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HomeMy WebLinkAbout04-14-11 (2) ANNUAL. REPORT OF GUARDIAN OF THE ESTATE ~, n ~.. ° n. COURT OF COMMON PLEAS OF rri~n ~ Cumberland COUNTY, PENNSYLVANIA ~~~ ~ ORPHANS' COURTDIVTSIONc~~~~ Estate of Elizabeth M. Gardosik O~o ='s • ~ an Incapacitated Person°' No. 21 08 0224 I. WTRODUCTION Sandra M. Gazdosik and Andrew T. Gazdosik ,was appointed m Plenary ^ Limited Guardian of the Estate by Decree of J. Wesley Oler, Jr. , J., dated April 16, 2008 ® A. This is the Annual Report for the period from Anril 16. 2010 to Aoril 16. 2011 (the "Report Period"); or ^ B. This is the Final Report for the period from to for the following reason: (the "Report Period"), and is filed 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 Form G-01 rev. 10.!3.06 Page 1 of 5 ~; ~--~ ~~ ~> n "U ~--, ,=j ;...~ -r, -_~ ~= c=>, cn p 'Ti Estate of Elizabeth M. Gardosik II. SUMMARY 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? E. What are the balances remaining at the end of the Report Period? 1. Principal $ 230,933 2. Income $ 55.000.00 3. Total of Principal and Income 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.): Fixed Annuity Brokerage Account Bank accounts /Checking and Savings Real Estate An Incapacitated Person $ 366,212 $ 295.430 $ n.o4a $ 59,497 235,933 $ '~" 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 0 No Form G-07 rev. /0.13.06 Page 2 of 5 Estate of Elizabeth M. Gardosik b. List purpose and amount of expenditures: Assisted Living (monrhlyfeec) Compensation to Dave Gardosikfor 24 hour care of Elizabeth. An Incapacitated Person $ 43.889 $ $ 12,000 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 O 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.): Social Sea~riN $ 12,888 Pantinn (R~rp $ 51.556.00 Intrest on annuity $ 5,2,nnn nn Pro^r~/ Tax RaharP $ ~~nn $ $ Total income received during Report Period: $ 17,044 ~-~:&e'~ Form c-oa .n•. ro.~ao6 Page 3 of 5 Estate of Elizabeth M. Gardosik _, An Incapacitated Person 2. How is income currently invested? (Please specify, e.g., restricted bank accounts, client care account, etc.): Income is currently deposited into a checking account. 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 (assisted living ), clothing, medicine, dental, Handycap accesories, medical insurance, and co-pay for medical appointments. D. Other Ezpenditures Specify what other expenditures were made during the Report Period. (Do not include any items stated in response to question C above.) Taxes, utilities, home repair, home insurance, life insurance, personal hygene, post-office box fees, stamps. 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 50.00 ^Yes ^No ^Yes ^ No F~ c-oa m. /0.!3.06 Page 4 of 5 ,~ Estate of Elizabeth M. Gardosik An Incapacitated Person F. Counsel Fee List amounts paid as counsel fee, and indicate whether Court approval was obtained. Amount Court Approval Obtained ^ 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. § 4904 relative to unsworn falsification to authorities. n vzot t ~, .~..~ Dale Slgtrsttvrs ojGuardlan ojthe Estate ~/ ~ ~t~~~ $Pj Marboj ROao( ~,1,.-~.x, P,r r~v3z Sandra M. Gardosik Name ojGrardian ojthe Estate (type or print) 3030 North 3rd Street Address Harrisburg, PA 17110 City, State, Z!p 717-236-2056 Tdephom 7t7 - J'~io-S7.2G Form G-02 rev. /0. /3.06 Page 5 of 5