HomeMy WebLinkAbout07-22-09 (2)
Clerk of Orphans' Court of Cumberland Counfiy
IN RE: ~J 4 ~ Y1 I v ~~~' , I ~ ~ Docket No. G ~ ~~ p J ~ ~ y
An Incapacitated erson ~
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ANNUAL REPORT OF GUARDIAN OF THE ESTAT~_ ._~~; "' ~'
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appointed plenary azdian(s) o the estate of ~ 6 ~vI N Y ~ ?' ~
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by Decree of the Honorable .fudge (~ I ~r .Dated ~unt/ 3~. This is my annual
report for the period from ~l 1.~a08 to ~~ ~~} J, 02 D~ y , ("The Report Period").
I. SUMMARY
B. Total amount of income earned dunng the report penod? un ~-~-,-payQ ~ $
Total amount of all expenditures made for caze and maintenance of the
C. incapacitated person during the Report Period?
1. -From principal $ _ o
A. Value of principal assets at the beginning of the Report Period? $
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2. From income
D. Total amount spent for alI other purposes during the Report Period?
E. Total amounts remaining at the end of the Report Period?
1. Principal
2. Income
Total Income and Principal
$ ~~5~
$ ~ ~ ~~i
$
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II. ADDITIONAL INFORMATION
A. Principal:
1. Total amount remaining at the end of the Report Period?
2. How is principal currently invested?
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3. Have there been any expenditures from principal during the Report
Period? ^ Yes C~'1~
If you answered YES, was there Court approval for all expenditures
from principal? ^ Yes ~o
4. Did you receive any principal assets during the report period which
were not included on the inventory or a prior report filed for the estate? ^ Yes fr~'1<10
If you answered YES, did you receive Court approval prior to receiving ~ ~
additional principal? ^ Yes G~No
5. State the sources and amounts of the additional principal you received:
B. Income:
1. State sources and amounts of income received during the Report Period (i.e., social
security, pension, rents, etc.):
G C ,. S ~G e (~ h. ~rv Surma ~~79,~ $ 7 ~
Total Income received during Report Period $ ~ps'
2. How is income currently invested? (Please specify, restricted bank accounts, client care
account, etc.)
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~ 1
3. Specify what payments were made for the care and maintenance of the incapacitated
person (i.e., clothing, nu/rsing home, medi~yc(-ine, suppCCOrt, etc.).
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4. Specify what other payments were made during the Report Period.
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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. X4904 relative to
unsworn falsification to authorities.
~~ / 0D9
Date Signature of G dian
* FILING FEE $15 MUST ACCOMPANY THIS FILING.