In The Matter Of The Application For Temporary Guardianship Of

Form 3T

S.C. No.

SUPREME COURT OF YUKON

PURSUANT TO THE DECISION MAKING, SUPPORT AND PROTECTION TO

ADULTS ACT, S.Y. 2003, C.21 (the “Act”); specifically SCHEDULE A, THE

ADULT PROTECTION AND DECISION MAKING ACT, PART 3, COURT

APPOINTED GUARDIANS (“Part 3”)

IN THE MATTER OF THE APPLICATION FOR TEMPORARY GUARDIANSHIP OF

(name of adult)

also known as, (if applicable)

TEMPORARY GUARDIANSHIP APPLICATION

Name of Applicant

(name of applicant who is asking to be appointed as principal guardian)

1. DATE AND LOCATION OF HEARING OF THIS APPLICATION

This application will be heard by a Justice of the Supreme Court of Yukon on,

the

, day of

a.m./p.m.,

(day of week)

(day)

(month)

(year)

or so soon thereafter as may be heard, at the Law Courts, 2134 Second Avenue in the

City of Whitehorse, in Yukon.

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Parent category: Legal