HomeMy WebLinkAbout08-27-07
.
.
ANNUAL REPORT OF .
GUARDIAN OF THE ESTATE
o COURT OF COMMON PLEAS OF
\..)1'<\ ~ \4" d COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
Estate of N \ c.0l..E ~~~
No. olo -D~
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. an Incapacitated Person
I. INTRODUCTION
~~ .P\\\.)\:) ~t-...~ .\.\L::P\\J{:iL
~Ienary DLimited Guardian of the Estate by Decree of
dated <6 J'~ \ I c:J.p .
, was appointed
. J.,
11 A. This is the Annual Report for the period from _~\.) ~ ~ \ , ~
to _~\ ") Gl ~ \ . Leo,? (the "Report Period"); or
D B. This is the Final Report for the period from
to
(the "Report Period"), and is filed
for the following reason:
1. The death of the Incapacitated Person. Date of death:
Name of Personal Representative:
2. The Guardianship was terminated by the Court by Decree of
J., dated
Form G-02 rev. 10.13.06
Page 1 of5
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Estate of N \COLE .\\L~~
. An Incapacitated Person
II. SUMMARY
A. State the value of the estate reported on the Inventory
$
cp
B. State the value(s) of principal assets at the beginning of
the Report Period. (Same as Inventory if first Report,
otherwise, ending balance from last Report.)
$
cp
C. What is the total amount of income earned during the
Report Period?
$ S \ ~ . <c,4.
D. What is the total amount of income and principal
spent for all purposes during the Report Period?
$ 4<6<(SC1. ~lp
E. What are the balances remaining at the end of the Report
Period? ~
1. Principal $.
2. Income $ "Z-~
3. Total of Principal and Income
2~L\..Ob
~
/'
$
ID. ADDITIONAL INFORMATION
(If more space is needed, please attach additional pages.)
A. Principal
1. How is the principal balance listed above currently
invested? (Please specify, e.g., real estate,
certificates of deposit, restricted bank accounts, etc.):
~€\\~\\j~f\\CL ~-\-e.-
e \"("\P\O~e.e C\"edr-\- \..M\OY\
2. Have there been any expenditures from the principal
during the Report Period? ............................ D Yes f51No
If yes:
a. Have all expenditures from the principal been for
the sole benefit of the Incapacitated Person? . . . . . . .. 0 Yes 0 No
Form G-02 rev. 10.13.06
Page 2 of5
Estate of
N \ C-OL-'5 ~~ V~
b. ~i,t purpose and amount of expenditures:
~ ~R\Ou~ -CSt-1=.
~-rt~~ C~
t=='LLJlA '\ S~~F tJT
. An Incapacitated Person
$ 4.G..XGl, lo~
$
$
$
c. Was Court approval received prior to
expending the principal? ....................... a Yes ~No
3 . Were additional principal assets received during the
Report Period which were not included in the
Inventory or a prior Report filed for the Estate? ........... DYes lilNo
If yes:
a. Was Court approval requested prior to
receiving the additional principal? . . . . . . . . . . . . . . .. a Yes a No
b. State the sources and amounts of the
additional principal received:
B. Income
1. State sources and amounts of income received
during the Report Period (e.g., Social Security,
pension, rents, etc.):
S~\:""
f.:>~ SSP
~s.eCu.... l)\\hcl.C2"d fr:.r"\.~~
,
Total income received during Report Period:
Form G-Q2 rev. 10./3.06
$
$
$
$
$
$ 4-'6q" .S~
$ '"'Z..' q I -z.. 0
$ L\ . <6~
$
$
$
$
~
./
5\23.<.eLl
Page 3 of5
Estate of
~\COLE -\-\~~.f\C
. An Incapacitated Person
2. How is income currently invested? (please
specify. e.g.. restricted bank accounts, client
. C(;:~:~~\ U"-Y\ \=- ~-\e-
Exv,p \c"6€.e- C'E'-cld \j(\lOy\
C. Expenses for Care and Maintenance
Specify what expenditures were made from the principal and
income for the care and maintenance of the Incapacitated
Person (e.g.. clothing, nursing home. medicine. support, etc.):
C\~\~ ) ~'t"\\~1
F0~~t'"€1 ~\.co.JL o0\-~-~Ocke.:t1
Doo~S, ~\~S ,~a\\e~\es.,
s--.~~SI~e..cc-e~C)t'\'~~ '\' ~
o..r'\d ~e.., ~~\ ~o..\\<.. e.'{ pensecs
D. Other Expenditures
Specify what other expenditures were made during the Report
Period. (Do not include any items stated in response to
question C above.)
Not)€.-
E. Guardian's Commissions
List amounts of compensation paid as Guardian's commission
and state how amount was determined:
Amount
Method of Determination
Court
Approval Obtained
NOf'\€--
DYes DNo
DYes DNo
Form G-02 rev. 10.13.06
Page 4 of5
Estate of
N \ COLE +-\L--p\~
. An Incapacitated Person
F. Counsel Fee
List amounts paid as counsel fee, and indicate whether Court approval was obtained.
Amount
Court
Approval Obtained
DYes MNo
DYes DNo
.~~ .00
(\l"C\0dQ~\0\ C\~ ahJve:-
~,e..'(~~S ')
I verify that the foregoing information is correct to the best of my knowledge,
information and belief; and that this Verification is subject to the penalties of 18 Pa.C.S. ~ 4904
relative to unsworn falsification to authorities.
?>'2~~
Date
~ '2J\ChulU" .)
Ignature of Guardian afthe Estate
~~ ~L~~C-
Name of Guardian afthe Estate (type or prim)
q O~~~ \.!)"E~~
Address
~~\~ ~~ \\0\5
City, State, Zip
"\ \\ - L-S~-s~<olc
Telephone
Form G-02 rev. 10.13.06
Page 5 of5
.
8/21/2007
Niki's Cash Flow
8/31/2006 Through 8/2112007
Category Description
INFLOWS
Interest Ine
PA SSP Income
SSllncome
TOTAL INFLOWS
OUTFLOWS
Attorney
Niki Guardianship
TOTAL Attorney
Childcare
Clothing
Dining
Expense Reimbursement
Furniture
Bedding
TOTAL Furniture
Medical
Melmark Incidental Account Deposit
Mise
Book
Hair Accessories
Snacks
Toiletries
TOTAL Mise
Personal Care
Purchase Gifts
Recreation
Snacks
TOTAL OUTFLOWS
OVERALL TOTAL
Page 1
8/31/2006-
8/21/2007
4.86
219.20
4,899.58
~3.64 ~.
36.00
36.00
40.00
383.66
31.59
830.27
2,145.32
2,145.32
3.00
1,200.00
5.30
15.11
4.77
10.99
36.17
17.00
66.47
49.98
50.20
C- 4,889.66 -'l
C- 23~