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HomeMy WebLinkAbout06-14-11 (2)ANNUAL REPORT OF ~~ "-~= ~~ GUARDIAN OF THE ESTATE ~~? ~ f~i ~ `,~/ ~ _` t ? c ~ v~ ~ ~- , , ;.. ~ one ,~ ~`~ COURT OF COMMON PLEAS OF ©~-'' ~ - -= '~> CUMBERLAND COUNTY, PENNSYLVANIA '~~ ~ ~,~ ORPHANS' COURT DIVISION ~,_ Estate of Susan J. Myers , an Incapacitated Person No. 21-10-0220 I. INTRODUCTION Patricia A.M. Havens ,was appointed 0 Plenary 0 Limited Guardian of the Estate by Decree of J. Wesley Oler, Jr. J. dated Apri126, 2010 ® A. This is the Annual Report for the period from Apri126 ~ 2010 to Apri126 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: Name of Personal Representative: 2. The Guardianship was terminated by the Court by Decree of J., dated Form G-02 rev. 10.13.06 Page 1 of 5 l^L Estate of Susan J. Myers , An Incapacitated Person II. SUMMARY A. State the value of the estate reported on the Inventory $ 65,000.00 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.) $ 65,000.00 C. What is the total amount of income earned during the Report Period? $ 27,467.00 D. What is the total amount of income and principal spent for all purposes during the Report Period? $ 26,447.00 E. What are the balances remaining at the end of the Report Period? 1. Principal $ 68,744.00 2. Income $ 1,020.00 3. Total of Principal and Income $ 69,764.00 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.): Personal restricted checking account Personal checking account Insurance policies Automobile 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. 10.13.06 Page 2 of 5 Estate of Susan J. Myers , An Incapacitated Person b. List purpose and amount of expenditures: 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: George M. Myers Trust final distribution $ 3,744.00 B. Income 1. State sources and amounts of income received during the Report Period (e.g., Social Security, pension, rents, etc.): Social Security Interest and Dividends George M. Myers Trust Total income received during Report Period: $ 11,532.00 $ 8,135.00 7,800.00 $ 27,467.00 Form G-02 rev. I0.13.06 Page 3 of 5 Estate of Susan J. Myers , An Incapacitated Person 2. How is income currently invested? (Please specify, e.g., restricted bank accounts, client care account, etc.): Social Security Representative Payee Checking Account with PSECU-Restricted Susan Myers Guardian Checking Account with PSECU-Limited Guardian Account with M&T Bank-Limited 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.): See Attachment A - $16,519.00 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.) See Attachment A - $9,928.00 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 0.00 ^ Yes Q No ^ Yes ^ No Form e-Ol rev. /0./3.06 Page 4 of 5 Estate of Susan J. Myers , An Incapacitated Person F. Counsel Fee List amounts paid as counsel fee, and indicate whether Court approval was obtained. Amount Court Approval Obtained 0.00 ~ 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 Signature of Guardian of the Estate ~~r, _~ ~ f~, i'~- ~~to~ s Name ojGuardian of the Estate (type or print) /a-3 S ~~es~~~ld ~~~~~~ Address f< /~~ ,ran S~U~ GG'r~ ! 7 7 ~ i City, Stare, Zip S~7U-3~-7- Q1~7~ ~~~ Telephone Farm c-oz rev. !0.13.06 Page 5 of 5 ATTACHMENT A Susan S. Myers Annual Report of Guardian Estate - 2011 Section Ili (Aj{2){b) -Expenditures Expenditures Annual Utliitles 6036 Food 3640 Clothing 2400 Rx 1200 Gas 2080 Cleaning 1050 Repairs 800 Service 500 ET Carelnsurance 1200 Autolnsurance 860 Health Insurance 1656 Medical/Hospital Bills 537 Car Payment 4488 Total Expenditures ~ 26447 fix enditures Annual $ Section III (C)• Care and Maintenance utilities 6036 Food 3640 Clothing 2400 Rx 1200 Cleaning 1050 Health lnsurance 1656 Medical/Hospital Bills 537 Tota! Expenditures t 16519 Section ill (D)• Other Expenditures