HomeMy WebLinkAbout10-19-09 (2),~~
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ANNUAL REPORT OF ~ -~
GUARDIAN OF THE ESTATE ~ ;~
COURT OF COMMON PLEAS OF `""?
CUMBERLAND COUNTY, PENNSYLVANIA ~~•'
ORPHANS' COURT DIVISION ~
F;state of Louise
No. 21-09-0459
an Incapacitated Person
I. Introduction
Shaun E. O'Toole ,was appointed
^Plenary 8 Limited Guardian of the Estate by Decree of Kevin A. Hess , J.,
elated May 21 2009
^A. This is the Annual Report for the period from
to (the "Report Period"); or
8 B. This is the Final Report for the period from May 21, 2009 to June 30, 2009
(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
3. Other: Guardian was pointed as Emergency Guardian of the Estate b ty he
May 21 2009 Order Guardianship terminated b~peration of law.
~~
II. Summary
A. State the value of the estate reported on the Inventory $
616.31
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?
E. What are the balances remaining at the end of the
Report Period?
1. Principal $ 0.02
2. Income $ 616.31
3. Total of Principal and Income
4.
IILADDITIONAL INFORMATION
(If more space is needed, please attach additional pages.)
A. Principal
616.31
$ 1,455.35
$ 1,455.33
$ 616.33
1. How is the principal balance listed above currently invested? (Please specify,
e.g., real estate, certificates of deposit, restricted bank accounts. etc.):
Resident Account at Forest Park Health Center- M & T Bank
2. Have there been any expenditures from the principal during the Report
Period?... ^ Yes Q No
If yes:
a. Have all expenditures from the principal
been for the sole benefit of the Incapacitated
Person? D Yes ^ No
b.
List purpose and amount of Expenditures:
Skilled Nursing Care $ 1 455.33
_ $
c. Was Court approval received prior to
expending the principal? ^ Yes D 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?..........
Yes ^ No D
If yes:
a. Was Court approval requested prior to receiving the addition
principal? ^ Yes D No
b. List purpose and amount of Expenditures:
B. Income
I . State sources and amounts of income received during the Report Period (e.g.,
Social Security, pension, rents, etc.):
Social Security $ 839.00
Black Lung Pension $ 616.30
Interest $ .OS
Total Income received during Report
Period: $ 1,455.35
2. How is income currently invested? (Please specify, e.g., restricted bank
accounts, client care account, etc.,):
Resident Account at Forest Park Health Center (M & T Bank)
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.):
Nursing Home
$ 1,455.33
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.)
None
E. Guardian's Commissions
List amount of compensation paid as Guardian's commission and state how
amount was determined:
Amount Method of Determination
0.00
F. Counsel Fee
Court Approval Obtained
^ Yes ^ No
^ Yes ^ No
List amounts paid as counsel fee, and indicate whether Court approval was
obtained.
Amount Court Approval Obtained
0.00 ^ Yes ^ No
^ Yes ^ No
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.
o (~ ~ 1 o~s ~ ~~ ~
Date ignature of Guardian of the Person
Shaun E. O'Toole
Name of Guardian of the Person (type or print)
403 North Second St., Suite 201
Address
Harrisbur ,Pennsylvania 17101
City, State, Zip
(717) 695-0389
Telephone