HomeMy WebLinkAbout06-15-12 (2)ANNUAL REPORT OF
GUARDIAN OF THE ESTATE
COURT OF COMMON PLEAS OF
Cumberland COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
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Estate of Andrew Stern , an Incapacitated Person
No. 21-11-514 OC
L INTRODUCTION
John K. Stern and Paula A. Stern
was appointed
^/ Plenary ^Limited Guardian of the Estate by Decree of Court of Common Pleas J
dated 1 ~ June 2011
0 A. This is the Annual Report for the period from 17 June 2411
to 17 June 2012 (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
Estate of Andrew Stern
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?
An Incapacitated Person
$ 1,124.64
$ 1,124.64
$ 7,149.46
$ 7,339.25
E. What are the balances remaining at the end of the Report
Period?
1. Principal $ 914.11.
2. Income $ 20.74
3. Total of Principal and Income $
III. ADDITIONAL INFORMATION
(If more space is needed please attach additional gages.)
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.):
Not invested. It is in a Rep Payee Checking Account at M & T Bank,
Carlisle, PA Rep Payee Paula A. Stern
934.85
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 S
Estate of Andrew Stern , An Incapacitated Person
b. List purpose and amount of expenditures:
Ilealth and Welfare $ 3,400.00
Food and Entertainment $ 3,200.00
Clothes and Personal Items $ 566.00
Attorney Fee $ 1'73.25
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
I. State sources and amounts of income received
during the Report Period (e.~., Social Security,
pension, rents, etc.):
PA SSI DPW Supplement $ 306.22
Wages from Knisely's Pet and Farm ~ 904.22
SSI $ 5,938.88
Total income received during Report Period: $ 7,149.32
F~,-,~ c-oz ~-~,~. ~o.~~.06 Page 3 of 5
Estate of Andrew Stern , An Incapacitated Person
2. How is income currently invested? (Please
specify, e.g., restricted bank accounts, client
care account, etc.):
Not invested. Income from SSI and PA DPW goes into a Rep Payee
Checking Acct at M & T Bank in Carlisle, PA.
His wages from Knisely's Pet and Farm either are cashed and used by
Andrew Stern or are deposited in a joint checking acct Andrew Stern has
full access.
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.):
Health insurance, copays, food, clothing and personal items.
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.)
Entertainment- going to air shows, movies, gym membership, concerts, museums,
bowling, sporting events, community events and vacations.
E. Guardian's Commissions
List amounts of compensation paid as Guardian's commission
and state how amount was determined:
Amount Method of Detef~nination
0.00
0.00
Court
Approval Obtained
^Yes /^No
^Yes ^/ No
corm c-oz rev. ~0.~3.06 Page 4 of 5
1/stat .: ~~ _ _._ _. `_` _ -_ _ __._ _____ , An Incapacitated Person
_ _ _~uy~sel fee, and indicate whether Court approval was obtained.
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Corrr•t
Appto~~al Obtained
173.25 ~/ Yes ^ No
Q Yes ^ No
1 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 unswoi~ falsification to authorities.
_ _ ~'
l~ai e Signature of Co-Guardian of the Estate
Paula A. Stern
984 Mount Rock Road
Carlisle, PA 17015
(717) 440-6163
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Date Signcr ure o{ Ca- rm-dian o{the Estate
1 K. Stem
984 Mount Rock Road
Carlisle_ PA 1701 ~
(717) 440-6163
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