Annual Report On Ward Form - Lake County, Illinois
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1IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT
LAKE COUNTY, ILLINOIS
GUARDIANSHIP OF
)
)
)
Case No. ________________________
_____________________________________________ )
A disabled person
)
ANNUAL REPORT ON WARD
Now comes the Guardian of the person named in the caption hereto, under penalties of perjury as provided under
Section 1-109 of the Code of Civil Procedure, stating:
1. An Order was entered on __________________________________, finding said person to be a disabled adult,
and appointing the undersigned Guardian of the person;
2. The last Annual Report to the Court was made on ___________________________________.
3. The ward’s current mental, physical and social condition is: ___________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
4. The ward has no minor or adult dependent children.
The ward has minor or adult dependent children.
5. The ward’s present living arrangement, a description and address of every residence where the ward lived during
the reporting period and length of stay at each place is:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
6. A summary of the medical, educational, vocational and other professional services given the ward is:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
7. A summary of the guardians visits with and activities on behalf of the ward is: ____________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
8. The undersigned guardian recommends continued guardianship.
The undersigned guardian does not recommend continued guardianship.
9. Other information which may be useful to the Court is: _______________________________________________
__________________________________________________________________________________________
All which is respectfully submitted. Date: ___________________, 20____.
Prepared by:
__________________________________________
Name: ____________________________________________
Signature of Guardian
Attorney’s Name: ____________________________________
__________________________________________
Address: __________________________________________
Guardian’s Address
City ____________________________ State _____________
__________________________________________
Phone: ____________________ Zip Code _______________
City, State and Zip Code
FAX: ______________________________________________
ARDC #: __________________________________________
171P-19 (Rev. 12/11)
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