HomeMy WebLinkAbout04-08-15 �
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ANNUAL REPORT OF � � � � o
GUARDIAN OF THE ESTATE � A � �' � �
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COURT OF COMMON PLEAS OF �, c�.� � � � �
Cumberland COt1NTY, PENNSYI�VAI�'I
ORPHANS' COURT DIVISION 3�3 � � ca
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Estate of David B. Weaver , an Incapacitated Person
No. 21-12-0357
I. INTRODUCTION
Pauline E. Myers , was appointed
�Plenary �Limited Guardian of the Estate by Decree of David E3. Weaver J.�
dated April 6, 2013
� A. This is the Annual Report for the period from January 1 � 2014
to December 31, , 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
For„�c-oz ,-ev. lo.�s.o6 Page 1 of 5 �\
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Estate of David B. Weaver , An Incapacitated Person
II. SUMMARY
A. State the value of the estate reported on the Inventory $ 150.00
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.) $ 150.00
C. What is the total amount of income earned during the
Report Period? $ 14,688.00
D. What is the total amount of income and principal
spent for all purposes during the Report Period? $ 14,688.00
E. What are the balances remaining at the end of the Report
Period?
1. Principal $
2. Incame $
3. Total of Principal and Income $ 0.00
III. ADDITIONAL INFORMATION
(If more space is needed,please attach additional pages.)
A. Principal
1. How is the principal balance listed above cun•ently
invested? (Please specify, e.g., real estate,
certificates of deposit, restricted bank accounts, etc.):
There may be monies held in trust that I have no access to. They were left to
the trustees of the trust in York County upon the death of his Mother. I have
no access to these monies.
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 Persan? . . . . . . . . ❑ Yes ❑No
Form G-02 rev. 10.13.06 Page 2 of 5
Estate of David B. Weaver , An Incapacitated Person
b. List purpose and amount of expenditures:
$
$
$
$
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 reyuested 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 $ 14,688.00
$
$
$
$
$
Total income received during Report Period: $ 14,688.00
Form G-02 rev.10.13.06 Page 3 of 5
Estate of David B. Weaver , An Incapacitated Person
2. How is income currently invested? (Please
specify, e.g., restricted bank accounts, client
care account, etc.):
I have no information concerning investments. [ncome from SSI is spent
entirely on David's living expenses.
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.):
Monthly SSI money was spent entirely on keeping David healthy and happy.
Expenses include Rent, utilities, cable, food, vitamins, clothing and routine doctor
visits as well as veterinarian visits and grooming for his dog, Gracie.
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.)
I pay any additional expenses for David out of my retirement income. I don't
receive any $ from investments that may be held in his trust by Helen Shoemaker
and Ellen Rahn
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 I accept no money for David's care �Yes �No
�Yes �No
FormG-02 rev. I0.l3.06 Page 4 of 5
Estate of David B. Weaver , An Incapacitated Person
F. Counsel Fee
List amounts paid as counsel fee, and indicate whether Court approval was obtained.
Court
Amount Approval Obtained
0.00 �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.
April 6, 2015 � �t-R �'���"�
Date tgnature of Guardiari o/�the Estat
Pauline E. Myers
Name of Guardiarv of the Estate(rype or print)
365 E. Baltimore Street
Address
Carlisle, PA 17013
Ciry.State.Zip
717-448-9115
Telephone
Fo�c-oz rev. 10.13.06 Page 5 of 5