Petition Form For Finding Incapacity/appointment Of Guardian/successor Guardian

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)
)
IN THE PROBATE COURT
COUNTY OF: ___________________________
)
)
IN THE MATTER OF : ________________________
(Alleged Incapacitated Person)
CASE NUMBER: _______________________________________
______________________________________
PETITION FOR:
PETITIONER
vs.
FINDING INCAPACITY
APPOINTMENT OF:
_______________________________________
_______________________________________
GUARDIAN
RESPONDENT
SUCCESSOR GUARDIAN
I.
ALL PETITIONERS MUST COMPLETE THIS SECTION.
1.
Give your relationship to the alleged incapacitated person, if any, and your interest in this proceeding.
________________________________________________________________________________________
2.
Information -- Alleged Incapacitated Person
Name:
Age:
Date of Birth:
Address:
City/State/Zip:
Telephone:
To my knowledge, above named
DOES
DOES NOT have a Health Care Power of Attorney.
To my knowledge, above named
DOES
DOES NOT have a Living Will (Declaration of a Desire for a
Natural Death.)
3.
Venue for this proceeding is in this county because the alleged incapacitated person:
resides in this county.
is present in this county.
is admitted to an institution pursuant to an order of a court of competent jurisdiction in this county.
4.
Information—Family of alleged incapacitated person, including dates of birth of minors. If there are no
minors, so state.
Relationship to
Name
Date of Birth
Address
Alleged
Incapacitated
Person
(use additional sheet if necessary)
FORM #530PC (4/13)
Page 1 of 4
62-5-301, 62-5-302, 62-5-303, 62-5-304, 62-5-305
62-5-307, 62-5-309, 62-5-310, 62-5-311

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