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HomeMy WebLinkAbout06-15-12 (2) ANNUAL REPORT OF ~ z-,.. =~ GUARDIAN OF THE ESTATE ~ =~' Lr ~ COURT OF COMMON PLEAS OF d~ ~=~- o~:- ~ ~' =- CUMBERLAND COUNTY, PENNSYLVANIA ' -z-~ n `~ ORPHANS' COURT DIVISION D ~ ~, Estate of Susan J. Myers , an Incapacitated Person No. 21-10-0220 I. INTRODUCTION Patricia A.M. Havens was appointed ~ Plenary ^ Limited Guardian of the Estate by Decree of J. Wesley Oler, Jr. J dated April 26, 2010 0 A. This is the Annual Report for the period from April 26 2011 to April 26 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 Susan J. Myers 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 $ 65,000.00 $ 68,744.00 $ 25,788.00 $ 24,050.00 E. What are the balances remaining at the end of the Report Period? 1. Principal $ 67,027.00 2. Income $ 1,749.00 3. Total of Principal and Income $ III. ADDITIONAL INFORMATION (If more space is needed, please attach additional pages.) A. Principal I . 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 Automibile 68,776.00 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-O2 rev. ~o.ls.o6 Page 2 of 5 Estate of Susan J. Myers b. List purpose and amount of expenditures: An Incapacitated Person 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 Interest and Dividends Jane C. Myers Trust Total income received during Report Period: $ 12,690.00 $ 1,749.00 11,349.00 $ 25,788.00 Form G-02 rev. 10.13.06 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&TBank-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 - $16,806.00 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 - $7,244.00 E. Guardian's Commissions List amounts of compensation paid as Guardian's commission and state how amount was determined: Amount Method of Determination 0.00 Court Approval Obtained ^ Yes Q No ^ Yes ^ No Form G-02 rev. /0.13.06 Page 4 of 5 Pstate of Susan J. M An Incapacitated Person F. Counsel Fee I_,ist amounts paid as counsel fee, and indicate whether Court approval was obtained. Arnorrnt Court A~~r•oval Obtained 0.00 0 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. ~ X1904 relative to unsworn falsification to authorities. /L / Dale Slguatrrre of Guardian of the Estate Patricia A.M. Havens rVar»e of Grrarr(irnr of fire Eslale (tS7~e or print) 1235 Crestfield Drive Address Williamsport, PA 17701 Cifj~, Slale, Zip (570) 327-9079 (H) Telephone rorrrr G-oa rev. 10.13.06 Page 5 of S ATTACHMENT A Section III (A)(2)(b) -Expenditures Section III (C) -Care and Maintenance Expenditures Utilities 5795 Food 3900 Clothing 1200 Rx 934 Gas 2080 Cleaning 975 Repairs 300 Service 100 LT Care Insurance 1409 Auto Insurance 860 Health Insurance 1644 Medical/Hospital Bills 1200 Car Payment (may - nov) 2495 Part B Medicare 1158 Total Expenditures $ 24,050.00 Expenditures Utilities 5795 Food 3900 Clothing 1200 Rx 934 Cleaning 975 Health Insurance 1644 Medical/Hospital Bills 1200 Part B Medicare 1158 Total Expenditures $ 16,806.00 Section III (D) -Other Expenditures Expenditures Gas 2080 Repairs 300 Service 100 LT Care Insurance 1409 Auto Insurance 860 Car Payment (may - nov) 2495 Total Expenditures $ 7,244.00