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RECQ;°:`,�v �i�,'"l+,L t7�'
ANNUAL REPORT QF ft��,� ;e�, �� _ ?�`�
GUARDIAN OF THE PERSON ,;,,;3 (`�flY 7 �i!'1 3 27
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COURTOFCi7MMONPLEASCIF O�F��'��� �����f��
CUMSERLAND COLTNTY, PENNSYLVA�A$ERlAN�? i,C., ;'A:
ORPHANS' COURT I)TVISION
Estate of Georgia D. Jahnstone , an Incapacitated Person
��y. 21-U9-04377
I. INTRODUCTI4AI
Gary J. Muccia ,was appointed
m Plenary�Limited Guardian of the Person by Decrea of J• �'esley Oler, 7r. J.
dated 7une ]0 2009
� A. This is the Annual Report for the period from April 1 2012
to March 31 , 2013 (the "Report Period"),or
� B. This is the Final Report far the period fcom ,
to , {the "Report Period"}, and is filed
for the following reasan:
1. The death of the Incapacitated Person. Date of death:
2. The Guardianship was terminated by the Court by Decree of
3., dated
For u Final Repart, orreit Sectirtns II through IT!
Fo.m o.03 rev. 10/3.06 Page 1 of 4
�
t
Estate of Georgia D. Johnstone , an Incapacitated Person
II. PERSONAL DATA
Age of the Incapacitated Person: �6 Date of Birth: Apri16, 1937
III. LIVING ARRANGEMENTS
A. Cunent address of the Incapacitated Person:
The Oaks @ Bethany Village
5225 Wilson Lane, Room#51
Mechanicsburg, PA 17055
B. The Incapacitated Person's residence is:
0 own home/apartment
�nursing home
❑boarding home /personal caze home
�Guardian's home/apartment
�hospital or medical facility
�relative's home (name, relationship and address)
0 other:
C. The Incapacitated Person has been in the present residence since March 22, 2009
. If the Incapacitated Person has moved within the
past yeaz, state prior residence and reason(s) for move:
Form G-03 rev. 70.13.06 Page 2 of 4
�
Estate af Georgia D. 7olmstone , an Incapacitated Person
D. Name and address af the Incapacitated Person's prirnary caregiver:
Gary J. Mnecio
6 Derbyshire Drive
Carlisle,PA 17Q15
IV. MEDICAL INFORMATION
A. The major medical or mental problems of tha Incapacitated Person are as fallows:
Advanced cognitive dysfunotion compatible with prirnary degenerative process,
likely Alzheimer's disease, history of seizure disorder,hypothyroidisrn and other
ailments.
B. Specify what, if any, social,medical,psychalogical and support serviees the
Incapacitated Person is receiving:
5ervices provided by the skilied nursing facility and augmented by private duty
nursing care.
V. GUARAIAN'S OPINION
A. It is the opinion of the Guardian of the Person that the guazdianship should:
m continue
�be rnodified
�be tettninated
FarmG-03 rev. 70./9.06 PB.gB 3 of 4
�
Estata af Georgia D. Johnstane
, an Incapacitated Person
The reasons for the foregoing opinion are:
The condition of the incapacitated person has not(and will not) improve.
B. During the past year, the C3uardian of the Person has aisi#ed the Incapacitated Persan
120 times with the average visiY lasting hours, 25 rninutes.
The report of a social service organization empCoyed by the Guardian to uversee and
coordinate the care af the Incapacitated Persan for the period covered b,y this Report may be
attaehed to suxrptement this Report.
I verify that the faregoing informatian is conect to the best of my knawiedge,
inforrnation and belief; and that this Verification is subject to the penalties of 18 Pa. C.S.A. § 4904
relative to unsworn £aleification to authorities.
51�� t � �c�.,� �`�.� ��
Date �� Srgnature of qrdi jlhe Person
Gary J. Muccio
Name of Guardian nf the Persan(type or prm7J
b Derbyshire Drive
Address
Carilsle,PA 17415
aty,srnre.zrp
717.385.Q507
Tetephone
Form G-03 rev. 10,13.06 p'd�+e 4 O�4