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ANNUAL REPORT OF �� � ,�-- '- ','
GUARDIAN OF THE ESTATE c`�` :: � ' ` �_�
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COURT OF COMMON PLEAS OF z' —
Cumberland COLJNTY, PENNSYLVANIA
ORPHANS' COURT DNISION
Estate of Doris G.Barron an Incapacitated Person
No. 21-09-0738
I. INTRODUCTION
Cynthia L. Baum ,was appointed
�Plenary ❑Limited Guardian of the Estate by Decree of M. L. Ebert,Jr. �J �
dated Segtember 17,2009
❑ A. This is the Annual Report for the period from September 4 2013
to Au�ust 13 , 2014 (the"Report Period"); or
❑ B. This is the Finat 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. /0.13.06 Page l of 5
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Estate of Doris G. Barron ,An Incapacitated Person
II. SLTMMARY
A. State the value of the estate reported on the Inventory $ 92,210.00
B. State the value(s)of principal assets at the beginning of
the Report Period. (Same as Inventory if first Repart,
otherwise, ending balance from last Report.) $ 213,082.00
C. What is the total amount of income earned during the
Report Period? $ 21,133.00
D. What is the total amount of income and principal
spent for all purposes during the Report Period? $ 21,133.00
E. What are the balances remaining at the end of the Report
Period?
1. Principal $ 92,210.00
2. Income $ 0.00
3. Total of Principal and Income $ 92,210.00
III. ADDTI'IONAL INFORMATION
(If more space is needed,please attach additional pages.)
A. Principal
1. How is the principal balance listed above cunently
invested? (Please specify,e.g.,real estate,
certificates of deposit,restricted bank accounts,etc.):
Savings&Checking Accounts
2. Have there been any expenditures from the principal
during the Report Period? . . . . . . . . . . . . . . . . . . . . . . . . . . . . �Yes ❑No
If yes:
a. Have all expenditures from the principal been for
the sole benefit of the Incapacitated Person? . . . . . . . . �Yes ❑No
Form G-02 rev. 10.13.06 Page 2 of 5
_ _. __
Estate of Doris G. Barron ,An Incapacitated Person
b. List purpose and amount of expenditures:
Nursing Home&Prescriptions $ 124,627.00
Health Insurance $ 13,368.00
Clothing $ 395.00
20%IRA Distribution Federal Tax $ 9,475.00
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.):
Social Security $ 17,964.00
Pension $ 3,169.00
Interest $ 772.00
$
$
$
Total income received during Report Period: $ 2�,9os.00
Form G-02 rev.10.13.06 Page 3 of 5
Estate of Doris G.Barron ,An Incapacitated Person
2. How is income currently invested? (Please
specify,e.g., restricted bank accounts, client
care account,etc.):
Savings Account&Checking Account
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, Health Insurance,Prescriptions,and Clothing
D. Other Egpenditures
Specify what other expenditures were made during the Report
Period. (Do not include any items stated in response to
question C above.)
Closed out all IRA accounts and transferred into savings account. This required
paying$9,475 to cover 20%Federal Income Ta�c.
$30.00 payment to cover court filing fees.
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
❑Yes �No
❑Yes �No
Fo„�c-oz rev.10.13.06 Page 4 of 5
Y
Estate of Doris G. Barron An Incapacitated Person
F. Counsel Fee
List amounts paid as counsel fee, and indicate whether Court approval was obtained.
Court
Amount Approval Obtained
❑Yes �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. §4904
relative to unsworn falsification to authorities.
August 13, 2014 �
Date Signa ofGuardian ofthe Eslate
Cynthia L.Baum
Name of Guardimr of the Estate(rype or print)
1127 Atland Dr
Address
Mechanicsburg, PA 17055
ary,srate,z�p
717-697-8995
Telephone
Form G-02 rev.]0.13.06 PagO S Of S