Legal Guardian Advocate Petition

LEGAL GUARDIAN ADVOCATE PETITION

Petitioner Name: , Petitioner Address: , Telephone:

Proposed Guardian Advocate Name: , Address:

Person Alleged to Be Incapacitated (Proposed Protected Person) Name: , Date of Birth: , Address:

RECITALS

WHEREAS, Petitioner is a person entitled under applicable law to petition the court for the appointment of a guardian advocate on behalf of the person identified above; and

WHEREAS, the proposed protected person is alleged to lack the capacity to manage certain personal or financial affairs, as set forth in the factual statements and supporting reports attached to this petition; and

WHEREAS, Petitioner seeks appointment of the proposed guardian advocate to exercise limited advocacy powers necessary to protect the health, safety, and legal interests of the proposed protected person in a manner that imposes the least restrictive form of intervention consistent with the person's needs;

NOW THEREFORE, Petitioner respectfully petitions the court for relief as follows:

1. JURISDICTION

Petitioner alleges that this court has jurisdiction over the person and the subject matter of this petition under applicable statutory provisions governing guardianships and guardian advocates. Venue is proper in this court because the proposed protected person resides within the court's territorial jurisdiction.

2. RELIEF REQUESTED; SCOPE OF AUTHORITY

Petitioner requests that the court appoint the proposed guardian advocate to exercise the following powers on behalf of the proposed protected person, subject to the limitations stated:

Select requested type of appointment: Full guardian advocate appointment Limited guardian advocate appointment (specified powers) Temporary/expedited appointment

3. FACTUAL BASIS — NATURE OF INCAPACITY

Petitioner states under penalty of perjury that the following facts support the claim that the proposed protected person lacks the capacity to manage the specified affairs:

4. MEDICAL AND SUPPORTING REPORTS

Petitioner will file or has filed medical, psychological, or social reports in support of this petition. The names, addresses, and professional affiliations of persons expected to testify or provide written reports are as follows:

5. NOTICE TO INTERESTED PERSONS

Petitioner certifies that notice of this petition has been or will be provided to the following persons entitled to notice under governing law. Provide name, relationship, and address:

6. HEARING

Petitioner requests that this matter be set for hearing. Proposed hearing date:

7. BOND, COSTS, AND ACCOUNTING

Whether bond is requested or required: Bond required Bond waived by law or statute

If bond is requested, proposed amount:

8. PROPOSED ORDER LANGUAGE

Petitioner proposes the following form of order granting the requested appointment, specifying powers, duties, reporting and limitations:

9. CERTIFICATION AND OATH

I, the undersigned Petitioner, declare under penalty of perjury under the laws of the applicable jurisdiction that the foregoing is true and correct to the best of my knowledge, information, and belief. I acknowledge that knowingly making false statements in this petition may subject me to penalties under law.

10. ADDITIONAL CLAUSES

Governing Law: This petition, any appointment made pursuant to it, and the duties and powers of any guardian advocate appointed hereunder shall be governed by and construed in accordance with the laws of the jurisdiction in which this petition is filed.

Entire Agreement: This petition, together with any court order issued hereunder, constitutes the entire understanding between the parties regarding the matters contained herein and supersedes all prior agreements or understandings, whether written or oral, relating to the subject matter.

Severability: If any provision of this petition is held invalid or unenforceable by a court of competent jurisdiction, the remaining provisions shall remain in full force and effect to the greatest extent permitted by law.

Amendments and Waiver: Amendments to this petition or any order entered pursuant to it must be in writing and signed by the party seeking the amendment and approved by the court. No waiver of any right or provision shall be valid unless in writing and signed by the party waiving the right.

Notices: All notices required or permitted under this petition shall be in writing and shall be deemed given when personally delivered or when deposited in the United States mail, postage prepaid, addressed to the parties at the addresses provided herein.

Counterparts: This petition may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

DECLARATION OF PETITIONER

I declare under penalty of perjury that I am the Petitioner in this matter, that the statements contained in this petition are true and correct to the best of my knowledge, and that I will comply with all orders of the court relating to the duties and responsibilities of a petitioner in a guardianship proceeding.

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