HomeMy WebLinkAbout05-20-15 (2) ANNUAL REPORT OF
GUARDIAN OF THE ESTATE
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA67)
ORPHANS' COURT DIVISION c n o
Estate of Constance M. Meredith, an Incapacitated Person
r—
No. 06-0294 C'
I. INTRODUCTION
William R. Meredith , was appointed
Successor DPlenary nLimited Guardian of the Person by Decree of Edward E. Guido, J.,
dated June 6, 2013.
0 A. This is the Annual Report for the period from January 1, 2014 to
December 31, 2014 (the "Report Period"); or
11 B. This is the Final Report for the period from ,
to (the"Deport 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
Form G-02 rev. 10.13.06 Page 1 of 5
Estate of Constance M. Meredith, an Incapacitated Person
II. SUMMARY
A. State the value of the estate reported on the Inventory $235,877.53
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.) $2,207.35
C. What is the total amount of income earned during the
Report Period? $340.90 gross/month SS x 12 ($4,090.90)
$2,802.00 gross/month OPM Survivor Pension $37,714.90
D. What is the total amount of income and principal
spent for all purposes during the Report Period? $37,732.01*
E. What are the balances remaining at the end of the Report
Period?
1. Principal $2,190.24
2. Income $ -0-
3. Total of Principal and Income $2,190.24
* Ward is on Medical Assistance and her monthly income goes to the
nursing home.
III. ADDITIONAL INFORMATION
(If more space is needed, please attach additional pages.)
A. Principal
1. How is the principal balance listed above currently
invested? (Please specify, e.g., real estate,
certificates of deposit, restricted bank accounts, etc.):
Guardianship account at South Mountain Restoration Center. She is currently
receiving Medical Assistance to pay for her care at South Mountain.
2. Have there been any expenditures from the principal
during the Report Period? ........................................... 0 Yes ❑ No
If yes:
a. Have all expenditures from the principal been for
the sole benefit of the Incapacitated Person? ............. OYes ❑ No
Form G-02 rev. 10.13.06 Page 2 of 5
� �a ti.l w t. � . ... a..... .. . .,. �A� :a�?_ .n��... `..yam, T"'Si •t ,.Sus '�",-,bi--.. :�.
Estate of Constance M. Meredith, an Incapacitated Person
b. List purpose and amount of expenditures:
Personal Care Needs $ 17.11
c. Was Court approval received prior to
expending the principal? ............................ ❑ Yes 0 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 Z No
If yes:
a. Was Court approval requested prior to
receiving the additional principal? ............................El Yes ❑x 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 $340.90 gross/month
Federal OPM Survivor Pension $2,802.00 gross/month
Total income received during Report Period: $37,714.90
Form G-02 rev. 10.13.06 Page 3 of 5
... .,:;��>��`4'd �r.22�e.�:i.n�,swr:�'Ha,^-t-L=1.i-.as':',A' �x.-.;3fi:'r'�t�w.r�-�':'i.,,x;;,
Estate of Constance M. Meredith, an Incapacitated Person
2. How is income currently invested? (Please
specify, e.g., restricted bank accounts, client
care account, etc.):
Guardianship account at South Mountain Restoration Center. All income,
minus $45.00 personal needs allowance is paid to South Mountain for her
care.
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, clothing and qualified medical expenses.
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.) NONE
E. Guardian's Commissions
List amounts of compensation paid as Guardian's commission
And state how amount was determined: NONE
Court
Amount Method of Determination Approval Obtained
o Yes ❑ No
❑ Yes ❑ No
Form G-02 rev. 10.13.06 Page 4 of 5
Estate of Constance M. Meredith, an Incapacitated Person
F. Counsel Fee
List amounts paid as counsel fee, and indicate whether Court approval was obtained.
Court
Amount Approval Obtained
None ❑ 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.A. § 4904
relative to unsworn falsification to authorities.
Date Signature of Guardian of the Estate
William R. Meredith
Name of Guardian of the Estate(type or print)
404 Pine Grove Road
Address
Gardeners,PA 17324
City, State, Zip
(717)713-6471
Telephone
1
Form G-02 rev. 10.13.06 Page 5 of 5
�., .,
. � .. � � s
r/y -