Legal Guardianship Cases

GUARDIANSHIP AGREEMENT AND CONSENT

This Guardianship Agreement and Consent (the Agreement) is entered into as of by and between Guardian Name: of Address: ("Proposed Guardian"), and Protected Person Name: of Address: . Court of Jurisdiction: Case Number:

RECITALS

WHEREAS, the Protected Person is alleged to be incapacitated or in need of a guardian under applicable law due to: ; and

WHEREAS, the Proposed Guardian has agreed to serve as guardian and to assume the duties and responsibilities imposed by statute and by this Agreement; and

WHEREAS, the parties seek to record their agreement regarding the scope of guardianship, the powers to be exercised, reporting, and other matters necessary for presentation to the court.

NOW, THEREFORE

In consideration of the mutual covenants and the duties set forth herein, the parties agree as follows:

1. DEFINITIONS

For purposes of this Agreement: "Court" means the judicial body identified above; "Guardian" means the person appointed by the Court to act on behalf of the Protected Person; "Protected Person" means the individual identified above who is subject to guardianship proceedings.

2. APPOINTMENT; SCOPE OF AUTHORITY

The Protected Person and the Proposed Guardian request that the Court appoint the Proposed Guardian as guardian of the following scope (select all that apply):

Guardian of the person (personal decisions, health, residence) Guardian of the estate (financial affairs, property)

The Guardian shall have the powers conferred by statute and, subject to the limitations set forth in this Agreement, the powers described in Section 3 below. Any powers not expressly granted herein remain with the Protected Person unless otherwise ordered by the Court.

3. POWERS AND DUTIES OF THE GUARDIAN

The Guardian shall exercise reasonable care, diligence, and prudence in the performance of duties. The Guardian's powers include, without limitation, the authority to:

a) Make decisions regarding medical and mental health care for the Protected Person, including consenting to or refusing treatment, subject to applicable law and any advance directives provided by the Protected Person; specific medical instructions:

b) Determine residence and living arrangements for the Protected Person, including placement in supported living or institutional care when necessary; c) Manage financial affairs and property of the Protected Person, including receipt of income, payment of bills, and investment of assets consistent with the Protected Person's best interests; specific financial limitations:

4. LIMITATIONS ON POWER

The Guardian shall not, without prior Court approval: (a) sell or encumber real property owned by the Protected Person except as necessary for the Protected Person's support; (b) make any gift of the Protected Person's property contrary to the Protected Person's prior expressed intent; or (c) change the Protected Person's estate plan or beneficiary designations.

5. BOND; INVENTORY; ACCOUNTING

If the Court requires a bond, the Guardian shall procure and maintain a fiduciary bond in an amount set by the Court. Bond required: Yes No

The Guardian shall file an inventory and periodic accountings with the Court in accordance with statutory requirements and as the Court may order. The initial inventory shall be completed by: .

6. HEALTHCARE AND END-OF-LIFE DECISIONS

The Guardian shall make healthcare decisions consistent with the Protected Person's known wishes or, if unknown, in the Protected Person's best interests. The Guardian shall honor any valid advance directive or durable power of attorney for healthcare to the extent permitted by law.

7. COMPENSATION AND EXPENSES

The Guardian may be compensated for reasonable services and reimbursed for expenses incurred on behalf of the Protected Person as approved by the Court. Proposed rate or arrangement:

8. REPORTS AND COURT FILINGS

The Guardian shall promptly notify the Court of any change in residence, significant change in the Protected Person's condition, or any alleged abuse, neglect, or exploitation. The Guardian shall comply with all Court orders and statutory reporting obligations.

9. THIRD-PARTY RELIANCE; INDEMNIFICATION

Third parties may rely upon certified copies of the Court's order of appointment and on representations by the Guardian regarding authority granted hereunder. The Protected Person shall indemnify the Guardian and hold the Guardian harmless from claims arising from actions taken in good faith and in the exercise of authority granted by the Court, except for willful misconduct or gross negligence.

10. NOTICES

All notices, requests, consents and other communications required or permitted under this Agreement shall be in writing and delivered to the addresses below by personal delivery, certified mail, or other method authorized by the Court.

11. AMENDMENTS; WAIVER

This Agreement may be amended only by a written instrument signed by both parties and approved by the Court where such approval is required. No waiver of any provision shall be effective unless in writing and signed by the waiving party.

12. GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the state of , without regard to conflict of law principles.

13. ENTIRE AGREEMENT

This Agreement constitutes the entire agreement between the parties concerning the subject matter hereof and supersedes all prior agreements and understandings, whether written or oral, relating to the guardianship of the Protected Person, except to the extent otherwise ordered by the Court.

14. SEVERABILITY

If any provision of this Agreement is determined to be invalid or unenforceable, such provision shall be severed and the remainder of the Agreement shall remain in full force and effect.

15. COUNTERPARTS

This Agreement may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument. Facsimile or electronically transmitted signatures shall be treated as original signatures for all purposes.

CERTIFICATION

The parties certify under penalty of perjury under the laws of the governing jurisdiction that the facts stated in any accompanying filings are true and correct to the best of their knowledge, and that they have the authority to enter into this Agreement and to request relief from the Court consistent with its terms.

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