HomeMy WebLinkAbout10-20-08 (2),i
AMENDED
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND CO~tTY, ` ='
PENNSYLVANIA
ORPHANS' COURT DIVISION ~ j' ~ =' =~'
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In re:
: No. 21-06-0177 , ~=~-~; ~'
PATRICIA A. EICHELBERGER, : ' `r ~.,~
an incapacitated persan =-' --
ANNUAL REPORT OF GUARDIAN OF THE ESTATE UNDER
SECTION 5521(C) OF THE PROBATE, ESTATES AND FIDUCIARIES CODE
For the period: April 3, 2008 to September 3, 2008
1. I am the plenary guardian of the estate of the above-named incapacitated person. I was
appointed guardian by Order of the Court dated Apri13, 2006, which has not been modified by
subsequent Court Orders.
2. The incapacitated person is deceased. Patricia died July 31, 2008. Enclosed please
find an original death certificate.
3. My initial inventory was filed on Apri13, 2005 The inventory listed a total estate
value of $36430.63**. The inventory listed a total monthly income of $ 0 comprising the
following:
**This value was mistakenly listed as assets of Patricia when in fact they were assets of
her mother Evelyn G. Eichelberger. Patricia had no asserts in her name.
4. This report constitutes the filing of as Amended annual report.
5. At the beginning date of this reporting period, my initial balance on hand was 1i0.
6. During this reporting period, Evelyn Eichelberger (Patricia's mother & designated
payee and then Robert Eichelberger (Patricia's guardian & designated payee) received the
following income for the incapacitated person (add additional pages if needed):
Date Received Source of Income Amount
1. April 3, 2008 Social Security $959.00
2. May 2, 2008 Social Security $959.00
3. June 3, 2008 Social Security $959.00
4. July 3, 2008 Social Security $959.00
5. August 3, 2008 Social Security-- Check Returned
Unopened to Socia] Security
Total $3,836.00
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7. During this reporting period, I made the following payments for the incapacitated
person (add additional pages if needed):
Date
1. 04/03/08
2. OS/OS/O8
3. 06/04/08
4. 07/05/08
5.
Amount
$959.00
$959.00
$959.00
$959.00
Total $3,836.00
To Whom Paid
Church God Home
Church God Home
Church God Home
Church God Home
8. The present principal assets of the incapacitated person aze:
Description of Asset Present Value
No Assets in Patricia's Name $0.00
9. The sources and amounts of income that I expect to receive for the incapacitated person
are:
Amount of Income
(Indicate whether monthly,
quarterly or annually)
Sources of Income
None -Patricia Deceased $0.00
10. The monthly expenses I expect to pay for the incapacitated person aze:
To Whom Paid Amount
None- Patricia Deceased. (Prior expenses for Patricia were $0.00
paid by Medicaid.)
11. I ^have ®have not (check one) requested and received permission from the Court to
invade principal to meet the needs of the incapacitated person. If you have requested and
received permission to invade principal, list the expenses that you have paid from principal
during the reporting period:
To Whom Paid Pur~.~ Amount
Not Applicable
Reaso,~ for Payment
SS $ Amount to Home
SS $ Amount to Home
SS $ Amount to Home
SS $ Amount to Home
12. I ^have ®have not (check one) paid myself compensation for services I rendered as
guardian. The amount I paid myself totaled $ [amount) and was calculated at the following rate:
[rate) per ^ week ^ month (check one).
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13. If the incapacitated person is living, please check the correct response and complete, if
applicable: Not Applicable -Patricia Deceased.
(a) ^ There will not be a need for extraordinary expenditures on behalf of the
incapacitated person in the next 12 months.
(b) ^ There will be a need for extraordinary expenditures on behalf of the
incapacitated person in the next 12 months because.
14. If the incapacitated person is living, please check the correct response and
complete, if appropriate: Not Applicable -- Patricia Deceased.
(a) ^ The incapacitated person receives monthly social security benefits
directly.
(b) ^ I am the designated payee to receive the incapacitated person's social
security benefits.
(c} ^ The designated payee of the incapacitated person's social security benefits
is [name of designated person], whose address is [address]. The payee ^ is O is not
(check one) related to the incapacitated person as [relationship].
15. Please note any concerns about the incapacitated person's physical or mental well-
being or the finances that the Court should know.
16. I am the guardian of the person of Patricia A. Eichelberger. My annual report is
attached as well.
I certify that the information contained in this report is true and correct to the best of my
knowledge, information, and belief. This statement is made subject to the penalties of I8 Pa.C.S.
§ 4904 (relating to unsworn falsification to authorities). j
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obert D. Eichelb
Guardian of Patricia A. Eichelberger
182 Chain Saw Road
Dillsburg, PA 17019
Telephone : 649-7074
September 3, 2008