HomeMy WebLinkAbout05-13-13 (2) COURT OF COMMON PLEAS CUMBERLAND COUNTY,PENNSYLVANIA
ORPHANS' COURT DIVISION
IN RE: ELI PETROVICH ,AN INCAPACITATED PERSON
FILLE NO: 21-07-1027
ANNUAL REPORT OF THE GUARDIAN OF THE ESTATE
L INTRODUCTION
Pennsylvania Guardianship Association /Brian'D. Brooks was appointed the
Limited, X Plenary Guardian of the Estate by Decree of
Orphan's Court Judge Dated: 12/20/08
X (A) This is the Annual Report for the period from 12/20/11 to 12/20/12
(B) This the Final Report for the period from to
and is Sled 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
. Jud e. Dated
2. SUMMARY
A. State the value of the estate reported on the inventory "8387.70
B. State the value(s)of principle assets at the beginning of the Re�eriod.` r'rl
(Same as the inventory if this is the first report, otherwise,balance iom Ifflt rebrt)�.;
$ 1,938.78
C. What is the total amount of income earned during the report peAbd- o m -°n °
$41,82718 o n Za — 'T
� c C1
� m
D. What is the total amount of income and principle spent for all purposes dt&g tife
report period.
$ 39,867.41
E. What are the balances remaining at the end of the report period?
1. Principle $
2. Income $
3. Total principle and income $ 3,898.65
THE ESTATE OF: ELI PETROVICH
3. ADDITIONAL INFORMATION
(If more space is needed,please attach additional pages.)
A. Principle
1. How is the principle balance listed above currently invested? (Specify)
PAGA CUSTODIAL ACCOUNT/RESIDENT ACCOUNT AT FACILITY
2. Have there been any expenditures from principle during this report period?
E Yes X No
If yes:
a. Have al all expenditures from principle been for the sole benefit of the
Incapacitated Person? Yes _ No
b. List the purpose and amount of expenditures:
SEE ATTACHED ALL TRANSACTION REPORT.
c. Was approval received prior to expending principle?
Yes No
3. Were additional principle assets received during this report period that were not
included in the inventory or any prior report filed for the estate?
Yes X No
If yes:
a. Was court approval requested prior to receiving additional principle?
Yes No
b. State the sources and amounts of additional principle received:
B. Income
1. State sources of income received during the report period:
1. VA PENSION
2. SOCIAL SECURITY
3. INTEREST
4. GIFT
Total income received during report period: $41,827.28
2. How is the income currently invested? (Specify)
PAGA CUSTODIAL ACCOUNT t RESIDENT ACCOUNT AT FACILITY
• THE ESTATE OF: ELI PETROVICH
C. Expenses for Care and Maintenance:
(Specify what expenditures were made from the principle and income for the care and
maintenance of the incapacitated person)
SEE ATTACHED ALL TRANSACTION REPORT
D. Other expenditures (Specify any other expenditures not previously reported)
E. Guardians Commissions
(List the amounts of compensation paid as guardian's commission and state how amount
was determined:)
Amount Method of Determination Court Approval Obtained
$ 1200.00 12 tai 100.00
(YesL No
F. Counsel Fee
(List amounts paid as counsel fee, and indicate whether Court approval was obtained.)
I verify that the foregoing information is true and correct to the best of my knowledge,
information and belief; and that this Verification is subject to the penalties in 18 PA.C.S.A.
SIS 4904.
Date:
ran . Brooks
Pennsylvania Guardianship Association
PO Box 7295
Lancaster,PA 17604
717-299-4568
CLAREMONT NURSING & REHAB CTR
1000 CLAREMONT ROAD
CARLISLE, PA 17013-8805
(717) 243-2031
01/16/2013
Trust Fund
ELI PETROVICH C � 9813 3giOa �
a7�a9X ( a
BRIAN BROOKS.
PO Box 7295 ulna
LANCASTER, PA 17604 � Q�e
C�]
10/ 1/12 To 12/31/12
------------ ------------------------------------------------------------------------------------------
Date Memo Withdrawal Dep sits Balance
------------4--------------------`-------------------------------------------- ------------------------
10/01/12 Balance Forward 630 . 43 650. 43
10/03/12 OCT SS 710 . 00 1,360. 43
10/09/12 PA GUARDIAN/FEE (43462) 100. 00 1, 260 . 43
10/-15/12 OCT NET TNC 'DUE/43'.470 31238 . 00 - 1, 977 . 57-
10/15/12 OCT VA 2, 69. 00 791 . 43
10/29/12 CABLE FOR" OCT/43526 8 .00 783 . 43
10/31/12 interest for recon 10/31/2012 0 . 04 783. 47
11/06/12 NOV SS 10 . 00 1, 493. 47
11/06/12 PA GUARDIAN/FEE (43570) 100. 00 1, 393 . 47
11/07/12 NOV VA 2, 69. 00 4, 162 . 47
11/13/12 NOV CABLE%43584 8 . 00 4, 154 . 47
11/15/12 NOV NET INC DUE/43585 3, 238 . 00 916. 47
11/30/12 NOV NET INC DUE/43632 96.00 820. 47
11/30/12 interest for recon 11/30/2012 0.08 820 . 55
12/01/12 AMER.LEGION #109 VETERAN GIFT 78 . 66 899. 21
12/03/12 DEC SS 10 . 00 1, 609 . 21
12/04/12 DEC VA 2, 769 .00 4, 378 . 21 '
12/07/12 PA GUAR J.AN FEE/43654 100.00 4, 278 . 21
12%13%12 DEC NET INC DUE/43669 3, 334 . 00 944 .21
12/26/12 DEC CABLE/43720 8 . 00 936.21
12/31/12 interest for recon 12/31/2012 0. 07 936.28
-------------------------------------------------------------- ----------------------------------------
Ending Balance 936.28
CLAREMONT NURSING & REHAB CTR
1000 CLAREMONT ROAD . -
CARLI9LE, PA 17013-8805
(717) 243-2031
10/08/2012
rw Trust Fund
=PETROVICH � 48 13
BRIAN BROOKS
PO Box 7295
LANCASTER, PA 17604
07/01/12 To 09/30/12
4---------------------------- - ---°_----------------------------------------------------------------
Date Memo Withdrawal __ _
Deposits Balance _
-------------------------------------------------------------------------------------------------------
07/01/12 Balance Forward ' 251. 27 251 . 27
07/03/12 JUL VA 2, 769.00 3, 020.27
' 07/04/12 JUL SS 710.00 3, 730 .27
07/06/12 PA GUARDIAN FEE/43208 100 . 00 3, 630 . 27
07/17/12 JUL NET INC DUE/43220 3, 238 . 00 392 . 27
07/27/12 JULY CABLE (43248) .8 . 00 384 .27
07/31/12 interest for recon 07/31/2012 - 0 . 06 384 . 33
08/08/12 PA GUARDIAN/FEE (43287) 100. 00 284 . 33
08/13/12 AUG SS 710 .00 994 .33
08/13/12 AUG VA 2, 769 .00 3, 763.33
08/14/12 AUG NET INC DUE/43299 3, 238 . 00 525 . 33
08/20/12 CABLE/AUG (43335) 8 . 00 517 . 33
08/31/12 interest for recon 08/31/2012 0 . 03 517 . 36
09/01/12 SEP VA 2, 769. 00 3, 286.36
09/03/12 SEP SS 710. 00 3, 996. 36
09/07/12 PA GUARDIAN FEE/43367 100 . 00 3, 896. 36
09/13/12 SEP INC DUE/43377 3, 238 .00 • 658 . 36
09/21/12 CABLE SEP/43419 8 . 00 650 . 36
09/30/12 interest for recon 09/30/2012 0 .07 650 . 43
----------------------------------------------------------------=--------------------------------------
Ending Balance 650. 43
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CLAREMONT NURSING 6 REHAB CTR W.
1000 CLAREMONT ROAD
CARLISLE, PA 17013-8805
(717) 243-2031
04/16/2012
Trust Fund
ELI PETROVICH ( 4813
BRIAN BROOKS
PO Box 7295
LANCASTER, PA 17604
01/01/12 To 03/31/12
Date Memo Withdrawal Deposits Balance
----------------------------------------------
--------------------------
01t01/12 Balance Forward , 452.55 2, 452 . 55
01/09/12 PA GUARDIAN FEE/42620 100. 00 ' 2, 352 . 55
01/10/12 JAN SS INCOME 710. 00 3, 062 . 55
01/11/12 JAN VA 21769.00 5, 831 . 55
91/15/12 JAN INC DUE/42633 3, 213. 00 . 2, 618 . 55
01/24/12 JAN TV CABLE (42670) 8 . 00 2, 610 . 55
01/31/12 JAN INC DUE CNRC (42678) 25. 00 2, 585.55
01/31/12 interest for recon 01/31/2012 0. 10 2, 585. 65
02/08/12 FEB VA INC 2, 769 . 00 5, 354 . 65
02110112 FEB SS INCOME/2-3 710 . 00 6, 064 . 65
02/14/12 PA GUARDIAN FEE/42716 100. 00 5, 964 . 65
02/15/12 FEB NET INC DUE (42726) 3, 238 . 00 2, 726. 65
02/17/12 CABLE FOR FEB (42751) 8 . 00 2, 718 . 65
02/29/12 interest for recon 02/29/2012 0. 13 2, 718 . 78
-03/06/12 PA GUARDIAN/FEE (42811) 100. 00 2,618 . 78
03/09/12 MAR VA ---- _ —+2, 769. 00 " - 5, 387 . 78
03/12/12 MAR SS CHECK 710 . 00 6, 097 . 78
03/15/12 NET MAR INC DUE (42851) 3, 238 . 00 2, 859. 78
03/22/12 CABLE (42871) 8 . 00 2, 851 . 78
03/31/12 interest for recon 03/31/2012 0. 15 2,.851.93
---------------------------------------------------------------------------------
Ending Balance 2, 851 . 93
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