Petition To Create Funeral Expense Trust In Accordance with 20 Pa. C.S.A.§5537

Current through March 1, 2017

DECREE

Now, this _____ day of _____ , 20 _____ , upon consideration of the annexed Petition it is hereby ORDERED and DECREED that Henry Doe, Guardian of the Estate of Jane R. Dunn, an Incapacitated Person, is hereby authorized to create with Old Faithful Bank as Trustee a trust with a principal of $7,500 under the terms and conditions of 20 Pa. C.S.A. § 5537.

____J.

PETITION

The Petition of Henry Doe, Guardian of the Estate of Jane R. Dunn, an Incapacitated Person, respectfully states that:

1. Jane R. Dunn was declared an incapacitated person and Henry Doe appointed guardian of her estate by the Decree of the Honorable John Jones on September 1, 2000.

2. On September 15, 2000, Petitioner filed a report in accordance with the provisions of 20 Pa. C.S.A. § 5521.

3. The annual income of the incapacitated person's estate is $20,000, including Social Security payments.

4. The present value of the incapacitated person's estate is $360,000, consisting of a money market account at Old Faithful Bank.

5. The incapacitated person is residing at The Best Nursing Home, where she has been a patient since September 10, 2000.

6. The following persons are all of the persons who are sui juris and would be entitled to share in the estate of Jane R. Dunn if she died intestate:

Joan Smith

1200 Locust Way

Philadelphia, PA 19103

Henry Doe

P.O. Box 1234

Boston, MA 12345

7. The incapacitated person is receiving residential services from:

The Best Nursing Home

900 Lombard Street

Philadelphia, PA 19103

8. There is attached as Exhibit "A" hereto a list of all claims of the incapacitated person's creditors known to Petitioner, showing claims paid to date and those remaining unpaid.

9. No portion of the incapacitated person's estate is derived from the United States Veterans' Administration.

10. There is presently no provision for payment of the incapacitated person's funeral expenses. In view of the incapacitated person's physical and mental condition, it is likely that her estate will be exhausted by expenditures for her care and maintenance, leaving no funds available for funeral expenses.

Wherefore, Petitioner respectfully requests this Court to authorize Petitioner to create with Old Faithful Bank as trustee a trust with principal of $7,500 under the terms and conditions of 20 Pa. C.S.A. § 5537.

Respectfully submitted,

Henry Doe

Petitioner