HomeMy WebLinkAbout05-16-11ANNUAL REPORT OF
GUARDIAN OF THE ESTATE
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
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Estate of Georgia D. Johnstone , an Incapacitated Person
No. 21-09-00377
I. INTRODUCTION
Gary J. Muccio ,was appointed
~ Plenary ^ Limited Guardian of the Estate by Decree of J. Wesley Oler, Jr. J,,
dated June 10, 2009
® A. This is the Annual Report for the period from June 10 ~ 2009
to March 31 , 2011 (the "Report Period"); or
B. This is the Final Report for the period from
to (the "Report Period"), and is filed
for the following reason:
I . 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-o1 rev. 10.13.06 Page 1 Of 5
Estate of Georgia D. Johnstone
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 $ 645,481.27
2. Income $
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.):
Orrstown Bank 50+ Checking Account #14600716
Orrstown Bank Money Market Account #146001724
Fidelity Investments Brokerage Account #671-863351
Fidelity Investments Traditional IRA Account #671-921203
An Incapacitated Person
$ 717,670.63
717,670.63
16,564.09
$ 160,520.09
$ 645,481.27
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 G-02 rev. !0.!3.06 Page 2 of 5
Estate of Georgia D. Johnstone , An Incapacitated Person
b. List purpose and amount of expenditures:
Nursing Home Facility
Personal Care/Medical
Health Insurance
Prescriptions
$ 85,934.90
$ 65,513.74
$ 2,479.00
$ 1,445.18
Supplies/Clothing 960.96
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.):
Social Security Benefits $ 9,470.30
Fidelity Investments Brokerage Account $ 6,915.47
Orrstown Bank Money Market Account $ 178.32
Total income received during Report Period:
$ 16,564.09
Form G-02 rev. 10.13.06 Page 3 of 5
Estate of Georgia D. Johnstone , An Incapacitated Person
2. How is income currently invested? (Please
specify, e.g., restricted bank accounts, client
care account, etc.):
Orrstown Bank 50+ Checking Account #14600716
Orrstown Bank Money Market Account #146001724
Fidelity Investments Brokerage Account #671-863351
Fidelity Investments Traditional IRA Account #671-921203
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 Facility $ 85,934.90
Personal Care/Medical 65,513.74
Health Insurance 2,479.00
Prescriptions 1,445.18
Supplies/Clothing 960.96
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.)
E. Guardian's Commissions
List amounts of compensation paid as Guardian's commission
and state how amount was determined:
Amount Method of Determination
Court
Approval Obtained
912.50 Hourly ~ Yes ®No
Yes ^ No
Form G-O2 rev. 10.13.06 Page 4 of 5
Estate of Georgia D. Johnstone , An Incapacitated Person
F. Counsel Fee
List amounts paid as counsel fee, and indicate whether Court approval was obtained.
Amount
Court
Approval Obtained
2,873.81 ~ 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.
~_ ,
Date
`1
Signature Gua ian of the Estate
Gary J. Muccio
Name of Guardian of the Estate (type or print)
6 Derbyshire Drive
Address
Carlisle, PA 17015-9259
City, State, Zip
Telephone
Form e-02 rev. !0.13.06 Page 5 of 5
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ANNUAL REPORT OF ~ -_~'
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GUARDIAN OF THE PERSON ~_~
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COURT OF COMMON PLEAS OF ~ + ~ ~~~
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CUMBERLAND COUNTY, PENNSYLVANIA ` ~'
ORPHANS' COURT DIVISION
Estate of Georgia D. Johnstone , an Incapacitated Person
No. 21-09-00377
I. INTRODUCTION
Gary J. Muccio ,was appointed
~ Plenary Limited Guardian of the Person by Decree of J. Wesley Oler, Jr. J„
dated June 10, 2009
A. This is the Annual Report for the period from June 10 ~ 2009
to March 31 2011 (the "Report Period"); 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 II through II!
Form G03 rev. /0. /3A6 Page 1 Of 4
Estate of Georgia D. Johnstone
II. PERSONAL DATA
Age of the Incapacitated Person: 74
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
The Oaks @ Bethany Village
5225 Wilson Lane, Room #51
Mechanicsburg, PA 17055
B. The [ncapacitated Person's residence is:
an Incapacitated Person
Date of Birth: Apri16, 1937
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 March 22, 2009
If the Incapacitated Person has moved within the
past year, state prior residence and reason(s) for move:
Form G-03 rev. /0.13.06 Page 2 of 4
Estate of Georgia D. Johnstone , an Incapacitated Person
D. Name and address of the Incapacitated Person's primary caregiver:
Gary J. Muccio
6 Derbyshire Drive
Carlisle, PA 17015
IV. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are as follows:
Advanced cognitive dysfunction compatible with primary degenerative process,
likely Alzheimer's disease, history of seizure disorder, hypothyroidism and other
ailments.
B. Specify what, if any, social, medical, psychological and support services the
Incapacitated Person is receiving:
Services provided by the skilled nursing facility and augmented by private duty
nursing care.
V. GUARDIAN'S OPINION
A. It is the opinion of the Guardian of the Person that the guardianship should:
Q continue
be modified
®be terminated
Form G-03 rev. 10.13.06 Page 3 of 4
Estate of Georgia D. Johnstone , an Incapacitated Person
The reasons for the foregoing opinion are:
B. During the past year, the Guardian of the Person has visited the Incapacitated Person
120 times with the average visit lasting hours, 25 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 may be
attached to supplement this Report.
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 unsworn falsification to authorities.
`-mom ~ 3 ~0 I l _ -~,
Date ~ Si tune of G ardia f the Person
Gary J. Muccio
Name of Guardian of the Person (type or print)
6 Derbyshire ~ea~l- ~~-e,
Address
Carilsle, PA 17015
City, Srare, zip
(~c~~ 38s~~os~?
Telephone
Form G-03 rev. 10.13.06 Page 4 of 4