Fillable Fee Request (Guardian Ad Litem) Form printable pdf download

Fee Request (Guardian Ad Litem) Form

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IN THE PROBATE COURT FOR DAVIDSON COUNTY TENNESSEE

IN RE:

__________________________________________

DOCKET NO.:_________________

GUARDIAN AD LITEM FEE REQUEST

Comes now ___________________, the court-appointed guardian ad litem, whose services in this matter are

now complete, and makes the following request for fees to be paid out of the ward’s estate.

The guardian ad litem requests that the Court approve the amount of $

________, (total of expenses incurred

and fees for services rendered) for the time period from ________, 201___ through ___________, 201___

2. The fee requested is based on an hourly rate of $150.00 per hour for a total of _____ hours of service. Expenses

incurred during the same time frame total $____________.

3. The value of the ward’s estate, either as set forth in the petition or as estimated by the petitioner and/or

guardian ad litem, is approximately $____________.

4. A detailed itemization of the services rendered and expenses incurred on behalf of the ward is attached to this

motion. CAVEAT: if the fee/expense request is for other than a modest fee or routine service (i.e. extent of

time/hours required), a statement to justify the amount of service/time required shall also be included.

5. This application, together with the attachments, has been served upon the petitioner; ward’s next of kin, and all

other interested parties, if any.

6. (IF APPLICABLE): Fees are also being requested in a related case (i.e., siblings in separate guardianships, etc.),

being ______________ under docket number ______________. The aggregate of all fees requested in related

cases is $___________ of which $____________ is to be assessed to this file.

I swear or affirm that the above information and that set forth in the attachments is true.

Respectfully submitted,

______________________________________

Signature of Attorney

Address of Firm, Etc.

(Notary acknowledgement and certificate of service required)

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Fee Request (Guardian Ad Litem) Form

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