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State of Wisconsin Circuit Court County in Which This Case Form

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GN -3230 , 02/10 Consent to Serve as Temporary Guardian §§54.50 and 223.105(2), W isconsin Statutes This form shall not be modified. It may be supplemented with additional material. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF Amended Consent to Serve as Temporary Guardian Date of Birth Case No. 1. I am nominated to serve as temporary guardian of the person estate of the above named individual and consent to serve as temporary guardian of the person estate and will act in the best interest of this individual. 2. If appointed as temporary gua rdian of the estate , I will file an i nventory within 60 days of appointment, and account if required by the court . 3. I will exercise all powers and perform all duties as temporary guardian of the person estate as required by law. Name of Attorney/Petitioner ► Signature Name Printed or Typed Street Address Address Telephone Number Bar Number City, State, Zip Date Telephone Number

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Fill and Sign the State of Wisconsin Circuit Court County in Which This Case Form