Form G 02 PDF Details

In order to ensure that your company is in compliance with all state and federal regulations, it is important to have a thorough understanding of Form G 02. This form is used by employers to document any workers who are exempt from the mandatory overtime requirements set forth in the Fair Labor Standards Act (FLSA). By understanding when an employee is exempt from overtime pay, you can avoid costly fines and potential litigation. In this blog post, we will take a closer look at what Form G 02 entails, and provide some tips on how to correctly complete it.

QuestionAnswer
Form NameForm G 02
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namesform g 02 pa, pennsylvania form annual report, g 02 form, annual report guardian estate

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ANNUAL REPORT OF

GUARDIAN OF THE ESTATE

COURT OF COMMON PLEAS OF

COUNTY, PENNSYLVANIA

ORPHANS’ COURT DIVISION

Estate of

 

, an Incapacitated Person

No.

I.INTRODUCTION

, was appointed

“Plenary dated

“ Limited Guardian of the Estate by Decree of

 

, J.,

.

“

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

 

,

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

 

, An Incapacitated Person

II.SUMMARY

A. State the value of the estate reported on the Inventory

$

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.)

$

C. What is the total amount of income earned during the

 

Report Period?

 

 

 

$

D. What is the total amount of income and principal

 

spent for all purposes during the Report Period?

$

E. What are the balances remaining at the end of the Report

 

Period?

 

 

 

 

1.

Principal

$

 

 

 

2.

Income

$

 

 

 

3.

Total of Principal and Income

$

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.):

2. Have there been any expenditures from the principal during the Report Period? . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If yes:

a. Have all expenditures from the principal been for the sole benefit of the Incapacitated Person? . . . . . . . .

“Yes

“Yes

“No

“No

Form G-02 rev. 10.13.06

Page 2 of 5

Estate of

 

, An Incapacitated Person

b. List purpose and amount of expenditures:

$

$

$

$

c. Was Court approval received prior to

expending the principal? . . . . . . . . . . . . . . . . . . . . . . .

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? . . . . . . . . . . .

If yes:

a. Was Court approval requested prior to

receiving the additional principal? . . . . . . . . . . . . . . . .

b. State the sources and amounts of the additional principal received:

$

$

$

$

$

“Yes

“Yes

“Yes

“No

“No

“No

B.Income

1.State sources and amounts of income received during the Report Period (e.g., Social Security, pension, rents, etc.):

$

$

$

$

$

$

Total income received during Report Period:

$

Form G-02 rev. 10.13.06

Page 3 of 5

Estate of

 

, An Incapacitated Person

2.How is income currently invested? (Please specify, e.g., restricted bank accounts, client care account, etc.):

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.):

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.)

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

“Yes

“No

“Yes

“No

Form G-02 rev. 10.13.06

Page 4 of 5

Estate of

 

, An Incapacitated Person

F.Counsel Fee

List amounts paid as counsel fee, and indicate whether Court approval was obtained.

 

Court

Amount

Approval Obtained

“Yes

“Yes

“No

“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.

Date

Signature of Guardian of the Estate

 

 

 

Name of Guardian of the Estate (type or print)

 

 

 

Address

 

 

 

City, State, Zip

 

 

 

Telephone

Form G-02 rev. 10.13.06

Page 5 of 5

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