Fill and Sign the Wisconsin Rights Additional Form

STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use IN THE MATTER OF       Statement of Emergency R equesting Removal of Rights and Transfer of Additional Powers to Guardian       Date of Birth Case No.       I am: guardian. another interested person. I request the removal of rights from the ward and transfer to the guardian of powers in addition to those specified in the order of appointment of the guardian, based on an expansion of the ward’s incapacity. The specific rights requested to be removed from the ward and powers requested to be transferred to the guardian and relevant support for this request are as follows: See attached       Signature of Person Making Statement       Name Printed or Typed       Address             _____________________________________________ DateName of Attorney       Address       Telephone Number       Bar Number       GN-3644, 01/07 Statement Requesting Removal of Rights and Transfer of Additional Powers to Guardian §54.63, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material.