Guardian of the Person and Property

IN THE COURT OF CHANCERY OF THE STATE OF DELAWARE

FINAL ORDER FOR APPOINTMENT OF
GUARDIAN OF THE PERSON AND PROPERTY

WHEREAS, on leave blank a hearing was held in the above-matter

("hearing");

WHEREAS, Petitioner is the of

(hereinafter called “the disabled person”), and the

disabled person's next of kin has/have waived notice and consented (agreed) to or has/have

received notice through certified mail on the appointment of as

guardian of the person and property of the disabled person;

WHEREAS, leave blank Esquire, the previously appointed

attorney ad litem for the disabled person has been personally served at least ten (10) days before

the date of the Hearing, or in the alternative has filed a Waiver of Service, and has rendered

his/her report;

WHEREAS, the Court having reviewed the Petition and affidavits, considered the

medical report, and considered the statements made and evidence presented at the hearing, finds

that is a disabled person because he/she is aged, mentally

infirmed, and/or physically incapacitated. By reason thereof such disabled person is unable to

properly manage and/or care for his/her person and consequently, such disabled person without

guardian is in danger of substantially endangering his/her health or becoming subject to abuse by

other persons or becoming the victim of designing persons AND is unable to properly manage

and/or care for his/her property and consequently, such disabled person without a guardian is in

danger of dissipating or losing such property by becoming the victim of designing persons.

IT IS HEREBY ORDERED, this day of 20 as follows:

1. is hereby appointed guardian of the person and

property of a disabled person.

2. Before entering upon his/her duties as guardian pursuant to this Order,

shall execute a bond to be taken in the name of the State

of Delaware in the amount of $ leave blank with/without surety as a condition for the

faithful performance of his/her duties as guardian, and shall be filed within seven days of

the date of this Order.

3. The guardian appointed herein is granted such powers, rights and duties which are

necessary to protect, manage and care for the person and property of the disabled person

as provided for 12 Del. C., Ch. 39.

4. The guardian, shall open one or more bank account(s) at

and/or its successors AND shall deposit ALL monies of the

disabled person in such account(s). The account(s) shall be entitled “COURT OF

CHANCERY, GUARDIANSHIP ACCOUNT FOR

DISABLED, GUARDIAN, WITHDRAWALS ONLY

BY ORDER OF THE COURT."

5. The guardian may withdraw up to $ leave blank total per month without further notice

of the Court. Otherwise, the guardian may NOT make ANY withdraws from the

account WITHOUT first having a Court Order to do so.

6. A first inventory is due within thirty (30) days of today's date.

7. The guardian shall file an accounting of the guardianship accounts at least once every

year on the anniversary date of the appointment of the guardian (the date of this Order)

and at any other time the Court shall direct as required by the Rules of this Court.

8. The guardian shall file a status report with the Register in Chancery every year on the

anniversary date of the appointment of guardian (the date of this Order) as required by

the Rules of this Court and at any other time the Court shall direct. The status report

shall include the current mailing address of both the disabled person and the guardian,

and the current medical statement from the attending physician setting forth the current

medical status of the ward and addressing the need for continued guardianship.

9. The guardian shall within thirty days submit proof to the Register in Chancery that the

terms of this Order have been complied with and the bank account(s) provided for in this

Order has/have been opened in accordance with the provisions of this Order.

10. The guardian is required to pay $ leave blank to

Esquire, for his/her services as the attorney ad litem for the disabled person. The

attorney ad litem is hereby discharged from further service as attorney for the disabled

person.

11. The Register in Chancery of this Court is appointed agent of the guardian to accept

service of process on behalf of the guardian as to any claim arising out of the

guardianship if, by reason of the guardian's absence from this State, he/she cannot be

served.

12. In the event of the disabled person's death, the guardian shall notify the Office of

Register in Chancery within ten (10) days.

(Vice) Chancellor or Master