Fill and Sign the Notice Removal Form 497431025

STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use IN THE MATTER OF       Amended Notice of Appointment of Statement Requesting Removal of Rights and Transfer of Additional Powers to Guardian       Date of Birth Case No.       To: 1. The ward named above. 2. The guardian. 3. County Department of Social Services or Human Services if Ward is Protectively Placed or Receives Long-Term Support Services as a Public Benefit. 4. Agent under Ward’s Power of Attorney for Health Care, if any. 5. Agent under Ward’s Durable Power of Attorney for Finances, if any. 6. Any Other Persons Determined by the Court       You are notified that a Statement Requesting Removal of Rights and Transfer of Additional Powers to Guardian (copy attached) has been submitted to the court on (date)       . If, after 10 days after notice is provided, or earlier if the court determines that the circumstances are extraordinary, no person submits to the court an objection to the request, the court may amend the order appointing guardian and enter a determination and the amended order that specifies any change in the powers of guardian. If, within 10 days after notice is provided, a person submits to the court an objection to the request, the court shall hold a hearing, unless the objector declines a hearing, under procedure for review and modification of guardianship. Signature of Person Making Statement       Name Printed or Typed       Address       Name of Attorney       Address             Date Telephone Number       Bar Number       GN 3648, 01/07 Notice of Statement Requesting Removal of Rights and Requesting Transfer of Additional Rights to Guardian § 54.63, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material.