HomeMy WebLinkAbout01-29-15 (2) ANNUAL REPORT WCORDil-ED OFFICE OF
GUARDIAN OF THE PERRONTEER o- WILLS
COURT OF COMMON PLEAS OF OF
CumberlandCOUNTY, PENNSWVP
C U A 5
ORPHANS' COURT DIVISION
Estate of Jay William Bedard an Incapacitated Person
No. 21-12-1154
I. INTRODUCTION
Kelly Ann Landis was appointed
91 Plenary[Limited Guardian of the Person by Decree of Thomas A. Placey J.,
dated January 7,2013
P1 A. This is the Annual Report for the period from
to 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 I of 4
Estate of Jay William Bedard , an Incapacitated Person
II. 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:
n own home/apartment
rl nursing home
boarding home/personal care home
Guardian's home/apartment
hospital or.medical facility
relative's home(name,relationship and address)
Barbara Bedard (Mother)
227 Pine Road, Mount Holly Springs PA 17065
pother:
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 Jay William 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:
n continue
D be modified
El be terminated
Form G-03 rev.10.13.06 Page 3 of 4
Estate of Jay William 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 d�'
Date Signature rdianofth Person
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