The URL can be used to link to this page

Home My WebLink About06-17-14 � � � � c� � --� -�� ,� Y � {...� :� �" r..� ' r:;:'� c-- ',�� c'� t�"I � L . � ..i7 ANNUAL REPORT OF .-' " ,l� �, �;? , � � , �� GUARDIAN OF THE ESTATE :_y �� ; �� ,,..~� c.:7 —,, � ... �: <:� t'.,v H • C`� � `�� ::y �-il COURT OF COMMON PLEAS OF � ,� U, �, Cumberland COUNTY, PENNSYLVANIA � � ORPHANS' COURT DIVISION Estate of ��'e�'M. Stern , an Incapacitated Person No. 21-11-0514 OC I. INTRODUCTION John K. and Paula A. Stern was appointed OPlenary ❑Limited Guardian of the Estate by Decree of Court of Common Pleas �J.� dated 17th day of June 2011 m A. This is the Annual Report for the period from 17 June � 2013 to 17 June , 2014 (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 death of the Incapacitated Person. Date of death: Name of Personal Representative: 2. The Guardianship was terminated by the Court by Decree of J., dated Form G-02 rev.10.13.06 Page 1 of 5 Estate of ��e"�'M. Stern , An Incapacitated Person II. SUMMARY A. State the value of the estate reported on the Inventory $ 314.82 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.) $ 314.82 C. What is the total amount of income earned during the Report Period? $ 6,468.88 D. What is the total amount of income and principal spent for all purposes during the Report Period? $ 6,384.70 E. What are the balances remaining at the end of the Report Period? 1. Principal $ 364.00 2. Income $ 35.00 3. Total of Principal and Income $ 399.00 III. 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 bank accounts, etc.): It is 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 Account Holders Paula A Stem and Andrew M Stern. 2. Have there been any expenditures from the principal during the Report Period? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Yes ❑No If yes: a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? . . . . . . . . �Yes ❑No Fo,m G-o2 rev.10.13.06 Page 2 of 5 Estate of ��'e�'�'M. Stern ,An Incapacitated Person b. List purpose and amount of expenditures: Health and Welfare $ 3,600.00 Food and Entertainment $ 2,165.00 Clothes and Personal Items $ 619.70 $ c. Was Court approval received prior to expending the principal? . . . . . . . . . . . . . . . . . . . . . . . ❑Yes �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? . . . . . . . . . . . ❑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 sources and amounts of income received during the Report Period(e.g., Social Security, pension,rents,etc.): SSI $ 5,694.06 PA SSI DPW Supplement $ 306.36 Wages from Knisely's Pet and Farm $ 468.46 $ $ $ Total income received during Report Period: $ 6,468.88 Fo�c-o2 rev. 10.13.06 Page 3 of 5 Estate of An�'eW M. Stern ,An Incapacitated Person 2. How is income currently invested? (Please specify,e.g.,restricted bank accounts, client care account, etc.): It is 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 Account Holders Paula A Stern and Andrew M Stern. 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.): Health Insurance,copays,nutritional supplements, specialized diet food-gluten free and casein free,dental visits 2x year, eye doctor yearly,medical doctor yearly,one emergency room visit,massage 15 visits this year, salt cave 8 visits this year,clothing and personal items. 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.) Entertainment-going to air shows,movies, gym membership to the YMCA, 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 Determination Approval Obtained 0.00 ❑Yes �No 0.00 ❑Yes �No Fo,�„�-oz rev.10./3.06 Page 4 of 5 Estate of ��'�`n`�• ��e� ,An Incapacitated Person F. Counsel Fee List amounts paid as counsel fee,and indicate whether Court approval was obtained. Court Amoutzt Approval Obtained 0.00 [)Yes �No 0.00 []Yes 0 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. § 4904 � relative ta unsworn falsification to authorities. � l� �-�� t7nte ignat�rre oJCo-Guardtati of the Estate . Paula A. Stern 984 Mount Rock Road Carlisle, PA 17015 (717}440-6163 !7 <J�,�� ' Dni e Sign ture of Co- unrclian of the Estate John K. Stern 984 Mount Rock Road Carlisle. FA 17015 (717) 440��8�� Forn:G-O2 rev.10.13.06 Page 5 of 5 �. � c � ^' rn _:� � � !;'; c� ;_� c_ .:,_ c'� rr� ��' �, Z ,::,-� �x"I :;';7 ,�;; �....:. �� "_'-7 ANNUAL REPORT OF T `�' �' �� w f �:� GUARDIAN OF THE PER50N :-;tl � L;; � ` =; �:,� t.:. _� �..', _: c-' =-� }--• :-� r,� --� o �n o • y� � � COURT OF CONIMON PLEAS OF Cumberland COIJNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of Andrew M Stern , an Incapacitated Person No. 21-11-0514 OC I. INTRODUCTION John K. Stern and Paula A. Stern ,was appointed �Plenary�Limited Guardian of the Person by Decree of Court of Common Pleas � J.� dated 17th day of June 2011 � A. This is the Annual ReQort for the period from 17 June � 2013 to 17 June 2014 (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 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. Form G-03 rev.IO.I3.06 Page 1 of 4 Estate of ��'ew M Stern , an Incapacitated Person II. PERSONAL DATA Age of the Incapacitated Person: 26 Date of Birth: November 08, 1987 III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: 984 Mt Rock Rd Carlisle,PA 17015-9328 B. The Incapacitated Person's residence is: ❑own home/apartment ❑nursing home ❑boarding home/personal care home 0 Guardian's home/apartment ❑hospital or medical facility ❑relative's home (name, relationship and address) ❑other: C. The Incapacitated Person has been in the present residence since August 1982 . If the Incapacitated Person has moved within the past year, state prior residence and reason(s) for move: Form G-03 rev.10.13.06 Page 2 of 4 Estate of ��'ew M Stern , an Incapacitaxed Person D. Name and address of the Incapacitated Person's primary caregiver: John K. Stern and Paula A. Stem 984 Mt Rock Rd Carlisle,PA 17015-9328 IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: Autism and Moderate Mental Retardation B. Specify what, if any, social,medical,psychological and support services the Incapacitated Person is receiving: See attached page. V. GUARDIAN'S OPINION A. It is the opinion of the Guardian of the Person that the guardianship should: �continue ❑be modified ❑be terminated Form G-03 rev. 10.13.06 Page 3 of 4 Attachment for Section IV B Annual Report of Guardian of the Estate of Andrew Stern, an incapacitated person, No 21-11-05140C .June 17,2014. Andrew Stern still resides at 984 Mt. Rock Rd., Carlisle, PA 17015,with both his biological parents which are his co-guardians. Andrew Stern still has Autism and moderate mental retardation. Andrew continues to live at home with his parents/co-guardians. Andrew continues to receive the Autism Waiver which entitles him to 40 hours/week of community inclusion, 6 hours/week of direct behavior specialist, 2.5 hours/month of behavior specialist consult, and 30 hours/month of respite. His support coordinator for the Autism Waiver is Christy White of UDS, 1901 Olde Homestead Ln,Lancaster, PA 17605, 717-847-7586, fax 717-293-1595. Focus Behavioral Health of 639 Frederick St, Hanover, PA, 717-688- 3303 is the agency that provides the staff for community inclusion, behavior specialist and respite. Andrew continues to see his doctor, Dr. Pion in Newville, PA for yearly check ups and any medical issue, sees Dr. Gildea of Mt. Holly Springs, PA once every other month for chiropractic adjustments, Dr Killian of Cazlisle, PA twice a year far teeth cleaning and check ups, Dr. Chotiner of Harrisburg, PA once a year to check if his lens implants are in place and for a vision exam, Dr. Chris Turnpaugh of Mechanicburg, PA for neurobiological interventions using casein free, gluten free diet and nutritional supplements and he sees Melissa Brehm at the Carlisle YMCA far massage therapy one- two times a month. He also has enjoyed going to the salt cave in Carlisle,PA. Andrew continues to enjoy numerous activities: church on Sunday fallowed by visit to his grandparents in Shippensburg, PA, community inclusion with staff or his parents during the week to the YMCA,movies, library, bank, stores,parades, community events, air shows, sporting events,volunteer work,parks/lakes and visits to family and friends. He continues to work once every other week at Knisely's Pet and Farm. Andrew continues to need full time supervision and support for his own safety and well being. We,John K. and Paula A. Stern,think it is in Andrew's best interest to continue the guardianship. Estate of ��rew M Stern an Incapacitated Person The reasons for the foregoing opinion are: Andrew Stern continues to need full time supervision and support far his own well-being and safety. We,John K.and Pau1a A. Stem,think it is in Andrew's best interest ta continue the guardianship. B. During the past year,the Guardian of the Person has visited the Incapacitated Persan 365 times with the average visit lasting i6 hours, minutes. The report af a social sef-vice organization employed by the Guardian to oversee and coordinate the care of the Ineapacitated 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 Verifieation is subject to the penalties of 18 Pa. C.S.A. §49Q4 relative to unsworn falsification to authorities. � ��v�- �r� _. Dcrte ignatrrre ojCo-Guardian ojthe Estate Paula A. Stern 984 Mount Rock Road � Carlisle, PA 17015 (717) 44Q-6163 ��; dv�a�f �� Da e � Sig�a�tu-e o C Gunr�fi n of the Estate K. Stern 984 Mount Rock Road Carlisle, PA 17015 � (717) 440-Ja��'o21� Fonn G-G3 rer.L0./3.06 Page 4 of 4