HomeMy WebLinkAbout01-14-08
ANNUAL REPORT OF
GUARDIAN OF THE PERSON
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COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY PENNSYLVANIA
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ORPHANS' COURT DIVISION
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Estate of DONNA L. NEAD
, an Incapacitated Person
No. 21-07-0682
I. INTRODUCTION
PASTOR DANNIE L. KEEN
, was appointed
IZlPlenaryDLimited Guardian of the Person by Decree of EDWARD E. GUIDO , J.,
dated OCTOBER 8, 2007
D A. This is the Annual Report for the period from
to (the "Report Period"); or
IZl B. This is the Final Report for the period from OCT. 8, 2007
to DEe. 24, 2007
(the "Report Period"), and is filed
for the following reason:
1. The death of the Incapacitated Person. Date of death: DEe. 24, 2007
2. The Guardianship was terminated by the Court by Decree of
J., dated
For a Final Report, omit Sections II through IV,
Form G-03 rev. /0. /3.1)6
Page 1 of 4
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Estate of DONNA L. NEAD
, an Incapacitated Person
II. PERSONAL DATA
Age of the Incapacitated Person: t /;;
Date of Birth: AU7 ~?.J/.. /9~/
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
B. The Incapacitated Person's residence is:
o own home / apartment
iii nursing home
o boarding home / personal care home
o Guardian's home / apartment
o hospital or medical facility
o relative's home (name, relationship and address)
o other:
C. The Incapacitated Person has been in the present residence since ./f../ '1- tJ~
. If the Incapacitated Person has moved within the
past year, state prior residence and reason(s) for move:
Form G-03 rev. 10. /3.06
Page 2 of 4
Estate of DONNA L. NEAD
, an Incapacitated Person
D. Name and address of the Incapacitated Person's primary caregiver:
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5 II I ffMVI~ ) /.IV 5 f/V,
IV. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are as follows:
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B. Specify what, if any, social, medical, psychological and support services the
Incapacitated Person is receiving:
)J/A
V. GUARDIAN'S OPINION
A. It is the opinion of the Guardian ofthe Person that the guardianship should:
D continue
D be modified
III be terminated
Foml C-03 rev. 10.13.06
Page 3 of 4
.
Estate of DONNA L. NEAD
, an Incapacitated Person
The reasons for the foregoing opinion are:
Death of Mrs. Nead.
B. During the past year, the Guardian of the Person has visited the Incapacitated Person
ifr)
times with the average visit lasting
hours, . .:70
minutes.
The report of a social service organization employed by the Guardian to oversee and
coordinate the care of the Incapacitated Person for the period covered by this Report may be
attached to supplement this Report.
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.A. ~ 4904
relative to unsworn falsification to authorities.
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Signature of Guardian of the Person
DANNIE L. KEEN
Name o(Guardian oIthe Person (type or print)
P.O. BOX 85
Address
ST. THOMAS, PA 17252
City. State, Zip
7/7-5'$2- ]}df
Telephone
Form G.03 rev. 10.13.06
Page 4 of 4