Form J - Initial Guardian Advocacy Plan Of The Person Page 3

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Under penalties of perjury, I declare that I have read the foregoing and the facts alleged
are true, to the best of my knowledge and belief.
Executed this
day of
, 20_____.
I hereby certify that a true copy of the foregoing has been furnished by mail to
___________________________ (name of attorney for the person with a developmental
disability) at ___________________________________ (address of the attorney for the person
with a developmental disability) this
day of _____________________, 20____ and to
_______________________________, (The person with a developmental disability).
__________________________________
Signature of Guardian Advocate
__________________________________
Printed Name of Guardian Advocate
Page 3 of 3 of Form J

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