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02-08-10
ANNUAL REPORT OF GUARDIAN OF THE ESTATE COURT OF COMMON PLEAS OF ~~~ COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of Tracv A. McHale . an Incapacitated Person No. 21-08-0011 I. INTRODUCTION Michael and Karin McHale .was appointed Plenary ®Limited Guardian of the Estate by Decree of M. L. Ebert, Jr. , J,, dated 02/12/08 ~ A. This is the Annual Report for the period from January 1, 2009 to December 31 2009 (the "Report Period"); or ® B. This is the Final Report for the period from y,~ Jy 1~ ~,_,- ~, c_:'r f.., , ,_ 6~7 ~: w~~ ~~ L_i.J ,._,., t C3: 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: c r ~ 2. The Guardianship was terminated by the Court by Decree of _ +..~ ~~~ J., dated o- C~~~~ co ~"' ~ ~ ~ _.~, 'C',C], ij ~ i W TLL `! `~i lVY n cv Pornr c-oz rev. 10.13.06 Page 1 of 5 c-- Estate of Tracy A. McHale , An Incapacitated Person II. SiJMMARY 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? $ 400,000.00 Met Life annuity policy $ 13,043.04 $ 13,043.04 E. What are the balances remaining at the end of the Report Period? 1. Principal $ 400 ~ 000.00 2. Income $ 0-~ 3. Total of Principal and Income $ 400 ~ 000 • ~ 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.): Met Life annuity 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 G02 rev. 10.13.06 Page 2 of 5 Estate of Tracy A. McHale . An Incapacitated Person b. List purpose and amount of expenditures: c. Was Court approval received prior to expending the principal? ...................... ^ Yes ^ 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 If yes: a. Was Court approval requested prior to receiving the additional principal? ................ ^ Yes ^ No b. State the sources and amounts of the additional principal received: B. Income 1. State sources and amounts of income. received during the Report Period (e.g., Social Security, pension, rents, etc.): Annual distribution from Met Life Insurance Company annuity Total income received during Report Period: $ 13,043.04 $ 13,043.04 Farm G-02 rev. !0.13.06 Page 3 of 5 . Estate of Tracy A. McHale , An Incapacitated Person 2. How is income currently invested? (Please specify, e.g., restricted bank accounts, client care account, etc.): client care and savings accounts 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.): see attachment -last page 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.) see attachment -last page 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 ®Yes ©No Form G02 rev. 10.13.06 ®Yes ^ No Page 4 of 5 ,' Estate of Tracy A. McHale , An Incapacitated Person F. Counsel Fee List amounts paid as counsel fee, and indicate whether Court approval was obtained. Amount Yes ~ No Court Approval Obtained 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. § 4904 relative to unsworn falsification to authorities. `„~ n,~?/~~.~~_ Asa Sigrwtun ojGuardian ofthe Estate Form a-02 rev. /0.!3.06 Michael J. McHale/Karin M. McHale Name of Guardian ojthe Estate (type or pant) 218 Woods Drive Addrew Mechanicsburg, PA 17050 City, State, Z!p (717) 766-0351 Telephone Page 5 of 5 Tracy McHale Met Life Annuity January, 2009 1/2/2009 1086.92 check from Met Life -586.92. to Money Management Savings -71.83 cell phone ck 271 1/2/2009 -200.00 rent ck 273 1/2/2009 -150.00 American Funds savings electronic 1/15/2009 -19.99 gym fee electronic 1/15/2009 -58.18 remains in checking 0.00 balance Febrary, 2009 2/1/2009 1086.92 check from Met Life -49.97 VISA ck 274 2/1/2009 -76.44 cell phone ck 275 2/1/2009 -683.00 car insurance (6 mo) ck 276 2/1/2009 -200.00 rent ck 277 2/1/2009 -19.99 gym fee electronic 2/15/2009 -57.52 remains in checking 0.00 balance March, 2009 3/2/2009 1086.92 check from Met Life -486.92 to Money Management Savings -200.00 n3r>t clc 281 3/1/2009 -78.02 cell phone ck 282 3/2/2009 -120.00 CATRA Ck 285 3/7/2009 -150.00 American Funds savings electronic 3/15/2009 -19.99 gym fee electronic 3/15/2009 -31.99 remains in checking 0.00 Balance April, 2009 3/31/2009 1086.92 check from Met life -486.92 to Money Management Savings -41.14 VISA ck 286 3/30/2009 -80.60 Cell phone ck 287 3/30/2009 -200.00 Rent Ck 290 4/20/2009 -120.00 CATRA ck 291 4/20/2009 -150.00 American Funds savings electronic 4/15/2008 -19.99 Gym fee electronic 4/17/2008 11.73 used from checking balance 0.00 Balance May, 2009 4/30/2009 1086.92 -486.92 -200.00 -74.41 -120.00 -10.00 -150.00 -19.99 -25.60 0.00 check from Met Life to Money Management Savings June, 2009 6/1/2009 1086.92 -236.92 -69.13 -270.89 -200.00 -100.00 -150.00 -19.99 -19.99 -20.00 0.00 Rent ck 297 Cell phone ck 298 CATRA ck 299 counseling co-pay dk 300 American Funds savings electronic gym fee electronic remains in checking Balance check from Met Life to Money Management Savings cell phone ck 301 VISA ck 302 rent ck 303 CATRA ck 304 American Funds savings electronic gym fee electronic gym annual fee electronic remains in checking Balance July, 2009 7/1/2009 1086.92 Check from Met Life -101.34 cell phone ck 309 -815.00 car insurance (6 mo) ck 311 -150.00 American Funds savings electronic -19.99 gym electronic -0.59 remains in checking 0.00 balance August, 2009 7/30/2009 1086.92 Check from Met Life -386.92 to Money Management savings -104.11 cell phone dk 313 -200.00 rent dk 314 -87.58 VISA dk 315 -10.00 counseling co-pay ck 317 5/1/2009 5/1/2009 5/2/2009 5/27/2009 5/15/2009 5/15/2009 5/29/2009 6/3/2009 6/3/2009 6/3/2009 6/15/2009 6/15/2009 6/29/2009 7/7/2009 7/15/2009 7/15/2009 7/15/2009 7/29/2009 7/29/2009 8/12/2009 8/12/2009 -150.00 American Funds savings electronic 8/17/2009 -19.99 gym electronic 8/17/2009 -25.32 debit prd -gas electronic 8/29/2009 -84.99 shoes -reimbursement ck 318 8/30/2009 -18.01 remains in checking 0.00 balance September, 2009 $/31/2009 1086.92 Check from Met life -386.92 to regular savings -80.96 cell phone ck 319 8/30/2009 -23.12 VISA ck 320 8/31/2009 -200.00 rent tk 322 8/31/2009 -10.00 counseling co-pay ck 323 9/5/2009 -70.00 counseling co-pay ck 321 9/30/2009 -150.00 American Funds savings electronic 9/15/2009 -19.99 gym electronic 9/20/2009 -145.93 remains in checking 0.00 balance October, 2009 9/30/2009 1086.92 Check from Met life -386.92 to regular savings -100.06 cell phone ck 324 10/1/2009 -285.00 rent/paybackforshoes dk325 10/1/2009 -80.58 VISA dk 326 10/1/2009 -100.00 CATRA ck 327 10/1/2009 -150.00 American Funds savings electronic 10/15/2009 -19.99 gym electronic 10/15/2009 35.63 used from checking balance 0.00 balance November, 2009 11/1/2009 1086.92 check from Met life -386.92 to regular savings -95.07 VISA ck 329 10/30/2009 -83.04 cell phone ck 330 10/30/2009 -35.00 counseling co-pay ck 331 11/4/2009 -200.00 rent ck 332 11/4/2009 -35.00 counseling co-pay ck 333 11/18/2009 -150.00 Ameripn Funds savings electronic 11/15/2009 -19.99 gym electronic 11/15/2009 -81.90 remains in checking 0.00 balance December, 2009 12/1/2009 1086.92 -486.92 -80.38 -115.29 -200.00 -35.00 -150.00 -19.99 0.66 0.00 2009 SiIMMARY check from Met Life to regular savings cell phone VISA rent counseling ce-pay American Funds savings gym used from checking balance balance ck 334 ck 335 dk 336 dk 337 electronic electronic 12/1/2009 12/1/2009 12/1/2009 12/2/2009 12/15/2009 12/17/ZQ09 13043.04 Annual Inaome from Met Life Insurance Company Annuity Annual Expenses -2671.52 to money management savings account -1647.68 to regular savings aaount -1650.00 to American Funds savings -391.70 to checking -1000.32 to cell phone bill -2200.00 to rent -259.87 to gym membership -560.00 to CATRA - horseback therapy -1498.00 to car insurance -205.00 to personal counseling fee -763.64 to VISA bill -25.32 to debit card -gas -169.99 to dothes -13043.04 ~~