Fill and Sign the Disbursements and Form

Or Appr Budget/Disbrsmnt/Ini Pers Care Plan (ORAPRT) - Page 1 of 3WPF GDN 05.0500 (02/2009) RCW 11.92.040, .043, .050Superior Court of WashingtonCounty ofIn the Guardianship of:_______________________________, Incapacitated PersonNo. Order Approving Budget,Disbursements, andInitial Personal Care Plan(ORAPRT)[ ] Clerk’s Action Required Clerk’s Information Summary [X] Due Date for Next Report and Accounting: ______________________________________________________[ ] Other (Date and Purpose): _______________________________________________________________________________________________________________________________________________________________Based upon the petition of the Guardian of the Estate and the documents filed with the petition, the court makes the following findings of fact : I. Findings of Fact 1.1 Acts of Guardian All acts required of the Guardian to date have been performed. 1.2Notice Notice has been properly provided to persons entitled to notice of this presentation.1.3 Budget and Care Plan The proposed Budget and Care Plan of the Guardian are reasonable and appropriate to the needs of the Incapacitated Person and should be approved. Or Appr Budget/Disbrsmnt/Ini Pers Care Plan (ORAPRT) - Page 2 of 3WPF GDN 05.0500 (02/2009) RCW 11.92.040, .043, .050 II. Orders 2.1 Approval of Initial Personal Care Plan The Initial Personal Care Plan is approved.2.2 Budget The Guardian is authorized to continue to receive the Incapacitated Person’s income and to apply the income and other resources toward the Incapacitated Person’s expenses:Room and Board$Medical$Rent/Mortgage$Personal and Incidental Expenses$Food and Household Expenses$Utilities$Guardian Fees$Other$Total Monthly Expenditures$2.3Outstanding Obligations of the Estate The Guardian shall be authorized to arrange payment schedules with the creditors of the guardianship estate for delinquent and past due payments.2.4Medical and Dental Expenses The Guardian is authorized to incur and pay reasonable and necessary medical and dental expenses that the Guardian determines to be in the best interest of the Incapacitated Person.2.5 Income Tax Payments/Accounting Fees The Guardian is authorized to make payments for income tax due as required, and to pay fees for accounting services required in connection with the preparation of income tax returns.2.6Miscellaneous Expenses The Guardian is authorized to pay all expenses incurred by way of fees of the Clerk of the Court, together with additional expenses incurred up to the amount of $50.00 per month in connection with this guardianship.2.7Accounting Due DateThe Report and Accounting of the Guardian shall be filed and submitted to the Court for approval not later than _________________________ (90 days after the first anniversary of the appointment of the Guardian). Or Appr Budget/Disbrsmnt/Ini Pers Care Plan (ORAPRT) - Page 3 of 3WPF GDN 05.0500 (02/2009) RCW 11.92.040, .043, .0502.8 Bond Bond is currently set in the amount of $ _________. The amount of the bond [ ] shall not be changed [ ] shall be changed to $ _________. 2.9Guardian Fees The Guardian is allowed to advance a monthly fee up to $ _______. This advance is approved for the next 12 months and 90 days thereafter, from the date of appointment of the Guardian to ___________________________________. Such fees are subject to review and approval by the Court at the next regular accounting. No presumption that these fees will be approved as reasonable is created by this authorization for advance. Amounts shall be advanced only for actual services provided, and costs actually incurred. Interim Guardian fees in the amount of $ ________ for services rendered and administrative costs (DSHS cases only) of $ ____________ between ____________ and ____________ are reasonable and approved.[ ]DSHS cases. The above fees and costs are approved for payment as a monthly deduction from the incapacitated person’s participation in the DSHS cost of care per WAC 388.79.030. [ ]Non-DSHS cases. The above fees are approved for payment from the guardianship estate assets.2.10Attorney Fees and Costs Attorney fees in the amount of $_________and costs in the amount of $ _________ are hereby approved as reasonable. They shall be paid from the guardianship assets of the Incapacitated Person, from the participation of the Incapacitated Person as an exception to policy, or other: ______________________________________.2.11Other_________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________.Dated ___________________________._______________________________________ Judge/Court Commissioner______________________________________ ____________________________ ______________Signature of Guardian/Attorney Print Name of Guardian/Attorney [ ]WSBA [ ]CPG#__________________________________________....________________________________________________Address City, State, Zip Code__________________________________________ ________________________________________________*Telephone/Fax Number Email Address*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. Use Form WPF GDN 03.0100, Guardianship Confidential Information form (Telephone Numbers), for this purpose.