Fill and Sign the Order Approving Guardian Washington Form

Superior Court of Washington County of In the Guardianship of: Incapacitated Person No . Order Approving Guardian’s Report, Accounting, and Budget (ORAPRT) [ ] Clerk’s Action Required, Para. 2.8 Guardianship Summary Date Guardian Appointed: Due Date for Report and Accounting (See paragraph 2): Date of Next Review (no later than anniversary date + 4 mo): Letters Expire On: Bond Amount: $ Restricted Account Agreements Required: [ ] Yes [ ] No Due Date for Receipt(s) of Funds in Blocked Account(s): [ ] Certified Professional Guardian (CPG) [ ] Public Professional Guardian (PUG) [ ] Lay (Family) Guardian (LGD) [ ] Training Completed [ ] Training Required Incapacitated Person (IP) Guardian of : [ ] Estate [ ] Person Name Address Phone* Facsimile Standby Guardian Interested parties Name Address Phone* Relation to IP Or Appr Gdn’s Rpt/Accounting/Budget (ORAPRT) - Page 1 of 3 WPF GDN 05.0400 (09/2012) RCW 11.92.040, .050 This Matter came on regularly for hearing on a petition to approve the Guardian’s annual/biennial/triennial report, accounting, and budget. The Court, having reviewed the Guardian’s Report, Accounting and Budget, and the records on file in this case, makes the following : I. Findings of Fact 1.1 Acts of Guardian All acts required of the Guardian to date have been performed. 1.2 Notice Notice has been properly provided to persons entitled to notice. 1.3 Budget and Care Plan The Guardian’s proposed Budget and Care Plan are reasonable and appropriate to the Incapacitated Person’s needs and should be approved. Based on the above, the Court makes the following: II. Orders 2.1 Approval of Guardian’s Report and Accounting The Guardian’s report and accounting is approved. 2.2 Budget The Guardian is authorized to continue to receive the Incapacitated Person’s income and to apply the income and other resources toward the Incapacitated Person’s expenses as provided in the Guardian’s Proposed Budget. 2.3 Medical and Dental Expenses The Guardian is authorized to incur and pay reasonable and necessary medical and dental expenses that the Guardian determines to be in the best interest of the Incapacitated Person. 2.4 Income Tax Payments/Accounting Fees The Guardian is authorized to make payments for income tax due as required, and to pay fees for accounting services required in connection with the preparation of income tax returns. 2.5 Miscellaneous Expenses The Guardian is authorized to make disbursements in an amount not to exceed $_______ ($500 if not filled in) on any one expenditure, from guardianship assets, for miscellaneous and necessary items that appear to be reasonable and in the best interests of the IP, without prior approval, to a maximum of $__________ ($1,500.0 if not filled in) per year without further order of the Court. 2.6 Guardian’s Next Report and Accounting The Guardian shall provide the next Report and Accounting for the [ ] 12 , [ ] 24 , or [ ] 36 month period from _______________________ through _________________; and the Report, Accounting, and Proposed Budget shall be filed with the Court within 90 days following the conclusion of that reporting period. The court must review the account or report within 120 days of the end of the reporting period. [ ] A review hearing is set for (date) _______________________. Or Appr Gdn’s Rpt/Accounting/Budget (ORAPRT) - Page 2 of 3 WPF GDN 05.0400 (09/2012) RCW 11.92.040, .050 [ ] The guardian must set a review hearing date on or before (date) ______________ [within 120 days of the end of the reporting period.] [ ] The court will review the account or report on or before (date) _______________ [within 120 days of the end of the reporting period], without a hearing. The court may set a review hearing at a later date. 2.6 Fees The Guardian’s fees of $_______________, attorney fees of $______________ and administrative costs (DSHS cases only) of $_____________ payable during the period covered in this report are hereby approved. The advance of Guardian’s fees for the upcoming reporting period, in the amount of $ ______________ per month, appear to be reasonable and necessary but are subject to court approval at the next hearing. Above fees are approved for payment from the [ ] guardianship estate assets OR [ ] as a monthly deduction from the incapacitated person’s participation in the DSHS cost of care per WAC 388.71. The monthly deduction from the participation in cost of care is authorized for the next reporting period and 120 days thereafter. 2.7 Bond Bond [ ] remains the same OR [ ] is changed to $__________________. 2.8 Letters of Guardianship The Clerk of Court is directed to issue new Letters of Guardianship with an expiration date of __________________ (one-hundred twenty days from the end of the reporting period). 2.9 Other . Dated ___________________________. Judge/Court Commissioner _____________________________________ _____________________________ _______________ Signature of Guardian/Attorney Print Name of Guardian/Attorney [ ]WSBA [ ] CPG# _____________________________________ _____________________________________________ Address City, State, Zip Code _____________________________________ _____________________________________________ *Telephone/Fax Number Email Address *If you do not want your personal phone number on this public form, you may list your telephone number on a separate form which may be available to parties and the court, as well as its staff and volunteers, but will not be made available to the public. Use Form WPF GDN 03.0100, Guardianship Confidential Information form (Telephone Numbers), for this purpose . Or Appr Gdn’s Rpt/Accounting/Budget (ORAPRT) - Page 3 of 3 WPF GDN 05.0400 (09/2012) RCW 11.92.040, .050