fred D. Large . . ,
Q ·Where do you live,. sir?
A Clays ville~
Q What is your occu.pation?
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Phys:l.cian ..
•.
·How long have you been a physician.?
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Do· you" presently q~;e -~~Y -duti~s~'ass'pci_ared ~ith,the W~shin'~ori
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County Men's Home:?
• .. ·i .. . .
Yes. I'm the d_octor down tnere-:,:
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How fong hayeyou beenthe·~octor.t9-ere? .. ~ t.·
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'This is st_rictly a guess, but .I'd· say five y_ears.
· Areyou a graduate o~ a medical school?
_ Te!Ilple Unive~rsify in Phil~delphi~.
Haveyou met ·require'ments to practice medicine in Pennsylvania?
I have.·
Doctor:. ·during the .co_urse of ,your duties C?-_t the Washington' County
Men's ·Home, did you ?ave .ari opportunity to examine an individual
by the name of Leroy Fletcher?
I did. · ,,
Do you remember how)ong ·ago you first saw hirr;_?
'-
No, I can't tell you.
When did you last see him?
T ·saw him today 'just before I. came up.
Could you tell the Court what condition_ you found this man in or
what his condition •Jm:S been as you have s_een it?·
· A. Well, would it_be·au right fo·r me to ask a co~ple'·que.stions? I'll
tell ou why I ask that. In examining this man, I asked him some
. 'I· .
20
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21
questions which we got his answers but we don't know whether they
were true or not because yv e don't know the answers to the qt;estions
which you.might know .
. Could you tell me then what que~:?tiorts he askErl::.yo.ul?
He. didn't ··ask me any questions.
Wh~t ·questions you asked hhr:i.
I asked-hirri"when he was born, where he was born, what his work
was, what children he had, what children.his children had, the ages . \
( '. ,-'.
of his children. ·< I ·r ~"'-. ~~ .,.. i . ... ~ . .. . . ~" ' < '
I think the. reco"rd will show, as it was taken in the last, in the first ..
I < ;.
and original and only heartpg; · that'he h~s no living children,. but tha
"'! ~ ~ ~ ' /"..1 .... '
he has .four grandchHgren; and that Of1e grandchild, who is our propc sed
• -• ' ,,; t • ' ~-~ ... ,,~ ~--~
administrator of." his estate h~s bee.n ·living with his wife and tchild
in the house with Leroy Fletcher before Leroy Fletcher finally went
to the Men's Home. What his occupation is, I don't know. He do~s
not have a wife li vip.g. I don't think· he has apy other close relative~
Is his grandson approximately 32 years old?
Yes. And the grandson, for. purposes of the further questions that
I will' ask. you, has been taki'ng care of the ho.use and attempting to pjiy
the mortgage payments an~ the varipus electric and water and other
bi~ls and coll~ct rents from one tenant~ and has been using his own ~oney
' to do this in the most part because ·he canno~ or has had a tough
time having Leroy Fletcher sign hi~ Social Security check so
that they would have cash in Leroy Fletcher's account with which
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to pay these bills. 'So did you get a chance to observe .him in terms
of his physical condition? .
I, f -1. . .
No. I was checking strictly his !:?ental condition today.
. And is he an elderly i~llow or not?
Yes, he is.
Wpuld you be in a position to determine whether or not :·in yo:ur
opinion, he could handle his money affairs and negotiate by himself
in a. h~use· or il;l an apartment o'r not?
·From a menta} standpoint, yes. Ph:ysically, I couldn't.say that.
I checked at the home. This ~rands on comes down every month
and MF. Fletcher ,signs his Social Security chec'k, and at the same
time, writes a, ch~·ck out for $200. 00 to the home. As I say, lie's
very clear on all the answers to all the questions I asked him from
what you ha v·e said there.
(At the direction of the Court, off-the-record discussion·was not
recorded by the stenographer).
.Doctor, looking at this individual in terms of the fact that as an
'.
individual'he would have many and varied affairs to handle, including
the running the operation of a house; as well as own private affairs,
his own eating and sleeping, etc., could .you form an opinion as to
.,
whether or not you feel that he is capabl~ of doing Jhis?
It's a hard 'question. I'd say there's nobody, that's going to pull
anything over on the old gentleman.
(At the direction of the Court,. off-the-record discussion was not
22
I
• I
.I
•
•
rec.ordE;d by the stenographer.)
(Stenographer reads back last question).
A No, he is not.
Q Car:i you tell us why, in your opinion, you feel that he is not?
A ~
Well, I feel that he is not because, as I say, it's a combip:ation of
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mental arid physical condition, that he is absolu,tely not up to handlin~
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the everyday things that would come along with handling the running
i 0 ... of a home and soforth .
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~ EXAMINATION BY THE COURT:
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to appoint a guardian of his estate so that those things could be lookEd
after·?·
Yes, I think it would be·.
Do you feel tha.t it would. be detrimental to ~1this person's welfare if
he were required to be here in Court today?
Yes, definitely.
. And next',. at his age and his present condition, what would.be the
prognosis at this time?
,.
j· It's po·or: ·~
t. f • j • '!' ~' -~ ~ r
He certainly w~uldn't be getting ~ny better, would he?
. No, he wouldn't be getting ·better.
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So that you definitely feel that it would be proper for this Court to
,J -'
23
-----------~~--------------------------------------------------------------------_L _______ j
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,appoint a guardian of his estate.
Yes.
. . .
I think that that ~ill be all, sir .... Thank yc;m"
-(Proce_edings Closed).
1 hereby certify tbat the proceeding& and evidence are contained
~ 'fully and·ac~urately in the notes taken by me on the hearing ot the above
0: :J 0 ~ cause, and that this copy is a correct transcript ot tbe same ..
<
0
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'fhe foregoing record of the proeee ngs upon the bearing of the ab ve
cause is hereby' approved and directed to be: .tiled.
(. .. ·. ,._
"'--/: . . \Brine ¢ourt,
I
\ "'{ ,1 \ ' ') ? \ 1~ ~··/ \ /
•
IN THE ORPHANS' COURT OF WASHINGTON COUNTY, PENNSYLVANIA
In Re: )
)
)
)
ESTATE OF LEROY FLETCHER,) NO. of 1968 O.C. ) ----
AN INCOMPETENT. )
PETITION FOR ADJUDICATION OF INCOMPETENCE
AND APPOINTMENT OF GUARDIAN OF ESTATE
AND NOW, comes JEROME P. FLETCHER, and petitions
your Honorable Court to adjudicate Leroy. Fletcher as an
incompetent and appoint a Guardian of the said Leroy Fletcher's
estate.
The following .facts and circumstances are averred
in support of this Petition:
1. Jerome P. Fletcher, the petitioner, is an adult
individual and is related to Leroy Fletcher, herein called
"alleged incompe.tent 11 , as grandson.
2. The alleged incompetent is 85 years of age,
~aving been·born on September 22, 1883, he is single, and
~resently resides at the Washington County Home, 2198.North
Main Street, Washington, Washington County, Pennsylvania, having
~een admitted to said institution on October 2, 1968.
3. The presence of the alleged incompetent in court
~ould be detrimental to his welfare because of his physical
and mental condition.
4. The names and addresses of the next of kin of the
-1-
alleged incompetent who would be entitled to share in his
estate should he now die intestate are:
Jerome P. Fletcher, 290 East Wheeling Street,
Washington, Pennsylvariia-~grandson;
Sandra L. Caffrey, 184 East Katherine Avenue,
Washington, Pennsylvania-~granddaughter;
Diane Stanley, 208 Lacock Road, Washington,
Pennsylvania~~granddaughter;
James Fletcher, Gregory Park, Unit 1,
280 Henderson Street, Jersey City,
New Jersey--grandson.
5. The gross value of the alleged-incompetent's
estate is estima.ted at $15,000.00, being the house and lot
located at 290 East Whee:;Ling' St:r:eet, Washington, Pennsylvania,
and the alleged incompetent otherwise receives a social security
check monthly in the amount of $90.00, the aforesaid being
the entire amount of assets owned or expected by the alleged
incompetent.
6. The alleged incompetent was not a member of the
Armed Services of the United States and is not receiving and is
not entitled to receive benefits from the United States Veterans
Administration or any similar agency.
7. The alleged incompetent is, because of mental
infirmities of old age, unable to manage his property, is
liable to dissipate it, and otherwise is incapable of caring for
his own basic needs and daily requirements.
8. The alleged incompetent has no guardian of his
estate.
9. No other court has ever assumed jurisdiction in
any proceeding.to.determine the competency of the alleged
incompetent.
-2-
10. The proposed guardian of the estate is your
petitioner, to-wit Jerome R. Fletcher. He resides and is
domiciled at 290 East Wheeling Street, Washington, Washington
County, Pennsylvania. He is a citizen of the United States of
America and is employed by the Pennsylvania Transformer Division
of McGraw-Edison in Canonsburg, Washington County, Pennsylvania.
He is qualified to be guardian of the estate of the alleged
incompetent because he is an adult individual, has the best
interests of the alleged incompetent at heart and has resided
with and/or near the alleged incompetent for many years and
is familiar with his affairs. The proposed guardian of the
estate is related to the alleged incompet~nt as grandson. The
,, i.
consent of the proposed guardian of the estate is attached
hereto as Exhibit A.
11. The proposed guardian of the estate has no
' ...
interest adverse to the alleged incompetent and is not a
fiduciary of any estate in which the.alleged incompetent has an
interest.
12. The petitioner requests the court pursuant to
the Act of February 28, 1956, P.L. (1955) 1154, as amended by
Act of July 11, 1957, P.L. 794, § 1, 50 P.S. § 3301, to award
a citation directed to the alleged incompetent, with notice
to his next of kin residing within the Commonwealth and to
such other persons as the court may direct to show cause why
Leroy Fletcher should not be adjudged an incompetent and why
Jerome P~ Fletcher should not be appointed guardian of his
estate.
13. Your petitioner requests that the sworn statement
of the Superintendent or other person in charge of the Washington
County Home wherein the alleged incompetent resides, be admitted
-3-
n,. . . ' . ·..,t '
;: .
~ '
in evidence in lieu 6f the personal appearance and. testimony of
i
such person.
14. Your petitioner requests that the sworn statement
by a physician as to the condition of the alleged incompetent
be admitted in evidence in lieu of the personal appearance and
testimony of such person.
And he will ever pray. ZELT & ZELT I (l ,,
cdtev, ' c. I? I . I I ~ I
I By: u 'U?_!----·--
WrayG. Zelt III
Counsel for Petitioner I I I
I I I
I
I
'
' .
: '
-4-
.... ·-·' ....... ' ~ :, ...... /-.;..~-~ •.
~ u·
. '
COMMONWEALTH OF PENNSYLVANIA)
) SS:
COUNTY OF WASHINGTON )
Before me, the undersigned authority, personally
appeared JEROME P. FLETCHER, who, being duly sworn according to
law, deposes and says that the facts set forth in the foregoing
Petition for Adjudication of Incompetence and Appointment of
Guardian of Estate are true and correct to the best of his
knowledge, information, and belief.
~P. Fletcher
Sworn to and subscribed before me
this o('Jdday of /~d?0J, 1968.
Notary Public
. ·"' ·, .
ALICE L. MILLER
Notary Public, Washington, Washington Co.
My Commission Ex~ires r::arch 20, 1972
\ \
\
IN THE ORPHANS' COURT OF WASHINGTON COUNTY, PENNSYLVANIA
In Re: )
)
)
ESTATE OF LEROY FLETCHER, ) NO.
)
AN INCOMPETENT. )
)
OF 1968 O.C.
CONSENT OF PROPOSED GUARDIAN.OF. ESTATE
I, JEROME P. FLETCHER, of 290 East Wheeling Street,
Washington, Washington County, Pennsylvania, agree to act as
guardian of the estate of Leroy Fletcher, an alleged incompetent,
' if appointed'by the court. I have no interest adverse to that
of the alleged incompetent and am not a fiduciary of any estate
in which the alleged incompetent has an interest.
~e P. Fletcher
Date: November 26 i · 196 8
EXHIBIT A
..
,,
IN THE ORPHANS' COURT OF
WASHINGTON COUNTY, PENNA.
NO. ·j J::)'Jqof 1968 O.C.
In Re:
ESTATE OF LEROY FLETCHER
AN INCOMPETENT.
PETITION FOR ADJUDICATION OF
INCOMPETENCE AND APPOINTMENT
OF GUARDIAN OF ESTATE, and CONSEN~~o:,~~~~~c•GUARDIAN
; v ~
~~
\ o '!J rr )'.
I
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I-> vl
-~
·~
ZELT &. ZELT
ATTORNEYS AT LAW
33 WE:ST BEAU STREET
WASHING~
~; 11-lo/~.l
/ ,.,_ .:;. -;7S
IN THE ORPHANS' COURT OF WASHING'IDN COUNTY, PENNSYLVANIA
IN RE: )
)
ESTATE OF LEROY FLETCHER, )
)
AN INCOMPETENT. )
NO. ~ OF 1968 O.C.
PRELIMINARY DECREE
~ ;;
. ~-!/ ' .
this ((; day of ~~96f;' upon AND NOW,
consideration of the annexed Petition, it is ORDERED AND DECREED
that a citation be awarded, directed to Leroy Fletcher, to show
cause why he should not be adjudged
appointed; hearing'to ·be held in ~~~~~~--~-
I
Washington
at ( o .. ~~
of the hearing shall be given
to Leroy Fletcher, the alleged incompetent, by personal service
of a copy of said Petition and Citation;by service of notice upon
the next of kin who are sui juris, personally or by Certified Mail
BY THE COURT,
~ . ~ .. ,: .. .. ~~ . ,~ · ... : ":-. ... , .. • . .· .·. ""'. ~·· ·.·' '• . ··:" .. ~ ,, .
JJn OJq~ OOrpqunn' Qtourt nf lhtn~iugtnn O.tnuuty, Jrnnnyluttuiu
IN RE: ( (
) }
( (
•-LEROY FLETCHER, l or itatinn. l
AN INCOMPETENT. l l
<lrnmmnnwrnltl) nf Jrnn!lylunnin { ll.!i:
_____________ <tlounty nf llmasqington )
.-ESTATE 'OF
NO. OF 1968
To: LEROY FLETCHER
Sur Petition of: JEROHE P. FLETCHER
~rrrtiug:
lfr O!OtnttUtUll ljUU, _ __,L=E~R'-"<-OY......__._li' ...... LE ..... T.....,Cu.~H ....... ER......__ ______ ~_
that, laying aside all business and excuses whatsoever, you do file in the
office of the Clerk of our Orphans 1 Court of Washington County, a full and
complete answer, under oath, to each and every of the averments of the said
petition, on or before Monday , the 27thday of .January
' .,
Hearing to be he1 d in Orphans' Court Room, Hashington County CourtHous
19 69,-at 10:00 o'clock _A_. M. ,/and show cause why the said
LEROY FLETCHER should not be adjudged an incompetent and a guardian
of his estate apnointed•
and further abide the order of our said Court in the premises,
If you fail hereof, the petition may be taken PRO CONFESSO and a
decree made against you.
WITNESS the Honorable P. Vincent Marino, President Judge of our
said Court, at Washington, Penna., the 16t~day of December , 1968 . ~~-~~·
Clerk of the Orphans' Court
Ze1t & Ze1t 1 Esq.
Attorneysfor Petitioner.
33 'tl .Beau St o,
(Seal) Washington, Pa.,
15301.
/
... _
"-·
-
,,
'1:
I .
:.
""
~
·.:~
IN THE! ORPHANS ' COURT OF
WASHI~GTON COUNTY, P~NNA.
NO. OF 1968 O.C.
IN RE:
ESTATE OF
LEROY FLETCHER,
AN INCOMPETENT.
PRELIMINARY DECREE
ZELT & ZELT
ATTORNEYS AT LAW
33 WEST BEAU STREET
WASHINGTON, PA. 15301
,.
_,r
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY~ PENNA.
ORPHANS' COURT DIVISION
IN RE:
ESTATE OF
No. 1579 of 1968
LEROY FLETCHER,
an alleged incompetent.
D E C R E E
.:
AND NOW, February l/ ; 1969, 'upon consideration of the
.
annexed petition and after a hearing held following due notice, it is
ORDERED AND DECREED that
LEROY FLETCHER is adjudged an incompetent. .
JEROME P. FLETCHER is appointed Guardian of the Estate of
LEROY FLETCHER.,. an incompetent.
The said guardian is directed to file an inventor:y in accordance
with the provisions of Section 402 of the Incompetents' Estates Act of 1955,
as amended.
The said Guardian shall file bond with sufficient surety in the
'~ cr-::> g~~ ~ ~C"; . ~ . -r ',,/_/?
sum of J a-tJ.-== .;~, ~~ . ~.A.e., ~.t.
,~/eV:~~, B~;cou~ \ ft>k~6'o v T P. J. /
"' ~ ....
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA
' ORPHANS' COURT DIVISION
IN RE:
ESTATE OF LEROY FLETCHER,
an alleged incompetent.
)
)
) NO. 1579 of 1968
)
)
INVENTORY OF GUARDIAN
,,
I 'f
·"'"'··
The following.comprises the total assets of Leroy
Fletcher, adjudged an incompetent on.February 21, 1969. The
assets are in the possession and under control od the Guardian
and consist of the following:
Real Estate
1 three-story house and lot located at 290
East Wheeling Street, Washington, Pennsylvania
(value as per appraisal of Bryant Real
Estate Company in November, 1968)-----------~--$15,500.0
Personal Property, Clothing, and Personal Effects
None
Furniture and Home Appliances------~--------~------------500.0
Cash
Income
An account at Pittsburgh National Bank
in the name of Jerome P. Fletcher,
Guardian of the Estate of Leroy Fletcher,
as of March 4, 1969----------------------------
Social Security---------------~----------------
Rental of apartment on second floor of
home at 290 East Wheeling Street--------------
Rental of basement at 290 E. Wheeling S!zt, 1--,, ··· · · · . ~?Wz:~
rome P. Fletcher
259.08
Guardian of Estate of Leroy
Fletcher, an incompetent
th
. . ·-.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF WASHINGTON
)
) ss:.
)
Before me, the undersigned authority, personally
appeared JEROME P. FLETCHER, Guardian of the Estate of Leroy
.J
~letcher, an ,incompetent, who, being duly sworn according to
law, deposes and says that the facts set forth in the foregoing
~NVENTORY OF GUARDlAN are true and correct to the best of his
!knowledge, information, arid belief.
pworn to and subscribed before me
lhis zdday of ·7J~L~·. , 1969 .
~otary ]?ubl~c
' . -' -:r-....
-., .' ~:. r" '"Al:fCE t. MILLER
< ·~ Notary Public, Wsshiilgtcn, Washington 001
hiY. Commission Expires March 20t 1~7a
·'
... , ,,
·"--
....
.,
.. ,,
IN THE ORPHANS' COURT OF
WASHINGTON COUNTY, PENNA.
NO. 1579 of 1968
IN RE:
ESTATE OF LEROY FLETCHER,
an alleged incompetent.
~-
INVENTORY OF GUARDIAN
.......
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' '
IN THE ORPHANS' COURT OF WASHINGTON COUNTY, PENNSYLVANIA
IN RE: ) . ·)
ESTATE OF LEROY FLETCHER, ) NO. 1579 OF 1968
) >
AN INCOMPETENT. )
AFFIDAVIT OF SERVICE
COMMONWEALTH OF PENNSYLVANIA)
) SS:
COUNTY OF WASHINGTON )
Personally before me, a Notary Public in and for
said County and Commonwealth, appeared Ralph C. Lowe
-------------' who, being duly sworn according to law, deposes
and says that he served a copy of a PETITION FOR ADJUDICATION
OF INCOMPETENCE AND APPOINTMENT OF GUARDIAN OF ESTATE AND
CONSENT OF PROPOSED GUARDIAN OF ESTATE, a PRELIMINARY DECREE,
and an original CITATION upon LEROY FLETCHER at the Washington
County Men's Home; 2198 North Main Street, Washington,
Washington County, Pennsylvania by handing same to him personally
on the 19th day of ~D~e~c~e~mb~e~r~----------------' 1968, at
4:10 o'clockP. M.
Sworn to and
7-L
this ~day
~-.. :
subscribed before~:
of A-t-e~e-~t-&£d , 19 6 8 .
I. ~ ~ : '· -~ ALICE L. MI.LLER
. . .. _' --," ~!tPijbJic, Washingto~. Was,hingforl Co.
~ . • , · J4Y Commission Expires March 20, 1972
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Mr. James Fletcher
900 Parkway Drive
Boulder, Colorado 80301
December 26, 1968
IN RE: Estate of Leroy Fletcher, an Incompetent
Dear Mr. Fletcher:
Enclosed find a copy of Citation and
Preliminary Decree in the above matter.
Very truly yours,
l"lray G. Zelt III
WGZ:jd
Enclosures (2)
CERTIFIED MAIL -RETURN RECEIPT REQUESTED
INSTRUCTIONS TO DELIVERING EMPLO .. YEE ·~ -.II Show to whom and O Show 1 h .. .
lQa date delivere~ . addresso w~e~~,d~~~;,;;d 0 Deliver ONLy
(Addttzonal charges req1ti dfi l . to addressee re or t~ese servtces) SENT~~CEIPT FOR CERTIFIED MAIL-30¢
CERTIFIED NO.
936823
INSURED NO.
I
Df.tE DELIVERED
SHOW WHERE DELIVERED (on/·v " ·-" ~ '' req11es1e •• 1
GPO
POSTMARK
OR DATE
Q z
December 19 , 1'9 6 8
IN RE: Estate of Leroy Fletcher, an Incompetent
Dear Mr. Fletcher:
Enclosed find a copy of Citation and
Preliminary necree in the.above matter.
WGZ :jd
Enclosures (2)
Very truly yours,
Wray G. Zelt III
CERTIFIED MAIL -RETURN RECEIPT REQUESTED
~r;:;RE;-C_EI_PT_F_O_R_C_ER_T_I F_l E_D~M~A:.:...:IL:::-...:.30:.:::¢--;-----:~-..,:~:
I SENT TO '
Mr · James Fletcher "gsT~· RKPA. f'i
1 ~~l
-t ~\ 19.1.
P.o., srArE,ANo zrPcooe2 80 Henderson St. . . ~\ 1968.~!·1
Jersey City, New Jerse ~
EXTRA SERVICES FOR ADDITIO::;;NA~L ';;FE:;;ES~----1 \. l.J ~ rv:,,
Return Receipt DeJ1"ver to ......
SlJows to whom Shows to whom, Addressee On/ ···~,.........._ , ..... J~' and date date, and where Y ·-"':iil'
t.r4ei1vered Odelivered 0 SO¢ fee : ~~;;~10~¢;,/~ee~!;~~3~5~¢~re~e~~~==~~_J __________ [
MPOarD. F1•96orm6 3800 NO INSURANCE: COVERAGE PROVIDED-(See other 51.de) .~ NOT FOR INTERNATIONAL MAIL ~ ., :,
'• '•
Mrs. Diane Stanley
208 Lacock Road
Washington, Pennsylvania
- - ----------:-----------~...,.,.--.,
December 19, 1968
15301
IN RE: Estate of-Leroy Fletcher, an Incompetent
Dear Mrs. Stanley:
Enclosed find a copy of Citation and
Preliminary Decree in the above matter.
WGZ :jd
Enclosures (2)
CERTIFIED MAIL
Very truly yours,
Wray G. Zelt III
RETURN RECEIPT REQUESTED
INSTRUCTIO~S TO DELil/ElUNG EMPLOYEE
r::J Show to whom and D Show to whom, date, and D Deliver ONLY
~ date delivered . address where delivered to addressee
(Additi01zal charges reqrtircd for these services)
RECEIPT
REGISTERED ND.
CERTIFIED NO.
936829
INSURED NO.
DATE DELIVERED SHOW WHERE DELIVERED (only if requested)
c55-16-71648-3 GPO
· RECEIPT FOR CERTIFIED MAIL-30¢
~ENT TO
I ~f:lr~s_. __ .DLan.e_S..t.anley _____ ~1 jTREET AND NO,
',2 0 8 Lacock Road
,;_ 0., STATE, AND ZIP CODE
Washington, Pa. 15301
\ EXTRA SERVICES FOR ADDIHONALFEE:':"S =------ld
Return Receipt
fhows to whom Shows to whom, ~ and date date, and where , delivered delivered
'!RJ 10¢ fee 0 35¢ fee 0 50¢ fee
)0 form 3800 NO INSURANCE COVERAGE PROVIDED->r. 1966 NOT FOR INTERNATIONAL MAIL
---~-----~--------
Mrs. Sandra L. Caffrey
184 East Katherine Avenue
Washington, Pennsylvania
December 19, 1968
15301
IN RE: Estate of Leroy Fletcher, an incompetent
Dear Mrs. Caffrey:
Enclosed find a _copy of Citation and
Preliminary Decree in the above matter.
Very truly yours,
Wray G. Zelt III
WGZ :jd
Enclosure's ( 2)
CERTIFIED MAIL -RETURN RECEIPT REQUESTED
INSTRUCTIONS TO DELIVERING EMPLOYEE
r::l Show to whom and D Show to whom, date, and D Deliver ONLY J.2!1 date delivered address where delivered to addressee
· (Additi01zal charges req11ired for these services)
RECEIPT
RECEIPT FOR CERTIFIED MAIL-30¢
SENT TO
-,..,.,,
REGISTERED NO. SIGNATURE OR NAME OF /\DDRESSEE (MIISt always be filled in) Mrs. Sa~dra L. C_qffre~-----1
~ CERTIFIED NO.
STREET AND NO.
936833
INSURED NO.
Return Recel pt
DATE DELIVERED Shows to whom Shows to whom,
and date date, and where
delivered delivered
fRJ 10¢ fee 0 35¢ fee
POSTMARK
OR DATE
, POD Form 3800 NO INSURANCE COVERAGE PI:IOVIDED-(See other side) ' Mar. 1966 NOT FOR INTERNATIONAL MAIL
.___ __ --------" ---------
Oeoember 18, 1968
-Ralph s. Blasiole, M.D.
881 East Beau Street
Washington, Pennsylvania 15301
.
!. I~ RE: Leroy Fletcher
Dear.Dr. Blasiole:
, You will recall. that I spoke to you on the
telephone about our petition to have Leroy Fletcher
adjudged an incompetent. He .presently resides in the
Washington County Z.1en 's Home. We attempted ·co have
· Dr. ·Large, who treated this man, present at the incompetency
hearing, but as you know, Dr. Large is ill. I hope it is
not too much .. to assume that you will attempt to be present
at the.hearing on January 27, 1969, at lO:OO.a.m. I
talked to the Orphans' Court Judge again, and he insists
·that your· presence ·is necessary and I do not·believe there are
any forms for you to fill out.
If it develops that you cannot be present at the
aforesaid time, please attempt to notify me or Judge P. v.
Marino. The home of Leroy Fletcher is mortgaged, and the
mortgage payments are falling behind, since the grandson,
who is the petitioner in this case, cannot get the
.incompetent's social security checks signed and cashed.
This is accordingly a mat~er of some .urgency.
Naturally,· if you have not attended to Leroy
Fletcher at the County Home, I hope you \vill take the
opportunity to do so.
If you have any problems or any questions, please
call me at your convenience. ·
Very truly yours,
Wray G. Zelt III
WGZ :jd
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IN THE ORPHANS' COURT OF
WASHINGTON COUNTY, PENNA.
~0. 1579 OF 1968
ESTATE OF LEROY FLETCHER,
AN INCOMPETENT.
AFFIDAVIT OF SERVICE
ZELT & ZELT
ATTORNEYS AT LAW
33 WEST BEAU STREET
WASHINGTON, PA. IS301
WRAY G· ZELT
WRAY G. ZELT lJI
LAW OFFICES
ZELT & ZELT
23 EAST BEAU STREET
WASHINGTON, PA. 15301
Mr. James Fletcher
Gregory Park, Unit 1
280 Henderson Street
Jersey City, New Jersey
December 19, 1968
AREA CODE 412
PHONE 225-3420
PHONE 225-2228
IN RE: Estate of Leroy Fletcher~ an Incompetent
Dear Mr. Fletcher:
Enclosed find a copy of Citation and
Preliminary Decree in the above matter.
Very truly yours,
_tlJ~~-~~/
Wray G. Zelt III ~
WGZ! jd
Enclosures (2)
CERTIFIED MAIL -RETURN .RECEIPT REQUESTED
LAW OFFICES
ZELT & ZELT
23 ~M~kreet
WASHINGTON, PA. IS301
tel :II ;iII' I :t ·~ [N:: 936832 J
MAlLO'
RETURN RECEIPT REQUESTED
·--·'::':~~-.......
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Mr. James ~le · Gregory Par Unit 1
2 8 0 Hend. ~· on Stre"et Jersey c· y, New Jersey
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Fi!?OM
0IRS£Y CIIYe NJ. 073
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RECEIPT
Received the numbered article described below.
REGISTERED NO. SIGNATURE OR NAME OF ADDRESSEE (Mrtst always be filled in)
.,.-
CERliFIED NO.
936832 SIGNATURE OF ADDRESSEE'S AGENT, IF ANY
INSURED NO.
DATE DELIVERED SHOW WHERE DELIVERED (onl;y if requested)
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