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HomeMy WebLinkAbout03-30-10USA FIRST-CLASS ,~ USA FIRST-CLASS I ~ n USA FIRST-CLASS ~ Llc ;„ .. .-- I ;. ~,~ r u !; '~ ~ ,. '~ ~ i ~.'~ r ,. . F c .i: ~~. ,~ ;, tF :,: ,~, f 1 .~ 4~ ;,. ,. ~ ''~s b ~, . , ~'; ~~ t ' ( ~1 ` I i I ~. i y '~ 1 ~ $~ 1 t i` d. "y , ~~ r " if- ?{ ~, •{, t. i i~ } i;.~ i s,' i Y '; ~ ~ i ~, },,~ P'. ~~- _ ~. { ~~ ;~. ~ ~,I ~ _ ~ ~ C1 i.~~O ~~~• ~~ ~~ ~~ ~ l t ~ h'~ hr ~l.:A.~ ,~ .J' ~ ~r C R~~~ r.l I "~~ ~A. J_, 1 '~~v~•~ UP~~.: `~ o ON f ~ y~o~ ~ V~~co Q o LL! g ~ a J .~ c 4 r a o ~ Q Z c~ ,~ " M ~ >- r-i ~ c ~ V .~ - ~ ('7 F- O Z Z I~ t ~ V NN N O ~ 4=on- V A ;~ ~ a~i o0 c~ U LL. ¢ W ~ ~ ~ ~ N W x ~ F- W ~ O = V V V t A~~TNUAL REPORT OF .. _ .. .. ,. . OUAR]DIAN ®~ T]E~E PERSON . CUMBERLAND T OF COMMON PLEAS OF _ COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of -NANCY M . STUCK -------------------- ; an Incapacitated Person c~ ~ Q (`~~ ~ ~ . ~~~ ~ C~;~rn W I. ~ INTROIDUCTION ~ ~~ ~ ~ ° DONALD B'. STUCK-------------~ ---- `~ ~"' _T~'_---- was=~ointed~ .+'~ ~/'' 0 Plenary,~,Limited Guardian of the Person by Decree of . J., -- dated • A. This ' t e _ nu a ort for the eriod from ~l-OI-200~ ,_ . to ,~ _ ;the "Report Penod"); or ~ B. This is the Final Report for the period from to ~ (the "Report Period"), and is filed „ for the following reason: 1. The death of the Incapacitated Person. Date of death: 2. The Guardianship was terminated by the Court by Decree of J., dated For a Final Report, omit Sections ~.~ tl~rougli ~Y Form G-03 rev. 10.13.06 Vr1~ Page 1 of 4 --,- ; ;:_~-, . -~,:.~; r ~ ~ _i L•' ~J~11 _. r J ~~, .S Estate of~~ y ~ ~ ~1n~C ~, ~ ~ ~ ~ ~~ ~ ~ ~~~ ~ ~ ~ ~~ll~ ~ ~~ ~ an Inca aci p fated Person II. FEfl2SONAL ]DATA Age of the Incapacitated Person:_,_„ ~ S Date of B irth:_ ~ ' ~ ~ - d ~ a S III. LN1NG A.RFtANGEM'ENTS .A. Current address of the Incapacitated Person: ~ ~ ~~ ~ ~i o~, ~~ ~V .~ ~ ~ vv~ o ~ ~ B. The Incapacitated Person's residence is: Q own home /apartment nursing home boarding home /personal care home _ .. .. , , , ,.. }~ Guardian's, home /apartment , '.. , ~ . ~ hospital or medical facility 0 relative's home (name, relationship and address) ®other: C. The Incapacitated Person has been in the present residence since ~ V ~ f G~ VV~,a t''~ Z ~ . If the Incapacitated Person has moved within the past year, state prior residence and reason(s) for move: Form G-03 rev. 10.13.06 Page 2 of 4 Estate of .~.. ~ ._ _... ~.~/l.~t~.._ . ~ . - ;.. -" . .- W . _ .. _;-~a.n~Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: rr~U~ ~ t~ D© Co~dw~ us N. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: ~bYl ~ B. Specify what, if any, social;~medical, psychological and support services the Incapacitated Person is receiving: GOES TO .DR . DOM I N I C M I RARCH I, D . 0:., OF INTERN-i STS OF CENTRAL PA lO8 LOWTHER STREET, LEMOYNE, PA 17043, ON REGULAR BASIS.. V. GUARDIAN'S OPII~IION A. It is the opinion of the Guardian of the Person that the guardianship should: . continue be modified be terminated ~~'u-e Form G-03 rev. 10.13.06 .Page 3 of 4 • .. Estate of ~~ C - _:_... __.. ...~..... ._.. - ~ ari IriCapacitated Person., ... ... . The reasons for the foregoing opinion are: B. During the past year, the Guardian of the Person has ;~isited the Incapacitated Person . `~- times with the average visit Ias+ing '-~' hours, minutes. The report of a social service organization employed by the Guardian to oversee and coordinate the care of the Incapacitated Person for the period covered by this Report maybe attached to supplement this Report. DURING WEEK DAYS, NANCY .M. STUCK, STAYS WITH MS. DaNDRA E.•wIRTH AT 1429 RAVEN HILL ROAD, MECHANICS$URG PA 17055 FOR NURSING AND DAY CASE . ~ ~ ~~ ~: ~ - • 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 unsworri falsification to authorities. ~ ~ . ~ ~ ~~ ~ .~ 20' ~. p Date Signarrre of Guardian ofthe Person Name of Guardian ofthe Person (typo orprtntJ a ~'D~aw~~ ~ v ~ I Ad~ess City, State, Zip Telephone Form G-03 rev 10.13.06 ~ Page 4 of 4 ~~ ~e ~a ~r.R Ufa, ~~ ~7~_