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Home My WebLink About06-10-15 ;.�� L7 i�---+� , � tJ'7 -' � Q �-'.i � ANNUAL REPORT OF � �' � ' � � ,- _ , �, -��. _„ , _.- � �. , ,_.:� GUARDIAN OF THE ESTATT� � : ' ; � :1 .� ; COURT OF COMMON PLEAS OF � � �-'' CUMBERLAND COUNTY, PENNSYLVANIA �`� " �� ORPHANS' COURT DIVISION �� w'- '�' � ��r Estate of Susan J. Myers , an Incapacitated Person No.21-10-0220 L INTRODUCTION Patricia A.M. Havens , was appointed ❑✓ Plenary ❑Limited Guardian of the Estate by Decree of Wesley Oler,Jr. J dated April 26, 2010 ❑ A This is the Annual Report for the period from , to , (the"Report Period"); or ❑✓ B. This is the Final Report for the period from April 26 2014 to May 13 2015 (the"Repart Period"), and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: May 13, 2015 Name of Personal Representative : Patricia A.M. Havens 2. The Guardianship was terminated by the Court by Decree of J., dated Form G-02 rev. IOJ3.06 Page 1 of 5 � '�. � Estate of Susan J. Myers , An Incapacitated Person II. SUMMARY A. State the value of the estate reported on the Inventory g 65,000.00 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.) $74,346.00 C. What is the total amount of income earned during the Report Period? $33,965.00 D. What is the total amount of income and principal spent for all purposes during the Report Period? $30,898.00 E. What are the balances remaining at the end of the Report Period7 1. Principal $ 74,346.00 2. Income $3,067.00 _ 3. Total of Principal and Income $77,413.00 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.): Personal restricted checking account Personal checking account Insurance policies Automobile 2. Have there been any expenditures from the principal. during the Report Period? . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑Yes ✓�o If yes: a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? . . . . . . . . DYes �To Form G-02 rev.10.13.06 Page 2 of 5 Estate of Susan J Myers , 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 requested 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.): Social Securitv $ 13.433.00 _ Interest and Dividends $0.00 Jane C Mvers Trust $20 532.00 $ $ $ Total income received during Report Penod: $ 33 965.00 _ Form G-02 rev.10.13.06 Page 3 of 5 Estate of Susan J. Myers , An Incapacitated Person 2. How is income currently invested? (Please specify, e.g., restricted bank accounts, client care account, etc.): Social Security Representative Payee Checking Account with PSECU-Restricted Susan Myers Guardian Checking Account with PSECU-Limited Guardian Account with M&T Bank-Limited C. Expenses for Care and Maintenance Specify what expenditures were made from the principal anci income for the care and maintenance of the Incapacitated Person (e.g., clothing nursing home, medicine, support, etc.): See Attachment A D. Other Expenditures Specify what other expenditures were made during the Repart Period. (Do not include any items stated in response to question C above.) See Attachment A E. Guardian's Commissions List amounts of compensation paid as Guardian's commission and state how amount was determined: Colcrt Amount Method of Determination Approval Obtairred 0.0 ❑Yes ❑No ❑Yes ❑No Form C�-02 rev. 10.13.06 Page 4 of 5 Estate of Susan.l. Mye�s 11n Incapaci#a#ed Person F. Connsel Fee List amounts paid as counsel fee, and indicate whether Court approval was obtained. Couf•t Amourit Approvcr�pUtained 0.0 ❑Yes ❑No []Yes ONo 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 penatties of 18 Pa.C.S. �49Q4 relative to unsworn falsi�cation to authorities. L �S� �� /�1 �' �/ / �,��,�.�� IQI� $fg�aatm'e OfGNardE4rr oflhe Estate Patricia A.M. Havens Name�CmarcBrm ofthe Gstcte fljpe ar print) 1235 Crestfield Drive Addre.�s Williamsport,PA 17701 City,State,Zip {�7a�s27-so�s�n� r�t�� Form G02 rev.iQ13_06 p��5 Qf 5 ATTACH M ENT A Section III(A)(2)(b)-Expenditures Expenditures I�� Utilities 5200 Food,Toiletries,Personal 5450 Clothing 1900 Rx 800 Gas 2100 Cleaning 1050 Repairs 2400 Contracted Services 1567 LT Carelnsurance 1996 Auto Insurance 734 Health Insurance 2544 Medical/Hospital Bills 952 Auto Maintence 800 Part B Medicare 1259 HOA 2124 TotalExpenditures 30,876.00 Section III(C)-Care and Maintenance Expenditures Utilities 5200 Food,Toiletries,Personal 5450 Clothing 1900 Rx 800 HOA 2124 Cleaning 1050 Healthlnsurance 2544 Medical/Hospital Bills 952 Part B Medicare 1259 Total Expenditures 21,279.00 Section III(D)-Other Expenditures Expenditures �� Gas 2100 Repairs 2400 Contracted Services 1567 LT Carelnsurance 1996 Autolnsurance �34 Auto Maintence $�o TotalExpenditures 9,597.00