Report On The Condition And Well Being Of A Ward (Page 2 of 4) in pdf

If Ward lives anywhere other than Guardian’s or Ward’s home, what is the name of the place Ward lives?

6. Length of time the Ward has resided in present home ___________________________________________________

Any change in residence in last year? Explain: ________________________________________________________

7. Annual Income of Ward: __________________________________________________________________________

8. Is there a Guardian for the Ward’s estate?

Yes

A. If there IS a Guardian for the Ward’s estate, please answer the following additional questions:

(1) Are you the Guardian for the Ward’s estate?

Yes

(2) Does Guardian of the Person receive an allowance from the Guardian of the Estate?

Yes

If YES, annual amount received __________________________________________________________

B. If there is NOT a Guardian for the Ward’s estate, please answer the following additional questions:

(1) Are you managing any funds of the Ward pursuant to Court order other than Social Security funds?

Yes

If YES, you must report on your management of those funds by attaching an income and expenses

worksheet to this Annual Report. Forms are available on the Court’s website or at the Court.

(2) Are you the representative payee of the Ward’s Social Security Disability (SSI) or Social Seciruty

Retirement Benefits?

Yes

If YES, you MUST attach to this Annual Report either (1) a copy of your most recent Representative

Payee Report provided by Social Security OR (2) the Court’s Representative Payee Report Form.

Forms are available on the Court’s website or from the Court. (Guardians of the estate will attach one

of these reports to the Annual Account.)

9. Ward

IS NOT under regular physician’s care.

Doctor’s name: __________________________________________________________________________________

10. During the past year ward has been treated or evaluated by the following:

Physician. Name:___________________________________________________________________________