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Estate of
ANNUAL REPORT OF
GUARDIAN OF THE PERSON
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
LONIE RAY WITMER
No. 21-07-0937
I. INTRODUCTION
Clarence V. Witmer and Betty J. Witmer
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an Incapacit,atE;d Person
was appointed
Plenary Limited Guardian of the Person by Decree of Edward E. Guido -_ ? J ,
dated November 13, 2007
® A. This is the Annual Report for the period from January 1 _ _2010
to December 31 2010 '
(the "Report Period"); or~
B. This is the Final Report for the period from
to (the "Report Period"), and its 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 IV.
Form G-03 rev. 10.13.06 Page 1 of 4
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Estate of
LONIE RAY WITMER
II. PERSONAL DATA
Age of the Incapacitated Person: 55
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
Cumberland Vista
1073 York Road
Dillsburg, PA 17019
an Incapacitated Person
Date of Birth: December 27', 1955
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 September 2006
. If the Incapacitated Person has moved within the
past year, state prior residence and reason(s) for move:
Form G-03 rev. 10.13.06 F'age 2 of 4
Estate of
LONIE RAY WITMER
an Incapacit.atE;d Person
D. Name and address of the Incapacitated Person's primary caregiver:
Clarence and Betty Witmer (through Cumberland Vista)
3 64 Nova Drive
Greencastle, PA 17225
IV. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are as follows:
Lonie Witmer has mental and physical disabilities related to brain damage. F[e is
unable to manage his financial affairs and property. He has limited communication
skills. He is unable to properly care for himself without assistance with personal
hygiene such as bathing, bathroom needs, and personal. grooming.
B. Specify what, if any, social, medical, psychological and support services thE;
Incapacitated Person is receiving:
All services are through his personal care home or are referred by behavioral care
staff.
V. GUARDIAN'S OPINION
A. It is the opinion of the Guardian of the Person that the guardianship should:
~ continue
®be modified
®be terminated
Form G-03 rev. 10.13.06
Pa.ge~ 3 of 4
Estate of
LONIE RAY WITMER
an Incapacit;ate;d Person
The reasons for the foregoing opinion are:
Lonnie Witmer has the mental capacity of a 2 or 3 year old. He had had mental
disabilities since childhood wit no expectations for improvement.
B. During the past year, the Guardian of the Person has visited the Incapacitated Person
~ _ times with the average visit lasting 7 °~ hours, 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 mczy 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.
Date Signature of Cua dian ~ e Person
Betty J. Witmer
Name of Guardian of the Person (type or print)
264 Nova Drive
Address
Greencastle, PA 17225
City, State, Zip
7i7 :~ g 7 0 ~ 3 ~7
Telephone
Form G-03 rev. 10.13.06
Page 4 of 4
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:.~>.A. § 4904
relative to unsworn falsification to authorities.
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Date Signature of Guardian of the Person
Clarence V. Witmer
Name of Guardian of the Person (type or print)
264 Nova Drive
Address
Greencastle, PA 17225
City, State, Zip
7~~- s~7- ~~~3 7
Telephone
Form G-03 rev. 10.13.06