HomeMy WebLinkAbout06-18-15 ANNUAL REPORT OF
GUARDIAN OF THE ESTATE
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,PENNSYC.VANIA
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ORPHANS' COURT DIVISION � ` �'
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Estate of ��'ew M Stem , an Iricapac�itat`�Perso�r
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No. 21-11-0514 OC '': --� . �
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I. INTRODUCTION
John K. Stern and Paula A. Stern ,was appointed
✓OPlenary 0 Limited Guardian of the Estate by Decree of Court of Common Pleas � J.�
dated 17th day of June 2011
✓� A. T'his is the Annual Report for the period from 17 Jizr7e � 2014
to 17 June , 2015 (the "R.eport 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_
Form G-02 rev.10.13.06 Page 1 of 5
�
Estate of ��'ew M Stern __,An Incapacitated Person
II. SUMMARY
A. State the value of the estate reported on the Inventory $ 314.82
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.) $ 399.00
C. What is the total amount of income earned during the
Report Period? $ 6,670.00
D. What is the total amount of income and principal
spent for all purposes during the Report Period? $ 6,545.00
E. What are the balances remaining at the end of the Report
Period?
1. Principal $ 68.00
2. Income $ 57.Ct0
3. Total of Principal and Income $ 125.00
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.):
It is not invested. It is in a Rep Payee Direct Checking Account at M&T
Bank, Carlisle,PA. Rep Payee Paula A. Stern for Andrew M. Stem and a
Joint Free Checking at M&T Bank Carlisle,PA Joint Account Holders
Paula A. Stern and Andrew M. Stern.
2. Have there been any expenditures from the princi�al
during the Report Period? . . . . . . . . . . . . . . . . . . . . . . . . . . . . �Yes 0 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
Esta.te of ��'e�'�'M Stem �,An Incapacitated Person
b. List purpose and amount of expenditures:
Health and Welfare $ 3,717.00
Food and Entertainment 1,400.00
$___.__
Clothes and Personal Items $ 1,428.00
$
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 0 No
If yes:
a. Was Court approval requested prior to
receiving the additional principal`? . . . . . . . . . . . . . . . . l..! Yes l�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 $ 5,792.00
PA SSI DPW Supplement $ 306.00
Wages from Knisely Pet and Farm _ $ 572.00
$
$
$
Total income received during Report Period: $ 6,670.00
Form G-02 rev. 10.13.06 Page 3 of 5
Estate of Andrew M Stern !^_,An Incapacitated Person
2. How is income currently invested? (Please
specify, e.g.,restricted bank accounts, client
care account, etc.):
It is not invested. It is in a Rep Payee Direct Checking Account at M&T
Bank, Carlisle,PA Pep Payee Paula A. Stern for,�ludrew M. Stem and a
Joint Free Checking at M&T Bank, Carlisle,PA Joint Account Holders
Paula A. Stern and Andrew M. Stern.
C. Ezpenses for Care and Maintenance
Specify what expenditures were made from the principal and
income for the care and maintenance of the Incapacit��ted
Person(e.g., clothing, nursing home, medicine, support, etc.):
Nutritional Supplements,gluten free soaps, shampoos and conditioner, gluten free
and casein free food„ dental visits 2x year, eye doctor yearly,medical doctor
yearly, massage 30 visits/yr, salt cave 8 visits/yr, clot}iing and other personal
items.
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.)
Entertainment-going to air shows,movies, eateries, concers,museums,bowlling,
sporting events, community events and vacations.
Misc items- cell phone,toys,books,new bed and bedding.
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 �Yes �No
[]Yes []No
Page 4 of 5
Form G-02 rev. 10.13.06
Estate of ��'��� �tem , An Inca.pacitated Person
F. Counsel Fee
�,ist amaunts paid as counsel fee,and indicate whether Court approval was obtained.
Court
Amount Approval Obtained
O.UO ❑Yes ✓[�No
❑Yes ❑No
I verify that the foregoing information is correct to the best of rny knowledge,
informatian and belief; and that this Verification is subject to the penalties of 18 Pa.C.S. § 4904
� relative to unsworn falsification to authorities. . _
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5ig�lature of Ct�-Gu�rdir�et of tlte Estnte
Dcrre
' Paula A. Stern
984 Mount Rock Road
Carlisle, PA 17015
(717) 440-616�
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� Da Si 1� tt+r•e o C r 'n•tlin�r oJthe Estnte
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O�iTl K. St+�111
984 Mount Rock Road
Carlisle, PA 17Q15
(717} 4�0-�-�=�� fi`� ':'-
Page 5 of 5
Form G-02 rev.10.13.06