HomeMy WebLinkAbout01-25-11 (4)>i
ANNUAL REPORT OF ~ Q a, _T_
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GUARDIAN OF THE PERSON
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COURT OF COMMON PLEAS OF '~1 ,-~-
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CUMBERLAND COUNTY, PENNSYLVANIA ' ry_; `'
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ORPHANS' COURT DIVISION
Estate of ROBERT C. WALLOWER , an Incapacitated Person
No. 21-09-1044
I. INTRODUCTION
Lori I. Wallower wads appointed
Plenary ®Limited Guardian of the Person by Decree of Edgar B Bayley , J.,
dated December 15, 2009
® A. This is the Annual Report for the period from December 15 2009
to October 31 2010 (the "Report Period'');', qr
® B. This is the Final Report for the period from ,
to (the "Report Period"), apd 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 li through IY.
Farm c-o3 rev. ]0.13.06 Page 1 of 4
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Estate of ROBERT C. WALLOWER
II. PERSONAL DATA
Age of the Incapacitated Person: 53
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
1239 Timber View Drive
Mechanicsburg, PA 17055
an Incapacitated Person
Date of Birth: 10/19/15`7
B. The Incapacitated Person's residence is:
®own home /apartment
nursing home
®boarding home /personal care home
~ Guardian's home /apartment
~ hospital or medical facility
® relative's home (name, relationship and address)
®other:
C. The Incapacitated Person has been in the present residence since 200$ ~ ;
. If the Incapacitated Person has mov$d within the
past year, state prior residence and reason(s) for move: I'~
Form G-03 rev. 10.13.06
Page 2 of 4
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Estate of ROBERT C. WALLOWER
an Incapacitated Person
D. Name and address of the Incapacitated Person's primary caregiver:
Himself
IV. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are a5 follows:
Paranoid schizophrenia
Slight heart murmur, leaky heart valve
High triglycerides
B. Specify what, if any, social, medical, psychological and support servicesi tie
Incapacitated Person is receiving:
Appointments every 7 weeks at Holy Spirit Mental Health Dept.
Regulaz appointments with primary Gaze physician, Richazd Davis, M.D'~.
Weekly church, Sunday School and Bible study attendance and visiting ~ home
with his mother, Betty Wallower
V. GUARDIAN'S OPINION
A. It is the opinion of the Guazdian of the Person that the guardianship should:
®continue
^ be modified
^ be terminated
Form G-03 rev. 10.13.06
'...,Page 3 of 4
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Estate of ROBERT C, WALLOWER , an Incapacitated Person
The reasons for the foregoing opinion are: Incapacitated pe~r~bn continues
to need assistance in maintaining his mental, physical and
psycfi~tric health and in making decisions about hs'l~ealth and
safety.
B. During the past year, the Guardian of the Person has visited the Incapa¢i~ated Person
numerous times with the average visit lasting 1 hours, ~, minutes.
Incapacitated person visits with his mother in the'hdme of
Guardian several times a week.
The report of a social service organization employed by the Guardian to' o~e~see and
coordinate the care of the Incapacitated Person for the period covered by this R~epo~t may be
attached to supplement this Report.
I verify that the foregoing information is correct to the best of my knowled~~,
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.
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Date Signature of Guardian of the Person
Lori I. Wallower
Name of Guardian of the Person (type or pri»Y)
12 Natures Crossing
Address
Enola, PA 17025
City, State, Zip
717-329-9103
Telephone
Form G-03 rev. 10.13.06
Page 4 of 4