Petition For Appointment Of Guardian (Page 3 of 3) in pdf

INSTRUCTIONS FOR COMPLETING

"PETITION FOR APPOINTMENT OF GUARDIAN OF INCAPACITATED INDIVIDUAL"

Please type or print neatly using black or blue ink.

Items A through Q must be read and filled in (when required) before your petition can be filed with the court. Please

read the instruction for each item. Then fill in the correct information for that item on the form.

Enter the name of the individual who you believe needs a guardian.

Enter the date of birth, race, and sex of the individual named in A . Enter the address where the individual is

currently located. This address may or may not be the home of the individual. For example, if the individual is

currently in the hospital, enter the address of the hospital.

Enter your name in the first line and your relationship to the individual (or your interest) on the second line.

Check this box if there is or has been a case in the family division of the circuit court involving the individual in

A . Examples of a family division case are personal protection, abuse or neglect, or a name change. If you

have checked this box, enter the name of the court, the case number of the action, the name of the judge

assigned to that case. Then place a check in the box indicating whether that case is still pending or not.

Enter the city, village, or township and county and state the individual is a resident of and the full home address

and telephone number of the individual.

Check the boxes that apply and provide the name(s) and address(es).

If the individual has a patient advocate and you believe there is a problem, check only the boxes that apply.

Check the boxes that you believe apply to the individual.

Explain in as much detail as possible specific examples of the individual's conduct that lead you to believe he

or she needs a guardian. Give specific examples of his or her conduct that supports what you checked in

H and that demonstrate the need for a guardian. This information is extremely important for the court

in making a decision about the need to appoint a guardian. Use additional sheets of paper if needed.

Enter the name, address, and telephone number of the person or agency who currently has care and custody

of the individual. If there is no one, leave blank.

Check whether the individual is or is not entitled to receive Veterans Administration benefits. If you checked

that the individual is entitled to benefits, enter his or her VA claimant number.

L - M Check all the boxes that apply and enter the names, relationships, addresses and telephone numbers of each

relative of the individual. If any of the adults named in L are under legal incapacity, enter the names in M .

If you check the last box in L (item 10), you must notify the Attorney General by sending a copy of this form

to: Attorney General, Public Administration, PO Box 30755, Lansing, Michigan 48909.

Enter the name, address, and telephone number of the person you want to be appointed as guardian of the

individual. Enter the relationship, if any, that this person has to the individual. Check the box for either a full

guardian or a limited guardian.

Check the box if there is an emergency requiring the appointment of a temporary guardian before the hearing

on this petition is held.

Enter today's date, sign your name, and enter your address and telephone number.

If the individual wants to nominate someone to be his/her guardian, check the box and enter the name, address,

and telephone number of the person the individual is nominating. The individual must sign and date the form.

Petition For Appointment Of Guardian Page 3