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HomeMy WebLinkAbout01-05-11s1-Uc~., Na~. . ANIV~JAI~ REPORT OF .. ~ . GUARDIAN OF TbIE PERSON COURT OF COMMON PLEAS OF .CUMBERLAND COUNTY, PENNSYLVANIA • ORPHANS' COURT DIVISION n ~.~ ~~ .T., ~ x cry o~o "dry •'~"'~ .. Estate of NANCY M . $TUCK _ an Incapacitated Person No. 21 (~t~-11. D 7 L INTRODUCTION DONALD ~ . $T.UCK . ... .was a~p~ointed QPlenary~,Limited Guardian of the Person by Decree of J,, .dated • A. This is the Annnal Repart for the eriod from . ®I - ©~ - G C~~ ~ Q to _L.~ - ~ 1 ~ 2-O C ~ ;the "Report Period"); or T - © l3. This is the Final Report for the period from ~ (the "Report Period"), and i5 ifiled for the following reason: 1. The death of the Incapacitated Person. Date of death: 2. The Guardianship was terminated by the Court by Decree of J., dated For a Final Report, omit Sections II Through IV. :~; ; ~~-c ,-~ =~ ~.~ .- - i ~.~ . "P'? ~7 ~~ -,~ ~~„ G03 rev. 10.13.06 P~gp 1 of 4 .. ~_ ....estate of Q111~C . .. C .. y . , ~. an Incapacitated Person II. PERSONAL DATA Age of the Incapacitated Person: ~~ '~SDate of Birth: ~ ' a"~i * i~ a S III. LIVING ARRANGE1WiENTS .A. Current address of the Incapacitated Person: 11 as ~'..a~ own bus HIV ~e ~ t L,,~Nn~f~Vl~ ~ca 1~ DG~3 V B. The Incapacitated Person's residence is: ~ own home /apartment Q nursing home boarding home /personal care home '~Cruardian's home /apartment ,',,...:. ~ hospital or medical facility ®relative's home (name, relationship and address} (~ other: C. The In acitated Perso~ has been in the present residence since ~ V ~ C'Y ~P 2 C7 Q "7 . ff the Incapacitated Person has moved within) tine past pear, state prior residence and reason(s) for move: Foy X03 n-: ~o.i3.o6 Page ~ of 4 . ~ ~ CC3 ... lstate of .._.. .._ - p ......_ _. - ~-- -- .~3 ~ - u-C - .~. - .. _ an~Inca acitated~ Person D. Name and address of the Incapacitated Person's primary caregiver: . ~ a v~c~1 c~ ~ . S~'u e ~L ~~ 11 O © Col d v,n 6us ~ v Q ~ I ~ ~ ,nom ~o~ (~ o ~F ~ ~~ . IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as fb~lows: ~OV1 ~ B. Specify what, if any, social;~medical, psychological and support services th$ Incapacitated Person is receiving: GOES TO DR. DOMINIC MIRARCHI, D.O.:t=OF INTERNI~TS'gF.CENTRAL PA IOH LOWTHER STREET, LEMOYNE, PA 17043, ON REGULAR I#ASIS. V. GUARDIAN'S OPINION A. It is the opinion of the Guardian of the Person that the guardianship should: continue ®be modified ~ be terminated Forne Goa m. X0.13.06 Pale 3 of 4 ~, , . . . .. . ... .. Estate of ~ C " --- _ ~ _ . _ an Irioapaeitated Person., ~ . The reasons for the foregoing opinion are: B. During the past year, the Guardian of the Person has ,visited the Incapacitateed Person '~' times with the average visit lasing '-~-' hours, _~~ minutes. . N~A 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 nngry be attached to supplement this Report. - NANCY M.- STUCK STAYED WITH COUINTRY. MEADOW, HERSHEY, PENNSYLVANIA, AND WITH HER SON,. DONALD B., STUCK AT -1100 COLOMBUS AvEy APT # 1, LEMQ'Y~~ fy ~ going 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.~.~1. § 4904 relative to unsworn falsification to authorities. 1~ S7(gnadtrs of Grrar~m- oftlx Perso„ ~~O UlQ l r~ ~ _ ~~ tl rr ~< ~1C ~p~7 ~51~ Eoo~a fir., F,~,y, pA j ~~:~ Form G03 rev 10.13.06 Nams ofGumd(an gft/uPsrfon (type orprintJ II©o ~'olaw~~s ~ve ~I ~ ,, ~-~r~ D ~at . ( p Chy, Stan, lip 73 ~--- a ~ 3~ Ta/epJtone Pale, 4 of 4