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HomeMy WebLinkAbout02-18-14 ANNUAL REPORT OF GUARDIAN OF THE ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of Constance M. Meredith, an Incapacitated Person z o r ri.. No. 06-0294 C7 t 71 r.... ': T� a -' N :n6 D (-n zi trz I. INTRODUCTION William R. Meredith was appointed Successor 9Plenary OLimited Guardian of the Person by Decree of Edward E. Guido, J., dated June 6, 2013. © A. This is the Annual Report for the period from January 1, 2013 to December 31, 2013 (the "Report Period"); or O 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 Form G-02 rev. 10,13.06 Page 1 of 5 U/ Estate of Constance M. Meredith, an Incapacitated Person II. SUMMARY A. State the value of the estate reported on the Inventory $235,877.53 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.) $1,792.09 C. What is the total amount of income earned during the Report Period? $336.00 gross/month SS x 12 $1.893.78 gross/month OPM Survivor Pension $26.757.44 D. What is the total amount of income and principal spent for all purposes during the Report Period? $42,297.62* E. What are the balances remaining at the end of the Report Period? 1. Principal $2,207.35 2. Income $ -0- 3. Total of Principal and Income $2,207.35 * Ward is on Medical Assistance and her monthly income goes to the nursing home. 1II. ADDITIONAL INFORMATION (If more space is needed,please attach additional pages.) A. Principal 1. How is the principal balance listed above currently invested? (Please specify, e.g., real estate, certificates of deposit, restricted ban/: accounts, etc.): Guardianship account at South Mountain Restoration Center. She is currently receiving Medical Assistance to pay for her care at South Mountain. 2. Have there been any expenditures from the principal during the Report Period? ........................................... ❑O Yes ❑ No If yes: a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? ............. ZYes ❑ No Form c-02 ev. 10.13.06 Page 2 of 5 Estate of Constance M. Meredith, an Incapacitated Person b. List purpose and amount of expenditures: South Mountain Nursing Home $8,400.00 Medical Expenses $4,344.36 Allowable Medicaid spend-down $2,795.82 c. Was Court approval received prior to expending the principal? ............................ ❑ Yes 0 No 3. Were additional principal assets received during the Report Period which were not included in the Inventory or a prior Report filed for the Estate? .....................0 Yes ❑ No If yes: a. Was Court approval requested prior to receiving the additional principal? ............................El Yes 0 No b. State the sources and amounts of the additional principal received: Net Office of Personnel Mgmt. (OPM) $16.583.99 Retroactive survivor payment which was $ Used for qualified spend-down for Medical $ Assistance and private pay to nursing home $ During 15 day ineligibility period. $ B. Income 1. State sources and amounts of income received during the Report Period (e.g., Social Security, pension, rents, etc.): Social Security $336.00 gross/month Federal OPM Survivor Pension $1,893.78 gross/month Total income received during Report Period: $26,757.44 Form c-02 rev. 10,13.06 Page 3 of 5 Estate of Constance M. Meredith, an Incapacitated Person 2. How is income currently invested? (Please specify, e.g., restricted bank accounts, client care account, etc.): Guardianship account at South Mountain Restoration Center. All income, minus $45.00 personal needs allowance is paid to South Mountain for her care. C. Expenses 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.): Nursing home, clothing and qualified medical expenses and Medicaid approved Spend-down. D. Other Expenditures Specify what other expenditures were made during the Report Period. (Do not include any items stated in response to question C above.) NONE E. Guardian's Commissions List amounts of compensation paid as Guardian's commission And state how amount was determined: NONE Court Amount Method of Determination Approval Obtained ❑ Yes ❑ No ❑ Yes ❑ No Form G-02 rev. 10.13.06 Page 4 of 5 Estate of Constance M. Meredith, an Incapacitated Person F. Counsel Fee List amounts paid as counsel fee, and indicate whether Court approval was obtained. Court Amount Approval Obtained None 17 Yes o No ❑ Yes ❑ No 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 unswom falsification to authorities. Date Signature of Guardian of the Estate William R. Meredith Name ojGuardian of the Estate(type or prim) 404 Pine Grove Road Address Gardeners, PA 17324 City,State. Zip (717) 713-6471 Telephone Farm G-02 rev. 10.13.06 Page 5 of 5