Fill and Sign the Name and Address of Guardian Form

Of The Person General Guardian Of The Person General Guardian Of The Estate Of The Estate 6. Add to the rights and privileges of the ward. Limit the rights and privileges of the ward. Modify a general guardianship to a guardianship of the person. Modify a general guardianship to a guardianship of the estate. Modify a guardianship of the person to a general guardian. Modify a guardianship of the estate to a general guardian. Other/Comment: STATE OF NORTH CAROLINA In The General Court Of Justice Superior Court Division Before The Clerk County File No. AOC-E-416, New 704 2004 Administrative Office of the Courts The Court makes the following specific findings of fact as to the nature of the ward's capacity: FINDINGS OF FACT Also present were: The ward was was not present. This court has jurisdiction over this matter and the parties. 1. The ward was represented by The guardian was was not present. The guardian was represented by . . 4. 2. 3. ORDER ON MOTION TO MODIFY GUARDIANSHIP G.S. 35A-1207 IN THE MATTER OF: Name And Current Address Of Ward Guardian Ward Other This matter coming to be heard before the undersigned upon motion of the: and upon hearing and reviewing the evidence, the Court does make the following: The movant indicated above asked the court to modify the guardianship as follows: 5. NOTE TO CLERK: Complete only if changing the ward's rights and privileges. Other: Understands conversation and communicates personal needs. Has capacity to communicate important decisions. Language and Communication A. Needs assistance Needs assistance Name And Address Of Guardian Name And Address Of Guardian Other: Can make and communicate choice in regard to employment. Demonstrates skills required to work. Can look for and find a job. Other: Has capacity to live alone. Has capacity to maintain private residence. Can recognize and communicate need for maintenance of private residence. Can make and communicate decisions about residential options. Other: Has capacity to identify and avoid life-threatening behaviors. Is able to recognize and avoid hazards in home. Can handle or seek help in emergencies. Can recognize when others present a danger and avoid that danger. Other: Can make and communicate decisions regarding health treatment. Can take care of minor health problems. Can follow prescribed routines and take prescribed medicines. Can alert others and seek medical help for serious health problems. Has capacity to keep a sanitary living environment. Other: Understands the need to bathe and maintain personal hygiene. Understands the need to maintain dental care. Is able to maintain personal hygiene and dental care. Uses proper hygiene when toileting. Other: Makes decisions about when and what to eat. Knows which foods he/she is unable to tolerate. Can maintain proper diet. Can follow a prescribed diet if needed. Nutrition B. Needs assistance AOC-E-416, Side Two, New 7/04 2004 Administrative Office of the Courts Employment G. Personal Hygiene C. Health Care D. Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance E. Personal Safety Residential F. Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Has capacity to determine degree of participation in religious activities. Other: Has capacity to appropriately relate to friends and family members. Has capacity to make decisions without undue influences from others. Has capacity to make decisions concerning social activities. Can identify his or her address and return home or seek assistance. Can utilize familiar community resources. Based on the evidence presented and testimony given the Court CONCLUDES that this guardianship should should not be modified. The guardianship is modified and the ward shall retain the following legal rights and privileges. (check all that apply) to remove rights and privileges previously ordered retained by the ward. to add to the rights and privileges of the ward. to a Guardianship of the Person and the General Guardianship is terminated. to a Guardianship of the Estate and the General Guardianship is terminated. to a General Guardianship and the Guardianship of the Person is terminated. to a General Guardianship and the Guardianship of the Estate is terminated. the Guardianship be modified Other: 1. I. H. Civil Independent Living J. Financial ORDER CONCLUSION AOC-E-416, Page Two, New 7/04 2004 Administrative Office of the Courts It is ORDERED that: File No. IN THE MATTER OF: Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Other: Can communicate wishes regarding legal documents or services. Can contact lawyer, police, advocates, etc. if being exploited or treated unfairly. Demonstrates willingness to vote and can acquire information accordingly. Has capacity to drive a car. Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Needs assistance Other: Is able to make and carry out major financial decisions. Can spend small amounts of money. Can manage a weekly or monthly budget. Is able to seek out and apply for government benefits. Has capacity to pay routine bills. Is able to maintain checking account and/or ATM card. 2. Determine his/her degree of participation in interpersonal relationships and social, religious, and community activities. Additional Specifications: Make Assist in decisions regarding living arrangements. Additional Specifications: Name Of Ward Of The Estate Other: The guardian shall file a final account with the clerk within days. (applies when terminating general guardianship or guardian of the estate) 4. 5. The motion is denied. 6. Of The Person General Guardian Of The Estate Of The Person General Guardian Assistant CSC Clerk Of Superior Court Make Assist in decisions regarding employment. Make Assist in decisions regarding health treatment. Take care of minor health problems. Additional Specifications: Maintain personal property other than funds, stocks, bonds, sureties, etc. Additional Specifications: Other. Enter into contracts regarding residential arrangements. Enter into contracts regarding social, religious, and community activities. Additional Specifications: Enter into contracts regarding health care, legal and other services. Additional Specifications: Consult with guardian regarding financial decisions. Additional Specifications: Handle amounts of money up to $ . Additional Specifications: Contact service providers as needed. Additional Specifications: Each person named below is appointed as guardian of the incompetent to serve in the capacity designated, and Letters of appointment shall be issued to each such person when he/she properly qualifies to serve. 3. Additional Specifications: Additional Specifications: AOC-E-416, Page Two, Side Two, New 7/04 2004 Administrative Office of the Courts Additional Specifications: Name And Address Of Guardian Signature Name And Address Of Guardian Date