Order Appointing Guardian

Order Appointing Guardian of Person and/or Estate

Superior Court of Washington

County of

In the Guardianship of:

,
Incapacitated Person

No.

Guardianship Summary

Certified professional guardian (CPG) Public professional guardian (PUG)

Lay (family) guardian (LGD) Training completed Training required

Page 2 of 9 Content

The AIP was present in court;

The hearing was conducted outside of the courtroom at the location of the AIP;

The AIP’s presence was waived for good cause shown other than mere inconvenience, as set forth in the file and reports in this matter;

The guardian ad litem was present. Other persons present:

I. Findings of Fact

1.1 Notices

All notices required by law have been given and proof of service as required by statute is on file.

1.2 Jurisdiction

The jurisdictional facts set forth in the petition are true and correct, and the court has jurisdiction over the person and/or estate of the AIP.

1.3 Guardian ad Litem

The Guardian ad Litem appointed by the court has filed a report with the court.

1.4 Alternative arrangements made by the AIP

The AIP did not make alternative arrangements for assistance, such as a power of attorney, prior to become incapacitated.

The AIP made alternative arrangements for assistance, but such arrangements are inadequate:

(Name) has been acting in a fiduciary capacity for the AIP and should not continue to do so:

1.5 Capacity

The AIP, , is:

incapable of managing his or her personal affairs.

incapable of managing his or her financial affairs.

The AIP is in need of a full guardianship over the person estate.

The AIP is capable of managing some personal and/or financial affairs, but is in need of the protection and assistance of a limited guardian of the person estate in the following areas:

1.6 Guardian

Proposed guardian’s address:

Phone No(s): Business Personal

Email:

1.7 Guardian ad Litem fees and costs

The Guardian ad Litem was appointed at county expense estate expense.

The Guardian ad Litem has requested a fee of $ and reimbursement of $

1.8 Bond

The assets of the AIP:

are unknown, and Bond shall be reviewed at review of inventory.

total less than three thousand dollars ($3,000) and no bond is required.

exceed three thousand dollars ($3,000), and a bond is required.

exceed three thousand dollars ($3,000) and should be placed in a blocked account.

1.9 Restrictions on AIP’s right to communicate, visit, and interact with others

1.10 Right to Vote

The AIP is capable of exercising the right to vote.

The AIP is not capable of exercising the right to vote.

II. Conclusions of Law

2.1. Incapacitated Person

(Name) is an incapacitated person within the meaning of RCW Chapter 11.88, and a:

Full Limited guardian of the person, and/or

Full Limited guardian of the estate should be appointed.

2.2 Guardian

(Name) is a fit and proper person as required by RCW 11.88.020 to be appointed as a guardian.

2.3 Powers and limitations of the guardian

All of the powers of a guardian pursuant to RCW 11.88 et. seq. and RCW 11.92 et seq. that are not expressly limited.

Other:

The guardian does not have power to consent to sterilization on behalf of the incapacitated person.

2.4 Restrictions on Incapacitated Person’s right to communicate, visit, and interact with others

Name of Person / Nature of Restriction

2.5 Limitations and restrictions placed on the Incapacitated Person

The following rights are revoked:

To vote or hold an elected office.

To marry, divorce, or enter into or end a state registered domestic partnership.

To make or revoke a will.

To enter into a contract.

To appoint someone to act on his or her behalf.

To sue and be sued other than through a guardian.

To possess a license to drive.

To buy, sell, own, mortgage, or lease property.

To consent to or refuse medical treatment.

To decide who shall provide care and assistance.

To make decisions regarding social aspects of his or her life.

Other limitations and restrictions

III. Order

3.1 Prior Power of Attorney

is not canceled.

is canceled in its entirety.

is canceled in its entirety except for those provisions pertaining to health care.

3.2 Appointment of guardian

(Name) is appointed as:

Full Limited Guardian of the Person and/or

Full Limited Guardian of the Estate of

3.3 Letters of guardianship

Valid until to (name of guardian)

3.4 Lay guardian training

Does not apply. The guardian is a certified professional guardian or financial institution.

The petitioner submitted evidence that the guardian successfully completed lay guardian training.

The guardian must complete and file proof of completion by .

3.5 Guardianship bond and security

Guardianship bond is set in the amount of $

Bond is waived.

Bond shall be reviewed at review of inventory.

The guardian shall have access to all accounts.

3.6 Report of substantial change in income or assets

Within 30 days of any substantial change, the guardian shall report to the court and schedule a hearing.

3.7 Inventory

A review hearing upon filing of the inventory is required not required.

3.8 Disbursements

On or before the date the inventory is due, the guardian shall apply to the court for an order authorizing disbursements.

3.9 Personal care plan

A review hearing upon filing of the personal care plan is required not required.

3.10 Status of incapacitated person

Unless otherwise ordered, the guardian of the person shall file an annual report on the status of the incapacitated person.

3.11 Substantial change in condition or residence

The guardian shall report to the court within thirty (30) days any substantial change in condition or residence.

3.12 Designation of standby guardian

Notice shall be filed within 90 days of appointment.

3.13 Authority for investment and expenditure

All of the powers of a guardian of estate pursuant to RCW 11.92 that are not expressly limited.

Other:

3.14 Duration of guardianship

Until it is terminated pursuant to RCW 11.88.140;

Until further order of the court.

Until the incapacitated person turns 18 years old;

Other:

3.15 Discharge/retention of guardian ad litem

The guardian ad litem is discharged; or

The guardian ad litem shall continue performing further duties:

3.16 Notice of right to receive pleadings

Name:

Address:

Name:

Address:

3.17 Guardian Fees

DSHS cases: guardian allowed fees and costs as permitted by WAC.

Non-DSHS cases: guardian shall petition court for approval of fees.

Advance amount per month: $

3.18 Guardian ad litem fee

Fees and costs are approved as reasonable.

Total amount: $

Paid from:

3.19 Legal Fees

Legal fees and costs of approved in amount of $

Paid from:

3.20 Guardian’s account or report

12-month 24-month 36-month

Report due by .

A review hearing is set for

The guardian must set a review hearing date on or before

The court will review without a hearing by

3.21 Other

Dated .

Presented by:

*If you do not want your personal phone number on this public form, you may list your telephone number on a separate form which may be available to parties and the court, as well as its staff and volunteers, but will not be made available to the public.

Copy received and approved by: