Return Date: MAY 17,2011 MARJORIE PARTCH, APPEAL FROM PROBATE DOROTHY PARTCH v.

MATTHEW CAPUTO SUPERIOR COURT

JUDICIAL DISTRICT OF STAMFORD/NORWALK AT STAMFORD COMPLAINT

1.

Dorothy Partch was born November 29,1929, Marjorie Partch is the daughter of said conserved person who's spouse has predeceased her.

2.

In 2004, the Petitioner Marjorie Partch moved her residence from Vermont to Connecticut to care for her mother, Dorothy Partch, the conserved person.

3.

On February 3, 2005, the conserved person Dorothy Partch gave to the Petitioner Marjorie Partch a durable Power of Attorney which specifically stated "this Power of Attorney SHALL NOT be affected by the subsequent disability or incompetence of the principal" (See Exhibit A annexed hereto).

4.

On said date the conserved person, Dorothy Partch also made Marjorie Partch her Healthcare Agent and Attorney In Fact for healthcare decisions. (See Exhibit B annexed)

5.

In said healthcare agent, she designated Marjorie Partch to be her Conservator, if one should be needed.

6.

On April 7, 2010, after suffering a major stroke, the conserved person Dorothy Partch was transferred from Norwalk Hospital to Wilton Meadows.

7.

In May of 2010, the Petitioner took issue with the care and treatment given to the conserved person Dorothy Partch and believes that Wilton Meadows breached its standard of care in causing severe injury to the Conserved Person, Dorothy Partch.

8.

In January 2011, Wilton Meadows, believing the conserved person Dorothy Partch's Medicare benefits would be ending recommended the Petitioner take the conserved person home and recommended Nursing and Homecare in Wilton, Connecticut.

9.

Wilton Meadows, upon learning that the conserved person Dorothy Partch had assets including a home, changed its position that she should be discharged and prepared an Application for Appointment of a Conservator with Matthew Caputo as Conservator.

10.

Said Application erroneously represented that "the Respondent (Dorothy Partch) has not appointed a healthcare representative."

11.

The Application erroneously represented that it was unknown whether the Respondent Dorothy Partch had executed a Power of Attorney for health care decisions.

12.

The Application erroneously represented that it was unknown whether the Respondent (Dorothy Partch) had executed a durable Power of Attorney.

13.

The aforesaid representations by Wilton Meadows in the Application for Appointment of Conservator were erroneous and were misrepresentations to the Court that Wilton Meadows knew

were erroneous since the Petitioner Marjorie Partch had used said documents when admitting her mother Dorothy Partch to Wilton Meadows. 14. Wilton Meadows knew how to contact Marjorie Partch but refused to ever do so, prior to its Application. 15. The Petitioner Marjory Partch did not receive notification of the Application for Appointment of Conservator Hearing until July 26 2010. 16. The Petitioner Marjorie Partch was not afforded the opportunity to be heard, to present evidence and/or witnesses concerning the intent of the conserved person, her mother, Dorothy Partch, and present the documents evidencing her mother's intent. 17. The actions of Wilton Meadows in seeking a conservator were contrary to its earlier position that the conserved person Dorothy Partch should be discharged and are an attempt (1) to financially benefit by retaining the conserved person Dorothy Partch as a patient, clearly against her will and (2) to avoid the Petitioner from taking legal action against them. 18. The actions of Wilton Meadows in seeking a conservator and choosing Matthew Caputo constitute a conflict of interest.

19.

Based on the misrepresentations

of Wilton Meadows, a conservator

and an attorney were appointed in the Norwalk Probate Court

20.

At the time of said of Hearing, the Petitioner Marjorie Partch was without funds and was unable to obtain an attorney in this matter until March of 2011 when the undersigned counsel appeared and the Motion to Reargue and for her appointment.

21.

The Estate of the conserved person, Dorothy Partch is subject to waste by payment to Wilton Meadows, the conservator, and Attorneys and brokers.

22.

On March 24, 2011 the Plaintiff, Dorothy Partch filed a Motion to Reargue the Appointment of the Conservator Matthew Caputo and to be appointed as the Conservator of said Dorothy Partch with Jeffrey Greenberg.

23.

Said Motion to Reargue was denied on March 30, 2011 by the Norwalk Probate Court without hearing a copy of which Motion and order is annexed hereto as Exhibit C.

24.

The Plaintiff is an aggrieved person and hereby files this appeal.

Richard H. ael 19 Ludlow Road Westport, CT 06880 Telephone No. 226-6168 Juris No. 101498 HER ATTORNEY

THE PLAINTIFF CLAIMS: 1_An order of this Court reversing the decision appointing Matthew Caputo as the Conservator of Dorothy Partch 2. An order Appointing Marjorie Partch as Conservator of the person and Jeff Greenberg as Conservator of the Estate of Dorothy Partch or in the alternative 3_An order that a Conservator is not required based on the Designation of Health Care Agent executed by Dorothy Partch

BY__·
Richard H_ Raphael 19 Lud low Road Westport, CT 06880 Telephone No. 226-6168 Juris No. 101498 HER ATTORNEY

_

BOND

Know All Men by These Presents that we, Richard H.

Raphael, 19 Ludlow

Road, Westport, Connecticut, as principal, and Lisa Snow, 200 School Street, Fairfield, Connecticut, as surety, are holden and stand firmly bound and obliged, jointly and severally, unto the state of Connecticut, in the penal sum of $150.00, to be paid to the state or to its certain attorney; to which payment, we do bind ourselves, our heirs, executors and administrators, firmly by these presents. The conditions of this obligation is such that whereas the above bounden principal has appealed from the order and decree of the Probate Court for the District of NorwalkIWilton made on March 31,2011, denying the Motion to Reopen and Reargue the Appointment of Marjorie Partch as Conservator to be held at Judicial District of Stamford/Norwalk at Stamford Connecticut on May 17, 2011. Now therefore, if the principal shall prosecute the appeal to effect, and pay any costs for which judgment may be rendered against him therein, then this bond shall be void, otherwise to remain in full force. Dated at Westport on this ~ day of April, 20 .
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Durable Power of Attornev
NOTICE: THE POWERS GRANTED B'{ THIS DOCUME\lT ARE BRO"A.D l\ND S\"x"'EEPING_ TI-iEY ARE DEFINED IN CONNECTIClJT ST:\TUTORY SHORT FORM PO\},?ER OF A ITORNEY ACT, SECTIO!\lS 1-42 TO 1-56, lNCLLSIVE, OF THE GENERAL ST\ TITES, WHfCII EXPR.f:SSLY PERlvrrrS THE LSE OF .\NY OTHER OR DIFFERENT IT)R\I Of POWE.R OF ATTORNEY DESIRED BY THE PARTIES CONCERNED. j(_._'-.JO\X! J. f\.·fF.N BY 1HESE PRESENTS, which are intended [0 constitute a GENERAL Al PO'V:,lEROF i\TTORNEY pursuanr TO Connecticut Statutory Shott Form Power of Attorney Act:

DOROTHY qf do herebv appoint
fit

S. PARTCH

20 Devil's Garden Road, South Norwalk, Cf 06854 MARJORlE PARTCH

20 Dcvil's Garden RoaJ, South Norwalk, TO ACT
aDY

cr 06854

my 3rtorney(s)-in-facr

First: In my name place and stead in
with respect to the following matters

way which I could do, if I were personally present.

defrned In the Connc-cricur Statutory Short Form Power of Artorney Act to the extent that I may he permitted by law to act through an agenr:
as each of [hem is

[:,mke out and initial ill the opposite box anyone or more of the subdivisions as ro which the principal docs NOT desire to giye the agent authority. Such elimination of anyone or more of subdrvisions (A) to (K), inclusive, shall automatically constitute an elimination also of subdivision (L)-J

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rcal estate trarisacriorrs: including the p0\.vc!: ro transfer anJ convey real property including

(B)

(C)
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property located at 20 Devil's Garden Road, South Norwalk, CT 06854: chattel and goods transactions; bond, share and commodity rransacnons; banking transactions; business operating transactions:
Insurance transacnons;

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estate transactions;

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claims and htigarion; personal relationships and affairs; benefits from military servtcc:
records, reports and statcrne nrs;

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EXHIBIT

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all other matters; Special provisions

to any

Second: With full and unqualified authority to delegate any or all of the foregoing powen; person or persons whom my a.ttomey(s)-in-fact shall select.

Third: Hereby ratifying and confirming all that said attomeyts) Dr substitute(s) may do or may cause to be done. Fourth: Without in any w~y limiting the generality of the foregoing powers, this DURABLE GENERAL POWER OF ATTORNEY also includes the power to:

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represent, me in all federal, state, local and foreign tax matters for all years, with full power, subject to revocation, to perform any and all acts that I can perf orm, including the power to sign Internal Revenue Service, Connecticut State powers of attorney; make, execute and file tax returns; and settle tax disputes or controversies;

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represent me in all Social Security Administration

matters;

accounts,

deal with any retirement or pension plans, including individual retirement rollovers, transfers to other plans, voluntary contributions and change the ownership or beneficiary designation on accounts, plans and/or annuities and waive non-employee spousal rights; make gifts in any amount, .outright or in trust (mcluding without limitation, creating, funding, revoking or amending a trust or adding property to an existing or subsequently created trust), of my property to any person, including my attorney-in-fact; create, exercise or release a power of appointment pursuant to Connecticut General Statutes Section 12-345b et seq.> including the power to create, exercise or release a power of appointment in favor of himself or herself, his or her creditors, his or bet estate or the creditors of his or her estate. Notwithstanding the previous sentence, my attorney-in-fact can create, exercise or release a power of appointment for his or her benefit only as necessary for the attorney-in-fact's health, education, maintenance or support; borrow funds to avoid forced liquidation of assets;
deal with and collect proceeds from life, health a.nd long-tenD care irtsurarice,

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including the power to surrender or change the ownership or beneficiary designations of life insurance policies;
forgive, collect and pay debts, including debrs to the attorney-in-fact hereiri

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mak ~~ d waive statutory elections pursuant to COIllJ~ rut General Statutes Section 45a-43b; disclaim or renounce any properry interest pursuant to Section 2518 of the Iriternal Revenue Code, as amended, or Connecticut General Statutes Acts Section 45a~578 et seq., or any similar or successor law;

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pay salaries of employees;
change the domicile of the principal for any and all purposes;

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qualify the principal for various government entitlement programs such as Medicaid or Supplemental Security Income, including the power to dives, me of sufficient assets to so qualify; hire counsel and otherwise act to represent and! or protect roy interest in any legal transaction; waive attorney-client and other similar privileges to facilitate consultations between the attorney-in-fact herein appointed and my attorney and other advisors; convert non-exempt resources into exempt resources to qualify for Medicaid; access safe deposit boxes; revoke Dr amend this powet of attorney or any provision hereof, and serve as the conservator of my person and property, to serve without bond, in the event that I shall be declared unable to manage my affairs pULsuant to Connecticut General Statutes Section 45a-654 er seq_, or any statute corresponding thereto, and make and complete charitable pledges and gifts.

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Fifth: If MARJORIE PARTCH is unwilling or unable to act as my attorney-in-fact, I appoint: ANNA MARIE ULSAM:ER of 49 Shelley Avenue, Hartsdale, NY 10530, myatto:m.eyin-fact to act.

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This Power of j--- mcy SfLl\LL NOT incompetence of the pnnCll-'''''''

be affected

by the

sequent

disability

or

Witness my hand

and seal this

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day of

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,2005.

SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF

DOROTHY S_rf'\RTCH

,.

State of Connecticut County of Fairfield

The
AUTHOR11Y

foregoing POWER OF ArrORNEY was acknowledged before me this ?

with

DOROTHY S. PARTCH.

my

proVIsIOn for SURVTV AL Of of Fifj:?LU~,: 2005, by

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THESE ARE MY HEALTH CARE INSTRUCT10NS:
My appointment of a health care agent, My appointment of an attorney-in-fact fOT health care decisions & The designation of my conservator of the person for my future incapacity

To alD'physician who

is

treating me:

These

are

my health

care instructions

including

those

concernmg

the wid1.holciing

or

withdrawal of life suppmt systems, together with the appointment of my health care agent and my attorney-ill-fact for health care decisions, and the designation of my conservator of the person for
future incapacity. }lS my physician, you may rely on any decision

made by my health care agent,
if I am unable

attorney-in-fact

for health care decisions or conservator

of my person,

to make a

decision for myself.

I, DOROTHY
request

S. PARTCH,

of 20 Devil's Garden

Road, South Nonvalk, CT 06854,
to be permanentlv

that, if my condition

is deemed

terminal or if I am determined

unconscious, condition,

I be allowed to die and not be kept alive through I mean that

life SUppOH systems. condition which,

By terminal
without the

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have an incurable

or irreversible

medical

administration

of life support

systems, will, in the opinion of my attending physician, result in death
coma or

within a relatively short time. By permanently unconscious I mean that I am in a permanent persistent vegetative state which is an irreversible condition in which

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am at no time aware of

myself or the environment

and show no behavioral response to the environment.

TIle life respiration,

SUppOl:[

systerris ,vhich resuscitation

I do not 'want include,

but ate not limited

to: artificial

cardiopulmonary

and artificial means of prm'iiling nutrition

and hy drati on.

I do want sufficient
taking of

pain medication
only that

to maintain mT physical comfort. not be unreasonably

I do not intend any direct

roy life, but

my dying

prolonged.

I appoint MARJORIE
Telephone

PARTCH
to

of 20 DeTI!'s Garden

Road, South Norwalk, CT 06854,
for health care the an

::--Jo.(203) 838-6825,

be my health care agent and my attornev-in-fact
that I am unable to understand and

decisions,
nature and

If my attending physician determines consequences
of health

and appreciate

care decisions

unable to reach and communicate

EXHIBIT

B

info=ed

decision regarding treatment,

my health care agent and attorney-in-fact

for health care

decisions is authorized to: (1) Convey support systems; (2) Take 'whatever actions are necessary to ensure that any wishes are given effect; (3) Consent, refuse or withdraw consent to any medical treatment as long as such
to

my physician my wishes concerning the withholding or removal of life

action is consistent with my wishes concerning the withholding systems; and

or removal of life support

(4) Consent to any medical treatment designed solely for me purpose of maintaining physical comfort.

If :MARJORIE attorney-in-fact

PARTCH

is unwilling or unable to serve as my health care agent and my MARIE ULSAJ\.1ER of 49 Shelley

for health care decisions, I appoint ANNA

Avenue, Hartsdale, NY 10530, Telephone No. (914) 949-9873, to be my alternate health care agent and my attorney-in-fact for health care decisions.

If a conservator PARTCH,
to

of my person

should need to be appointed,
If MARJORIE

I designate

:MARJORIE

be appointed

my conservator.

PARTCH

is unwilling or unable to No bond

serve as my conservator,

I designate ANNA

I\{ARIE

ULSA.M:ER as my conservator.

shall be required of any of them in any jurisdiction.

These requests, appointments,

and designations are made after careful reflection, while I am

of sound mind- ;lny party receiving a duly executed cop)' or facsimile of this document upon it unless such party has received actual notice of my revocation of it.

may rely

Date

."'-".

!7'-I..;.

.-

,2005

..

'./

DOROTHY S. PARTCH

TIlls document was signed in this document, understand

OUI

presence by DOROTHY S. PARTCH the author of

who appeared to be eighteen years of age or older, of sound mind and able to of health care decisions at the time this document was

the nature and consequences

signed. The author appeared to be under no improper influence. We have subscribed this document in the au;h0r's presence and at the author's reguest and in the presence of each other. ..JJ1"/~'-'~J\'/ 'J;r.Les s 'JTIl ~ l·'
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We, the subscribing witnesses, being duly sworn, say that we witnessed the execution of these health care instructions, the appointments of a health care agent and an attorney-in-fact, the designation of a conservator for future incapacity and a document of anarornica] gift by the author of this document; that the author subscribed, published and declared the same to be the author's mstructions, appointments and designation in our presence; mat we thereafter subscribed the document as witnesses in the author's presence, at the author's request, and in the presence of each

other; that at the time of the execution of said document the author appeared to us to be eighteen years of age or older, of sound mind, able to understand the nature and consequences of said document, and under no improper influence, and we make this affidavit at the author's request this
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Subscribed and sworn to before me this

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2005.

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Notary Pcblic /Commissioner of the Superior Court

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AUTHORIZATION TO RELEASE DURABLE POWER OF ATTORNEY

I, DOROTHY S. PARTCH, residing at 20 Devil's Garden Road, South No.rwalk, CT
06854, hereby authorize the law fum of Hersh & Fowler-Cruz, UP, 320 Post Road West, Westport, Connecticut 06880, or their designee, to release any original Durable Power of Attorney in their possession to my agent upon such agent's request.
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DOROTHY s. PARTeR

STATE OF CONNECTICUT COURT OF PROBATE COURT OF PROBATE DISTRICT OF NORWALKlWtL TON DISTRICT NO.1 03 In The Matter of Dorothy Partch alkla Dorothy S. Partch OF CONSERVATOR

MOTION TO REOPEN AND REARGUE APPOINTMENT

AND APPOINTMENT OF CONSERVATOR 1. Dorothy Partch was born November 29, 1929, Marjorie Partch is the daughter of said conserved person who's spouse has predeceased her. 2. In 2004, the Petitioner Marjorie Partch moved her residence from Vermont to Connecticut to care for her mother, Dorothy Partch, the conserved person. 3. On February 3, 2005, the conserved person Dorothy Partch gave to the Petitioner Marjorie Partch a durable Power of Attorney which specifically stated "this Power of Attorney SHALL NOT be affected by the subsequent disability or incompetence of the principal" (See Exhibit A annexed hereto). 4. On said date the conserved person, Dorothy Partch also made Marjorie Partch her Healthcare Agent and Attorney In Fact for health care decisions. (See Exhibit B annexed) 5. In said healthcare agent, she designated Marjorie Partch to be her Conservator, if one should be needed.

EXHIBIT

C

6.

On April 7,2010, after suffering a major stroke, the conserved person Dorothy Partch was transferred from Norwalk Hospital to Wilton Meadows.

7.

In May of 2010, the Petitionertook issue with the care and treatment given to the conserved person Dorothy Partch and believes that Wilton Meadows breached its standard of care in causing severe injury to the Conserved Person, Dorothy Partch.

8.

In January 2011, Wilton Meadows, believing the conserved person Dorothy Partch's Medicare benefits would be ending recommended the Petitioner take the conserved person home and recommended Nursing and Homecare in Wilton, Connecticut.

9.

Wilton Meadows, upon learning that the conserved person Dorothy Partch had assets including a home, changed its position that she should be discharged and prepared an Application for Appointment of a Conservator with Matthew Caputo as Conservator.

10.

Said Application erroneously represented that "the Respondent (Dorothy Partch) has not appointed a healthcare representative."

11.

The Application erroneously represented that it was unknown whether the Respondent Dorothy Partch had executed a Power of Attorney for healthcare decisions.

12.

The Application erroneously represented that it was unknown whether the Respondent (Dorothy Partch) had executed a durable Power of Attorney.

13.

The aforesaid representations

by Wilton Meadows in the

Application for Appointment of Conservator were erroneous and were misrepresentations to the Court that Wilton Meadows knew

were erroneous since the Petitioner Marjorie Partch had used said documents when admitting her mother Dorothy Partch to Wilton Meadows. 14. Wilton Meadows knew how to contact Marjorie Partch but refused to ever do so, prior to its Application. 15. The Petitioner Marjory Partch did not receive notification of the Application for Appointment of Conservator Hearing until July 26 2010. 16. The Petitioner Marjorie Partch was not afforded the opportunity to be heard, to present evidence and/or witnesses concerning the intent of the conserved person, her mother, Dorothy Partch, and present the documents evidencing her mother's intent. 17. The actions of Wilton Meadows in seeking a conservator were contrary to its earlier position that the conserved person Dorothy Partch should be discharged and are an attempt (1)to financially benefit by retaining the conserved person Dorothy Partch as a patient, clearly against her will and (2) to avoid the Petitioner from taking legal action against them. 18. The actions of Wilton Meadows in seeking a conservator and choosing Matthew Caputo constitute a conflict of interest.

19.

Based on the misrepresentations and an attorney were appointed.

of Wilton Meadows, a conservator

20.

At the time of said of Hearing, the Petitioner Marjorie Partch was without funds and was unable to obtain an attorney in this matter until March of 2011 when the undersigned counsel appeared and filed this Motion.

21.

The Estate of the conserved person, Dorothy Partch is subject to waste by payment to Wilton Meadows, the conservator, and Attorneys and brokers.

22.

The undersigned Petitioner remains ready, willing and able to undertake the conservatorship of her mother as requested by her

and that Jeff Greenberg of Stamford Connecticut be appointed the Conservator of the Estate

Wherefore, for all the foregoing reasons, the undersigned Petitioner requests that the Court grant a Hearing and that said decision on the Application to appoint conservator be reopened and that the undersigned Petitioner be appointed conservator of her mother's person, Dorothy Partch in accordance with her wishes and tht Jeff Greenberg be appointed Conservator of the Estate.

The Petitioner requests a Hearing and the opportunity to present Oral argument, testimony and evidence in furtherance of this Motion.

Richard H__J;(aphael 19 Ludlow Road Westport, CT 06880 Telephone No_ 226-6168 Juris No_ 101498 HER ATTORNEY

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Durable Power of Attomev
NOTICE: THE POWERS GR,,\NTED B'{ THIS DOCUME\lT ARE BRO.A,.D !\ND S\YTEPfNG_ THE''!' ARE DEFINED IN CONNECTICCT ST:\TUTORY SHORT FORM po\xrrJ{. Of' ADORNEY ACT, SECTIO~S 1-42 TO ] -56, lNCLLSIVE, OF THE GENERAL \T-\Tl:TES, \VHICII EXPRESSLY PERlvflTS THE l:SE OF /\NY OTHER OR DIFFERENT H)R\I OF P()\\i'ER OF ATTOR0JEY DeSIRED BY THE PARTIES CONCERNED.
l(_'_'-..jOW ;\lL MEN BY THESE PRESENTS, which are intended to constitute a GENERAL PO'J.:''ER OF ATTORNEY pursuant to Connecticut Starutory Short Form Power of Attorney Act:

That T,

DOROTHY

S. PARTCH

20 Dcvil's Garden Road, South Norwalk, do hereby appmnt of
my :lrtorney(s)-Hl-fact

cr 06t\S4

MARJORIE

PARTCH

20 Dcvil's Garden Road, South Norwalk, CT 06854
TO ACT:

First: In my name place and stead in any wav which I could do, If I were personally present, with respect to the following matters as each of [hem is defined In the Connecricur Statutory Shorr Form Power of Artorney Act to the extent that 1 may be permitted by law ro act through an agent: (:-,rnke out and ininal
princrpa l does NOT
111 the opposite box anyone or more of the subdivisions as to which [he desire to give the agent authority. Such elimination of anyone or more of (j\) to (1<.), inclusive, shall automatically constirure an elimination also of subdivision

subdrvisions (I J) ..] (;\)

real estate transactions; including the power to transfer and convey real property including property located ar 20 Devil's Garden Road, South No~alk, CT 06854; [
chattel and goods transactions; [

(H)

(C)
(D)

,L)
(F) (G) (H)

(I) (J) 0'-)

bond, share and commodity rransacrions; banking transactions; business operating transactions: Insurance transactions; estate transactions: claims and htiganon; personal relationships and affairs; benefits from militarv service; records, reports and statements;

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EXHIBIT

A

(L)

all other matters;
Special provisions

Second: With full and unqualified authority to delegate any or all of the foregoing to any person O.I persons whom my attomey(s)-in-fact shall select. Third: Hereby ratifying and confirming may cause to be done.

powers

all that said attomey(s)

or substirutejs)

may do or

Fourth: Wi.thout in any wiy limiting the generaliry of the foregoing powers, this DURABLE GENER.AL POWER OF l\ITORNEYalso includes the power to:

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represent me in all federal, state, local and foreign tax matters for all years, with full power, subject to revocation, to perform any and all acts that I can perform, including the power to sign internal Revenue Service, Connecticut State powers of attorney; make, execute and file tax returns; and settle tax disputes or controversies;

1 (N)
1(0)

represent me in all Social Security Ad=inistration

matters;

deal with any retirement or pension plans, including individual retirement accounts, rollovers, transfers to other plans, voluntary contributions and change the ownership or beneficia.ry designation on accounts, plans and/or annuities and waive non-employee spousal rights; make gtfts in any amount, .outright or in trust (including without limitation, creating, funding, revoking or amending a trust or adding property to an existing or subsequently created trust), of my property to any person, including my attorney-in-fact;
create, exercise or release a power of appointment pursuant to Connecticut General Statutes Section 12-345b et seq_, including the power to create, exercise or release a power of appointment in favor of himself or herself, his or her creditors, his or her estate or the creditors of his or her estate. Notwithstanding the prevIous sentence, my attorney-in-fact can create, exercise or release a power of appointment for his or her benefit only as necessary for the attorney-in-fact's health, education, maintenance or support;

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borrow funds to avoid forced liquidation

of assets;

deal with and collect proceeds from life, health and long-tet:m care insurance, including the power to surrender or change the ownership or beneficiary designations of life insurance policies; forgive, collect and pay debts, including debts to the attorney-in-fact herein

I(I)

2

appointed;

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ma.]~1d

waive statutory elections pursuant to Con

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General Statutes

Secuon 45a-43b; disclaim or renounce any property interest pursuant to Section 2518 of the Internal Revenue Code, as amended, or Connecticut General Statutes Acts Section 45a-578 et seq., or any similar: or successor law; pay salaries of employees; change the domicile of the principal for any and all pw:poses;

J(V)

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q=lify the principal for various govemrnent entitlement programs such as Medicaid or Supplemental Security, Income, including the power to dives"(me
of sufficient assets to so qualify;

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hire counsel and otherwise legal transaction;

act to represent

and/or

protect my interest in any

j (A.A)

waive attorney-chent and other similar privileges to facilitate consultations between the attorney-ill-fact herem appointed and my attorney and other advisors;
convert non-exempt resources into exempt resources to qualify for Medicaid;

j (BB)

1 ceq 1 (DD)
) (EE)

access safe deposit boxes; revoke or amend this power of attorney or any provision hereof; and

serve as the conservator: of roy person and property, to serve without bond, in the event that I shall be declared unable to manage my affairs pursuant to Connecticut General Statutes Section 4Sa-6S4 et seq., or any statute

corresponding thereto, and ](FF)
make and complete charitable pledges and gifts.

Fifth:
appoim:

If MARJORIE PARTCH ANNA MARIE ULSMfER of

is umvilling or: unable to act as my attorney-in-fact, I 49 Shelley Avenue, Hartsdale, NY 10530, my attomey-

in- fact to act.

3

--~--~--~----------~--~---.-.----

~~~¥d'f~~~~.
".-' -.

.,"-:J;

-------

This Power of !'~ ncy SI-LI\LL NOT incompercnce of the princil--"'_

be affected by the ---.... sequent

disability or

Witness my hand and seal this

3

day of

lfB"? ,.L{

/'f7'Z'1

,2005,

SIGN ED, SEALED AND DELIVERED IN THE PRESENCE OF

State of Connecticut County of Fairfield

The foregoing POWER OF ArrORNEY AUTHORITY was acknowledged before me this? DOROTHY SoPARTCH.

with

provision

for

day of

Iq~j:?cuJ,·

SURVIVAL OF 2005, by

4

THESE ARE MY HEALTH CARE INSTRUCTIONS:
My appointment of a health care agent, My appointment of an attorney-in-fact for health care decisions & The designation of my conservator of the person for my future incapacity

To a71)' hysician wbo i.r treating me: p

These are my health care instructions including those concerning the withholding or withdrawal of life support systems, together with the appomtment of my health care agent and my
attorney-in-fact for health care decisions, and the designation of my conservator

of the person for

future incapacity. As my physician, you may rely on any decision made by my health care agent,
attorney-in-fact

for health care decisions or conservator of my person, if I am

unable

to make a

decision for myself.

I, DOROTHY

S. PARTCH,
is

of 20 Devil's Garden
terminal

Road,
am

South Norwalk,

CT 06854,

request that, if my condition
unconscious,

deemed

or if

I

detennined

to be permanently
systems. Bv terminal

I be allowed to die and not be kept alive through life suppon

condition,

I mean that I bave an incurable or irreversible medical condition

which, without the

administration of life support systems, will, in the opinion of my attending physician, result in death
within a relatively shorrrrmc.

By permanently unconscious I mean that 1 am in a per-manent

corna or

persistent vegetative state which is an irreversible condition in which I am at no time aware of myself or the environment and show no behavioral response to the environment.

"TIle

life support system.s which [ do not want include, but are not limited to: artificial

respiration, cardiopulmonary resuscitation and artificial means of providing nutrition and hydration. T do want sufficient pain medication to maintain my physical comfort. I do not intend any direct taking of my life, but only that my dying not be unreasonably prolonged.

I appollt MARJORIE
Telephone

PARTCH
to

of 20 Devil's Garden Road, South Norwalk, CT 06854, for health care

No, (203) 838-C,825,

be my health care agent and my attorney-in-fact

decisions. If my attendmg physician determines that I am unable to understand and appreciate the nature and consequences of health care decisions and unable to reach and communi care an

EXHIBIT

B

informed decisions

decision

regarding to:
[0

treatment,

my health care agent and attorney-in-fact

[or health

care

is authorized

(1) Convey
support

my

physician

my wishes

concerning

the '\vithholding

or removal of life

systems; (2) Take whatever actions are necessary to ensure that any wishes are given effect;
(3) Consent, refuse with
Or

withdraw

consent

to any medical the withholding

treatment

as long as such

action is consistent systems; and

my wishes

concerning

or removal of life support

(4) Consent physical comfort.

to any medical treatment

designed solely for the purpose

of maintaining

If

:MARJORIE PARTCH
for health

is unwilling or unable I appoint

to serve as my health

care agent and my

attorney-in-fact Avenue, and

care decisions,

ANNA MARIE ULSAl\fER of 49 Shelley

Hartsdale, NY 10530, Telephone
attorney-in-fact

No. (914) 949-9873, to be

my alternate health care agent

my

for health care decisions.

If a conservator

of my person

should

need

to be appointed,

I designate1:1ARJORIE

PARTCH, to be

appointed

my conservator,

If MARJORIE PARTCH is unwilling or unable to
No bond

serve as my conservator,
shall be required

I designate ANNA l\L\RIE ULSAMER as my conservator.

of any of them in any jurisdiction.

These requests, of sound

appointments,

and designations a duly executed

are made after careful reflection, copy or facsimiJe of this document of it.

while I am may rely

mind. Any party receiving

upon it unless such party has received actual notice of my revocation

Dafe ,"',- I_; •

~ ..

.2005 DOROTHY S. PARTCH

This document was signed in our presence by DOROTHY

S. PARTCH the author of

this document, who appeared to be eighteen years of age or older, of sound mind and able to understand the nature and consequences of health care decisions at the time this document was

signed. The author appeared to be under no .irnproper influence. We have subscribed this document in the author's presence and at the author's request and in the presence of each other. _JJ1'-z/ ..\...'....A_J', ·(Ll.G.~ \K5kess ~:·':;;!h,?:!Jt7:..V/
, \X.'i~ss
,

r. :\ : '. P..

("

"

<>:
,// \

(/

Ii..

(\
I

/

L

j:...

. it: f -_/ ~ 'I b ~ ';/ (iLL'! -, J

f-

..~!

'../. _:··. t
..

!

I

Address
!.
'-

{

./

Address }
} S5.:

State of Connecticut County of Fairfield

1

t

~;"

.....

r-: ...j,-;;'rr
being duly sworn, say that we witnessed the execution

}
witnesses,

\J{!e, the subscribing

of the

these health care instructions, the appointments designation of a conservator of this document; instructions,

of a health care agent and an attorney-in-fact,

for future incapacity and a document of anatomical gift by the author

that the author subscribed, published and declared the same to be the author's and designation in our presence; that we thereafter subscribed the

appointments

document as witnesses in the author's presence, at the author's request, and in the presence of each other; that at the time of the execution of said document the author appeared to us to be eighteen
years of age or older, of sound mind, able to understand the nature and consequences

of said

document, and under no improper influence, and we make this affidavit at the author's request this __ ,~~~;~_ day of
_.-~. "":,~. ~'", 1"/ i'! ;.~. /.-,/ .!

2005.

l\ ddress

_---'_
. ~:. , ... ./ ," ,I

;. "

i.», /-

>-;_;.

.. \ddress -

Subscribed and sworn to before me this ~~--,-i_-

'_day
-.-

-'·.if
' ;'
"

of
'"

j':~}-;.">"/; '{/ //;'"-;---'~//

2005.

~,';.

i

,'."

Notary Pubbc/Comrnissioner

of the Superior Court

3

AUTHORIZATION TO RELEASE DURABLE POWER OF ATTORNEY

I, DOROTHY S. PARTCH, residing at 20 Dew's Garden Road, South Norwalk, CT 06854, hereby authorize the law firm of Hersh & Fowler-Cruz, LLP, 320 Post Road West, \Vestport, Connecticut 06880, or their designee, to release any original Durable Power of .Attorney in their possession to my agent upon such agent's request.

·~j.i'" I,... ..../
---;~~ I~
J

/~~
I /

!
r

i/:_~··-r ........ '

/ -,+./ ~;j

Dated

~200S

/

DOROTHY S. PARTCH

ORDER
The foregoing motion having been duly heard is hereby ordered

('mtIT~/DENIED. BY THE COURT

A true copy
Dated at N
orwa

of original order

lk

, Connecticut,

this 30th day of

Atte$t:--..z~~~~i4~"X.'<-~
March, 2011