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ANNUAL REPORT OF
GUARDIAN OF THE PERSON
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COURT OF COMMON PLEAS OF rn T _
Cumberland COUNTY, PENNSYLVANIAN ' cn
ORPHANS' COURT DIVISION _, c
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Estate of Derick W. Bobb an Incapacitated Person
No. 21-11-608
I. INTRODUCTION
David W. and Tammy J. Bobb was appointed
0 Plenary OLimited Guardian of the Person by Decree of J. Wesley Oler, Jr. J,
dated July 18, 2011
A. This is the Annual Report for the period from August 1 2012
to July 31 2013 (the "Report Period"); or
rl 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:
2. The Guardianship was terminated by the Court by Decree of
J., dated
For a Final Report, omit Sections II through IV. '
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Form G-03 rev.10.13.06 Page 1 of 4
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Estate of Derick W. Bobb
an Incapacitated Person
II. PERSONAL DATA
Age of the Incapacitated Person: 20 Date of Birth: 10/10/1992
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
333 Oak Flat Road
Newville, PA 17241
B. The Incapacitated Person's residence is:
El own home/apartment
0 nursing home
El boarding home/personal care home
®Guardian's home/apartment
®hospital or medical facility
®relative's home (name, relationship and address)
Mother and Father
mother:
C. The Incapacitated Person has been in the present residence since 1995
. If the Incapacitated Person has moved within the
past year, state prior residence and reason(s) for move:
Form G-03 rev./0./3.06
Page 2 of 4
Estate of Derick W. Bobb
an Incapacitated Person
D. Name and address of the Incapacitated Person's primary caregiver:
David W. Bobb and Tammy J. Bobb
IV. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are as follows:
Traumatic Brain Injury at I 1 months of age
B. Specify what, if any, social, medical, psychological and support services the
Incapacitated Person is receiving:
Total Medical and Therapeutic Support as needed, including vision, speech and
vocational training
V. GUARDIAN'S OPINION
A. It is the opinion of the Guardian of the Person that the guardianship should:
01 continue
0 be modified
be terminated
Form G-03 rev. 10.13.06
Page 3 of 4
Estate of Derick V. Bobb
an Incapacitated Person
The reasons for the foregoing opinion are:
Continued need for supervision and guidance with daily living
B. During the past year, the Guardian of the Person has visited the Incapacitated Person
365 times with the average visit lasting 24
hours, minutes.
The report of a social service organization employed by the Guardian to oversee and
coordinate the care ofthe Incapacitated Person for the period covered by this Report may be
attached to supplement this Report.
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.A. § 4904
relative to unsworn falsification to authorities.
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Signature ofGuardi S ojthe et on
Tammy J. Bobb
Name of Guardian ofthe Person
(type or print)
333 Oak Flat Road
Address
Newville, PA 17241
City,State,Zip
(717) 776-6970
Telephone
Form G-03 rev.10.13.06
Page 4 of 4