HomeMy WebLinkAbout01-29-15 Clerk of Orphans' Court of Cumberland County
IN RE:JEREMY AUGUSTINE PA No. - rZO
Account In Trust For Person
ANNUAL REPORT OF GUARDIAN OF THE ESTATE
FINAL REPORT
We, Steve Augustine & John Augustine, were appointed plenary guardians to establish trust for
to Jeremy Augustine by Decree of the Honorable Judge M. L. Ebert, Jr. Dated September 11, 2013.
This is our annual report for the period from January 1, 2014 to December 31, 2014, ("the Report
Period").
I. SUMMARY
A. Value of principal assets at the beginning of the Report Period? $ 65419.16
B. Total amount of income earned during the report period? $ 92.90
C. Total Amount of all disbursements made from the trust for the benefit of
Jeremy Augustine during the Report Period?
1. From principal $ 11167.60
2. From income $ 0.00
D. Total amount spent for all other purposes during the Report Period? $ 54344.46
1. From Distribution made to Amanda K. Augustine Trust $ 54284.23
2. From Federal Tax automatically withheld $ 59.44
3. From miscellaneous trust fund expenses $ .79
NOTE: Jeremy Augustine passed away on November I9`h, 2014. As required
by the Jeremy Augustine's Trust, the balance has been distributed to the Trust
of Amanda K Augustine (his surviving sister). See attached Death Certificate.
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E. Total amounts remaining at,the, '6 >id off) 60a Period? $ 0.00
t�Hd� 0
1. From principal 0 '3 10 $ 0.00
6f TI W� 6? tNfur, Sloe- $ 0.00
2. From income
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Total Income and Prine 1 0 $ 0.00
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II. ADDITIONAL INFORMATION
A. Principal:
1. Total amount remaining at the end of the Report Period? $ 0.00
2. How is principal currently invested?
Trust Account $ 0.00
3. Have there been any expenditures from principal during the Report
Period Yes
If you answered YES, was there Court approval for all expenditures
from principal? Yes
4. Did you receive any principal assets during the report period which
were not included on the inventory or a prior report filed for the estate? No
If you answered YES, did you receive Court approval prior to receiving
Additional principal?
5. State the sources and amounts of the additional principal you received:
Interest from savings/checking accounts $ 92.90
B. Income:
1. State sources and amounts of income received during the Report Period
(i.e., social security, pension, rents, etc.)
Interest from savings/checking accounts $ 92.90
Total Income received during Report Period $ 92.90
2. How is income currently invested? (Please specify, restricted bank accounts,
client care account, etc.)
Trust Fund has been closed down because of the death of Jeremy Augustine.
3. Specify what payments were made for the care and maintenance of the recipient of the trust
(i.e., general distribution of funds, etc.)
Distribution of funds directly to Jeremy Augustine $ 11167.60
4. Specify what other payments were made during the Report Period.
Distributed to Amanda K Augustine's Trust $ 54284.23
Federal Tax Withheld $ 59.44
From miscellaneous trust fund expenses $ .79
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.
f/-17/j5
Date S1,9nature of Trustee
*FILING FEE$15 MUST ACCOMPANY THIS FILING.