HomeMy WebLinkAbout01-29-15 (2) -RECORDED OFFICE OF
REGISTER, OF IWILLS
ANNUAL REPORT OF
2 19N 29 AM 1130
GUARDIAN OF THE PER�64
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ORPIS' CHRT
COURT OF COMMON PLEAS OF C U M B E WW
Cumberland COUNTY,PENNSYLVANIA
ORPHANS' COURT DIVISION
Estate of Jeffrey Alan Bedard an Incapacitated Person
No. 21-12-1153
I. INTRODUCTION
Kelly Ann Landis was appointed
El Plenary ElLimited Guardian of the Person by Decree of Thomas A. Placey
dated January 7,2013
M! A. This is the Annual Report for the period from
to -1 2014 (the"Report Period');or
0 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 H through IV.
Form G-03 rev.10.13.06 Page 1 of 4
Estate of Jeffrey Alan Bedard ,an Incapacitated Person
U. PERSONAL DATA
Age of the Incapacitated Person:47 Date of Birth: 5 December 1967
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
227 Pine Road
Mount Holly Springs PA 17065
B. The Incapacitated Person's residence is:
own home/apartment
E]nursing home
E]boarding home/personal care home
Guardian's home/apartment
F1 hospital or medical facility
M relative's home(name,relationship and address)
Barbara Bedard (Mother)
227 Pine Road,Mount Holly Springs PA 17065
D other:
C. The Incapacitated Person has been in the present residence since June 2006
. 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 Jeffrey Alan Bedard
an Incapacitated Person
D. Name and address of the Incapacitated Person's primary caregiver:
Kelly A.Landis
423 Main Street
York Springs PA 17372
IV. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are as follows:
Mental Retardation
B. Specify what, if any, social,medical,psychological and support services the
Incapacitated Person is receiving:
Job coaching,special olympics
V. GUARDIAN'S OPINION
A. It is the opinion of the Guardian of the Person that the guardianship should:
M continue
F1 be modified
F1 be terminated
Form G-03 rev.10.13.06 Page 3 of 4
Estate of Jeffrey Alan Bedard ,an Incapacitated Person
The reasons for the foregoing opinion are:
There has been no change in his mental acuity.
B. During the past year,the Guardian of the Person has visited the Incapacitated Person
300 times with the average visit lasting 2 hours, 30 minutes.
The report of a social service organization employed by the Guardian to oversee and
coordinate the care of the 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.
26 January 2014
Date ignature of than o the P son
Kelly A. Landis
Name of Guardian of the Person(type or print)
423 Main Street
Address
York Springs PA 17372
City,State,Zip
7175287357
Telephone
Form G-03 rev.10.13.06 Page 4 of 4