Form 17.1m - Report Of Guardian Of Minor printable pdf download

PROBATE COURT OF SHELBY COUNTY, OHIO

IN THE MATTER OF THE GUARDIANSHIP OF: ______________________________

CASE NO. ____________________________

REPORT OF GUARDIAN OF MINOR

(Local Rule 66.5)

1. This is the: (circle one) 1

, 2

, 3

, 4

, 5

, 6

, or __________________ Guardian’s Report.

2. Guardian’s present address: ____________________________________________________

(street)

______________________________________________________________________________

(city)

(state)

(zip code)

3. Guardian’s present telephone number: ___________________________________________

4. Minor’s present address: _______________________________________________________

(street)

______________________________________________________________________________

(city)

(state)

(zip code)

5. Minor’s living arrangements at above address are with: □ Minor’s Guardian(s) □ Minor’s

parent(s) □ Relative or non‐relative of the minor, whose name is _________________________

____________________ and relationship is __________________________________________

6. Name of school minor is attending: ______________________________________________

7. Are the reasons for this guardianship still valid? □ yes □ no IF NO, EXPLANATION REQUIRED:

______________________________________________________________________________

8. Has the child been hospitalized in the past year? □ yes □ no IF YES, EXPLAIN: ____________

______________________________________________________________________________

9. If the Guardian is also the guardian of the estate of the minor child, have there been any

changes in the financial assets of the child/ward, or any expenditures of the guardianship assets

without a Court order? □ yes □ no IF YES, EXPLAIN: __________________________________

______________________________________________________________________________

10. Is there any additional information and/or concerns about the minor child that you feel the

Court should know? □ yes □ no IF YES, EXPLAIN: _____________________________________

______________________________________________________________________________

___________________________

__________________________________________

Date

Guardian’s Signature

___________________________

__________________________________________

Date

Co‐Guardian’s Signature

FORM 17.1M – REPORT OF GUARDIAN OF MINOR

REVISED 12/02/14

Form 17.1m - Report Of Guardian Of Minor

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