Fill and Sign the Petition Guardianship Minor Form

STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use IN THE MATTER OF             Amended Petition for Temporary Guardianship Permanent Guardianship of Minor       Date of Birth Case No.       FOR TEMPORARY AND/OR PERMANENT GUARDIANSHIPS (Complete #1 through #14) UNDER OATH, I STATE THAT: 1. I am interested as: a relative       . a public official. My authority to act as petitioner is:       . other:       . 2. This petition is filed in: the county of residence of the minor. the county in which the minor is physically present. Other:       3. The residence of the minor is in       County, State of       , and post-office address is:       . 4. The minor’s date of birth is:       . 5. The name and post-office address of the person or institution, if any, that has care and custody of the minor or the facility, if any, that is providing care to the minor is: Name:       Phone Number:       Post-office Address:       6. I have exercised due diligence to locate all interested parties. The names and post office addresses of all interested parties and all others entitled to notice are as follows: See attached . NAME RELATIONSHIP POST-OFFICE ADDRESS                   7. The minor, if married, does does not have children who are not of the current marriage. 8. This petition is made in the best interests of the minor. The minor needs a guardian because:       9. I am not aware aware of a guardianship or other related proceeding or ordered proceeding involving the minor in another state or county. The details of the guardianship, or other related proceedings of which I am aware are as follows: See attached. guardian(s) appointed in Wisconsin: (Name and county where appointed)       guardian(s) appointed out-of-state: (Name and state where appointed)       A separate petition for receipt and acceptance of a foreign guardianship is being filed. GN-3290, 10/06 Petition for Temporary Guardianship and/or Permanent Guardianship of Minor §§54.10(1), 54.34, 54.50 and Ch. 54, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 4 GN-3290 Petition for Temporary Guardianship and/or Permanent Guardianship of Minor Page 2 of 5 Case No. 10 . The following person is nominated as guardian: See attached. Type of Guardian Name & Address Phone Guardian of the Person             Guardian of the Estate             Temporary Guardian of the Person             Temporary Guardian of the Estate             Standby Guardian of the Person             Standby Guardian of the Estate             One or both of the parents of the minor have not been nominated as guardian because:       11. A sworn and notarized Statement of Acts by Proposed Guardian and Consent to Serve: accompanies this petition. will be filed at least 96 hours before the hearing. will be provided, if required by the court for temporary guardianship. 12. A. The approximate value of minor’s property is: See attached. General Description Amounts General Description Amounts Cash/Bank $       Other Liquid Assets: $       Real estate: $       Other Assets : $       B. Assets of minor previously derived from or benefits of minor now due and payable from U.S. Department of Veterans Affairs are: none       See attached . C. The minor is receiving public benefits, including medical assistance, SSI, SSDI or long term community options program benefits: No Yes, type and amount:       D. Any other claim, income, compensation, pension, insurance or allowance to which the minor may be entitled is none. as follows: See attached. General Description Amounts (monthly) General Description Amounts (monthly) Social security $       Investment Income $       Child Support $       Other $       Disability $       Other $       13. I request the court order payment of child support. See attached. FOR PERMANENT GUARDIANSHIP (Complete #14) 14. I petition the court to appoint a permanent guardian of the minor with the following powers: A. Guardian of person and extent of powers consent to medical examination and treatment, and consent to voluntary medication, including psychotropic medication that is in the minor’s best interests, if the guardian has first made a good-faith attempt to discuss with the minor the minor’s voluntary receipt of the psychotropic medication and the minor does not protest. Guardian of person’s authority: full limited       GN-3290, 10/06 Petition for Temporary Guardianship and/or Permanent Guardianship of Minor §§54.10(1), 54.34, 54.50 and Ch. 54, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 5 GN-3290 Petition for Temporary Guardianship and/or Permanent Guardianship of Minor Page 3 of 5 Case No. authorize minor’s participation in an accredited or certified research project if the research project might help the minor, or others if minimal risk of harm Guardian of person’s authority: full limited       authorize minor’s participation in research that might not help the minor but might help others if greater than minimal risk of harm to the minor but evidence indicates minor would have elected to participate Guardian of person’s authority: full limited       consent to experimental treatment in the minor’s best interests Guardian of person’s authority : full limited       consent to receipt by minor of social and supported living services Guardian of person’s authority: full limited       consent to release of confidential records other than court, treatment, and patient health care records and redisclosure as appropriate Guardian of person’s authority: full limited       power to make decisions related to mobility and travel Guardian of person’s authority: full limited       power to choose providers of medical, social, and supported living services Guardian of person’s authority: full limited       power to make decisions regarding educational and vocational placement and support services or employment Guardian of person’s authority: full limited       power to make decisions regarding initiating a petition for termination of marriage Guardian of person’s authority: full limited       power to receive all notices on behalf of minor Guardian of person’s authority: full limited       power to act in all proceedings as an advocate of the minor, except the power to enter into a contract that binds the minor or the minor’s property or to represent the minor in any legal proceedings pertaining to the property, unless the guardian of the person is also the guardian of the estate Guardian of person’s authority: full limited       power to apply for protective placement or for commitment Guardian of person’s authority: full limited       power to have care, custody, and control of the minor Guardian of person’s authority: full limited       other specific powers, see attached. B. Guardian of the estate and extent of powers 1. duties under §54.19; 2. standard powers under §54.20(1), and 3. powers that do not require court approval under §54.20(3) Guardian of estate’s authority: full limited       Authorize the guardian of the estate to exercise additional powers requiring court approval under §54.20(2), other than to make gifts, as follows:       GN-3290, 10/06 Petition for Temporary Guardianship and/or Permanent Guardianship of Minor §§54.10(1), 54.34, 54.50 and Ch. 54, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 3 of 5 GN-3290 Petition for Temporary Guardianship and/or Permanent Guardianship of Minor Page 4 of 5 Case No. Dispense with bond and order deposit of minor’s funds of $100,000 or less in an insured account of a bank, credit union, savings bank or savings and loan association in the name of the guardian and the ward, and payable only upon further order of the court. Dispense with an appointment of a guardian of the estate and transfer the minor’s funds of $50,000 or less under one of the alternatives for small estates under §54.12(1), WI Statutes, as follows:       FOR TEMPORARY GUARDIANSHIPS (#15 through #19): 15. There has been no temporary guardianship of the minor in effect within the last 90 days . 16 . The minor’s particular situation, including the needs of the minor’s dependents, if any, requires immediate appointment of a temporary guardian for the following specific reasons:       See attached. 17. I petition the court for the appointment of a temporary guardian with authority limited to those acts that are reasonably related to the reasons for appointment. The authority requested for the temporary guardian is as follows:       18. I request that a hearing be held within 48 hours . Good cause exists to support this request for the following reasons:       19. A petition for appointment of a permanent guardian of the person or estate is NOT filed with this request because:       I REQUEST THAT THE COURT: 1. Order a hearing on this petition. 2. Make appropriate findings and appointments as requested above. 3. Award appropriate fees and costs. GN-3290, 10/06 Petition for Temporary Guardianship and/or Permanent Guardianship of Minor §§54.10(1), 54.34, 54.50 and Ch. 54, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 4 of 5 GN-3290 Petition for Temporary Guardianship and/or Permanent Guardianship of Minor Page 5 of 5 Case No. Subscribed and sworn to before me on       Notary Public/Court Official My commission expires:       Signature of Petitioner       Name Printed or Typed       Address       Name of Attorney       Address       Telephone Number       Bar Number       GN-3290, 10/06 Petition for Temporary Guardianship and/or Permanent Guardianship of Minor §§54.10(1), 54.34, 54.50 and Ch. 54, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 5 of 5