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Home My WebLink About06-10-13 _ _ __ _ _ �r� � COURT OF COMMON PLEAS CUMBERLAND COUNTY,PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: CAROLYN KIRK ,AN INCAPACITATED PERSON FILLE NO: 21-07-1121 ANNUAI.REPORT OF THE GUARDIAN OF THE PERSON � 1. INTRODUCTION Pennsylvania Guardianship Association /Brian D. Brooks was appointed the Limited, _ �� Plenary Guardian of the person by Decree of Orphan's Court . Jud�e Dated: 1/17/08 X (A) 'This is the Annual Report for the period from 1/17/08 to 1/17/09 _ (B) This the Final Report for the period from and is fi1ed 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 For Final Report, omit sections II through IV. 2. PERSONAL DATA Age of the incapacitated person 80 Date of Birth 1/26/28 -�.: 3. LIVING ARRANGEMENTS c� w � ,-�''T, A. Current address of the Incapacitated Person: � � G � � WEST SHORE HEALTH, 770 poplar church rd. camp hill,pa 17�Ls �-, � �'? � � Z,. r ►-. �.,.; ;--, r z m o :�: '�=-�' B. T'he Incapacitated Person's residence is: � cn � � ;:, Ward's own home/apartment ° � c� � �" ��; ' X Nursing Home � c - -�� ` � � ;�: ,.;� _ Boarding Home/Personal Caze Home � --3 � � �, _ Guardians Home/Apartment �- a� �' _ Hospital or Medical Facility _ Relative's Home(name,relationship and address) C. The Incapacitated Person has lived here since: 2008 If the Incapacitated Person has moved since the last report, sta.te the prior address and reason for move: hu� _ - _ _ _ �; _ _ _ _ _ ��. . , COURT OF COMMON PLEAS CUMBERLAND COUNTY,PENNSYLVANIA ORPHANS' COURT DIVISION rv IN RE: CAROLYN KIRK ,AN INCAPACITATED PEI�50N W � �'�', o � c, Q FILLE NO: 21-07-1121 rn = c� � G� r� � _,, cc� � y, r r-� r:; ,:� r- arn o �. '� ANNUAL REPORT OF THE GUARDIAN OF THE ES�1� x � `' _� -ra �, 0 � �, � -•:°; � �,.� o !'_ .� �'� 1. INTRODUCTION o � � _ �- ,�-� �._.. -o � � �"� � Pennsylvania Guardianship Association /Brian D. Brooks was ap�'ointed th�' Limited, X Plenary Guardian of the Estate by Decree of Or�han's Court , Jud�e Dated: 1/17/08 X (A} This is the Annual Report for the period from 1/17/08 to 1/17/09 _ (B) This the Final Report for the period from to and is 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 . Jud�e, Dated 2. SiTMMARY A. State the value of the estate reported on the inventory $ 3,130.51 B. State the value(s)of principle assets at the beginning of the Report Period. (Same as the inventory if this is the first report, otherwise, balance from last report) $ 3,130.51 ' C. What is the total amount of income earned during the report period? $ 17,036.88 D. What is the total amount of income and principle spent for a11 purposes during the report period. $ 20,210.27 E. What are the balances remaining at the end of the report period? 1. Principle $ 2. Income $ 3. Total principle and income $— 12.gg ��I _ __ _ . _ _ ��. - - THE ESTATE OF: CAROLYN KIRK 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 2. Have there been any expenditures from principle during this report period? X Yes No If yes: a. Have a11 expenditures from principle been for the sole benefit of the Incapacitated Person? X Yes No b. List the purpose and amount of expenditures: SEE ATTACHED ALL TRANSACTION REPORT. c. Was approval received prior to expending principle? Yes X 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 amou.nts of additional principle received: B. Income 1. State sources of income received during the report period: l. SOCIAL SECURITY 2. SERS PENSION Tota1 income received during report period: $ 17.036.88 2. How is the income currently invested?(Specify) PAGA CUSTODIAL ACCOUNT _ _ ____ . _ _ _ _ �e� _ _ � THE ESTATE OF: CAROLYN KIRK C. Ezpenses for Care and Maintenance: (Specify what expenditures were made from the principle and income for the care and maintenance of the incapacita.ted person) SEE ATTACHED ALL TRANSACTION REPORT D. Other egpenditures (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 $ 1.200.00 12 MONTHS Ca� 100.00 (Yes,� No F. Counsel Fee (List amounts paid as counsel fee, and indicate whether Court approval was obtained.) I verify that the foregaing information is true and correct to the best of my knowledge, informallon and belief; and that this Verification is subject to the penalties in 18 PA. C.S.A. S/S 4904. Date• r an . Brooks Pennsylvania Guardianship Associatioa PO Boz 7295 Lancaster,PA 17604 717-299-4568 _ __ __ _ ___ . .. .._. .— .- -_ . . . _- - �o�� - - ('7 � � N • tn p� � N a p p pppppppo�-p r-�op��p ao •.r �S�AOS��AOe-00�0�-OO�- a-�O�O.-Oe-O�O.-O��OOr�OCD I CMt7 Mp pMC'7 O.-MCMC(h�.-�MMp�p CMC7MC�f-C7t+)�p M �AIV 7 CO�oDO�MCOQ��OMtOWOGOCDChcOCDWOCqOQ�tDO�OMaDCAC�0�0>�� ,) O �-O�CQpe-� f�NCOCO�hN�1�COCD�h�-COa- I�rhr-OOe-I�O��Nh. 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