HomeMy WebLinkAbout06-17-13 _ _ _ _ .,�� -
ANI�UAL REPORT OF
GUARDIAN OF THE ESTATE
COURT OF COMMON PLEAS OF
C�mberland COUNTY, PENNSYLVAIVIA
ORPHANS' COURT DMSION
Estate of ��'ew M. Stern '��capaci�ed P�rsmr� '
�o_ 21-11-514 OC m � � � o
� x c-� --- cn �.,
b� I-- .—? �s
� � m N"' rTE r:-;
Z Cn � `� � C7
C7 n �` q La
O � -r^; '�'7
C7 O -E., „�
O C
I. aVTRODUCTION � � --c r�� m '
John K. Stem �' '"'' � Q
�appoi�'ted
mPlenary �Limited Guazdian of the Estate by Decree of C��of Common Pleas J
,
dated
� A. This is the Annual Report for the period from 17 June 2p12
to 17 7une 2013 (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 deat�of the Incapacitated Persoa Date of death:
Name of Personal Representative:
2. The Guazdianship was terminated by the Court by Decree of
J.,dated
Form G-01 rev.10.13.06 Y�e 1 Of 5
��IJ�/
_ __ _ ___ ��
Estate of A�'�M• S� _An Incapacitated Person
II. SUMMARY '
A. State the value of the esta#e reported on the Inventory $ 934.85
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.) $ 934.85 '
C. What is the total amount of income eamed during tfie ',
Report Period? $ 6,223.31 '
D. What is the total amount of income and principal '
spent for all purposes during the Report Period? $ 6,843.34 ',
E. What aze t�e balances remaining at the end of the Report � '
Period? '
1. Principal � 271.95 ',
2. Income � 42.87
3. Total of Principal and Income $ 314.82 '
III. ADDITIONAL INFORMAI'ION
(If more space is needec�please attach additiorral parges.) ',
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 Direct Checking Account at M& T Bank, ',
Carlisle,PA Rep Payee Paula A 5tern for Andrew M Stem and a Joint Free '
Checking at M&T Bank, Carlisle,PA Joint Acct Holders Paula A Stern and
Andrew M Stern. '
2. Have there been any e�cpenditures from ti�e principal
during the Report Period? . . . . . . . . . . . . . . . . . . . . . . . . . . . . �Yes �No '
�y�:
a. Have all expenditures from the principal been for
the sole benefit of�e Incapacitated Person? . . . . . . . . m Yes �No
Form G-02 rev.10.13.06 P3�e 2 Of 5
_ __ ___ i�.
--
_ _
_ r�n� __
Estate of ���M• S� _An Incapacitated Person
b. List purpose and amount of expenditures:
Health and Welfare $ 3,400.00
Food and Entertainment $ 3,200.00
Clothes and Personal Items $ 243.34 '
$
c. Was Court approval received prior to
expending the principal? . . . . . . . . . . . . . . . . . . . . . . . ❑Yes m No
3. Were additional principal assets received during the
Report Period which were not included in t�e
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 sowces and amounts of income received
during the Report Period(e.g., Social Security,
pension, rents,etc_):
SSI $ 5,624.08
PA SSI DPW Supplement $ 306.36
Wages from Knisley's Pet and Farm a 292_g�
$
�
�
Total income received during R�ort Period: $ 6,223.31
Form G-01 rev.10.13.06 Page 3 of 5
___ — _ — — —_ __ _ . - L��
__ _
_ . _ _ _ _ . r��
Estate of Andrew M. Stern _An Incapacitated Person
2. How is income currently invested? (Please '
specify, e.g.,restricted bank accounts, clie.nt '
care account, etc.):
Not invested. It is in a Rep Payee Direct Checking Account at M&T '
Bank, Carlisle,PA Rep Payee Paula A Stern for Andrew M Stern and a '
Joint Free Checking at M&T Bank,Carlisle,PA Joint Acct Holders Paula '
A Stem and Andrew M Stera '
C. Ezpenses 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,nutritional supplements,specialized diet food-gluten '
free and casein free, clothing,and personal items.
D. Other Eapenditures ',
Specify what other e�enditures were made during the Report '
Period. (Do not include any items sta#ed in response to '
question C above.) ',
Entertainment-going to air shows,movies,gym memberslups, eateries,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: '
Court
Amount Method of Deterneirurtion Approval Obtained '
0.00
❑Yes mNo
0.00 ❑Yes m No
Form G-01 rev.10.13.06 P�e 4 Of 5 ,
. __
_ _ _ . . _ _ _ _ _ _ I�. __
__ _ r��
Estate of ����• �� An Incapacitated Person
F. CQUnsel Fee
List amounts paid as counsel fee, and inciicate whether Court approvai was obtained.
Court
Arr�ount Approval Obtained
❑Yes ❑No
�Yes ❑No
I verify that the foregging informativn is correct to the best of my lrnowledge,
information and belief; and that this Verificatian is subject to the penalties of 18 Pa.C.S. §4904
relative to unswom falsification ta authorities.
1
--,
��^�:�. �
f�f �f` � ��3 � � �����
Dcrte Signati�re ojCo-Guardian ofthe E'stare '
Paula A. Stern
984 Mount Rock Rvad
Carlisle, PA 17015 ',
(717}440-6163
,
�
15F c� uN1rr 2U(� _
Date Sig�ature of Co Guardicue of the Estnte
K. Stern
984 Mount Rock Road
Carlisle. PA 17015
(717) 440-6163
F'orni G-07 rer.IQ.1�.lJ(5 P�e `J Of 5
- - _ __ _ �_�. —