Loading...
HomeMy WebLinkAbout09-02-08 (2)ANNUAL REPOR'T' OF GUARDIAN OF THE ESTATE ~, --~ ~ >_, , .~ ~;; ,.~ ~,.-~ COURT OF COMMON PL AS OF ~ENNSYLVANIA COUNTY ~'~ © N rx„; r~ - , ~ Wv~ ~ r~ ORPHANS' COURT DIVISION i .,p _ ~, ,~ ~_, _.-_ _ C . -) ..Y 1 Estate of ~ \ C D ~ 'E~ ~'`~ OI.V ~-G~~ an Incapacitated Person No. ~O --C?~~~ '~ I. INTRODUCTION ~~~~, a,~ ~ ~qr~p`, ~~ \1 OLG ,was appointed Plenary ^ Limited Guardian of the Estate by Decree of ~ + ~ ~ 'r'' , J•, dated ~ ( ~ A. This is the Annual Report for the period frpm ~ ~ ~ , to ~S (the "Report Period"); or ^ B. This is the Final Report for the period fronds 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: The Guardianship was terminated b~ the Court by Decree of J., dated Form G-02 rev. 10.13.06 Page 1 of 5 ~o Estate of __ t ~- ~ ~ Q 1 ~ -~--~ ~ ,n ~' , , An Incapacitated Person II. SUMMARY A. State the value of the estate reported on the Inventory 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.) C. What is the total amount of income earned during the Report Period? D. What is the total amount of income and principal spent for all purposes during the Report Period? $ a33.~S3 $ ~-I ~-}q ~ ~ S`7 $ ~U 1~,~3 E. What are the balances remaining at the end of the Report Period? 1. Principal $ ~ , 3.~ 2. Income $~c,oy , p l}. a a 3$ ~ (~. 3. Total of Principal and Income $ ,&9Q' III. 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.): ~e r~ r~Sv~ ~ V c~ r~ ~ c`. ~R.~ ~ 2. Have there been any expenditures from the principal during the Report Period? ............................ ~ Yes No If yes: a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? ........ ^ Yes ^ No Form c-oz rev. ]0.13.06 Page 2 of 5 Estate of 1 V ~ C ~ `~ ~ ~ 0.Q ~ , An Incapacitated Person b. Lisrt purpose and amount of expenditures: ~ ~ ~ ~, ~~ ~~,~-}- $ ~, $ c. Was Court approval received prior to expending the principal? ......, ................. ^ Yes ~To 3. Were additional principal assets received during the Report Period which were not included ~n the Inventory or a prior Report filed for the Estate? ........... ~ Yes Qt~ No If yes: a receiv n rthe additionalurinca a$~or to g p p ~? ................ ^ Yes ^ No b. State the sources and amounts o~ the additional principal received: B. Income 1. State sources and amounts of income received during the Report Period (e.g., Social S~lecurity, pension, rents, etc.): ~~ ~~ $ a ~ ss,~t 1 ~ $ -~ .orti T,,.-~ a c~s-k ~ $ ~ ~~S..~P $ $ Total income received during Report Period: $ ~ ~ I,I ~I Pa e3of5 Form G-02 rev. 10.13.06 i g Estate of 1 ~1 \ Cd l ~ `G~, ~ q L , An Incapacitated Person 2. How is income currently invested? (Please specify, e.g., restricted bank accounts, client care account, etc.): ~~rr~s~\vah~~, ~~~ ~rnP\ovJee., ~.~e~ ~-k U n ~ a~ 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.): 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.) No>J~ E. Guardian's Commissions List amounts of compensation paid as Guardian's commission and state how amount was determined: Court Amount Method of Determination Approval Obtained ~~n~- Yes ^No Yes ~ No Form G-02 rev. 10.13.06 Page 4 of 5 Estate of ~~ \ C.rO `E'- ~ ~~ ~~ 0.G , An Incapacitated Person F. Counsel Fee ~ List amounts paid as counsel fee, and indicate w~ether Court approval was obtained. ' Court Amount Approval Obtained ~~~ ®Yes ©No ~ Yes ^ No I verify that the foregoing information is correct to khe 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. ~ ~~~- Date Sisnature of Guardian of the Estate ^~a~ ~ ~o~.~~ Name ofGuardian of the Estate (type orprint) 00.~~ ~ c~,a~- F Address ', City. Sta~e, Zip -1 t 7 o~s - ~e ~2 Telepho e Form G-01 rev. 10.13.06 I Page 5 of 5 9/2/2008 Niki's Cash Flow 9/1/2007 Through 8/31/2008 OUTFLOWS Interest Inc ~, 5.86 PA SSP Income 274.00 SSl Income 4,218.71 TOTAL INFLOWS -~'4~~7 9/1 /2007- Category Description 8/31/2008 INFLOWS Clothing Dining Expense Reimbursement Gifts Given Haircut Medical Misc School Expenses Photos TOTAL OUTFLOWS OVERALL TOTAL 1,178.39 242.15 92.00 52.99 37.00 169.00 700.00 23.00 Page 1