This form may be used to petition for:
Guardianship for an adult;
Conservatorship for an adult or minor;
A protective arrangement instead of guardianship for an adult; or
A protective arrangement instead of conservatorship for an adult or minor.
Petition for Guardianship, Conservatorship, or Protective Arrangement
State of:. . ..
County of:. . ..
Name and address of attorney representing petitioner, if applicable:. . ..
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Note to petitioner: This form can be used to petition for a guardian, conservator, or both, or for a protective arrangement instead of either a guardianship or conservatorship. This form should not be used to petition for guardianship for a minor.
The court may appoint a guardian or order a protective arrangement instead of guardianship for an adult if the adult lacks the ability to meet essential requirements for physical health, safety, or self-care because (1) the adult is unable to receive and evaluate information or make or communicate decisions even with the use of supportive services, technological assistance, and supported decision making, and (2) the adult's identified needs cannot be met by a less restrictive alternative.
The court may appoint a conservator or order a protective arrangement instead of conservatorship for an adult if (1) the adult is unable to manage property and financial affairs because of a limitation in the ability to receive and evaluate information or make or communicate decisions even with the use of supportive services, technological assistance, and supported decision making or the adult is missing, detained, or unable to return to the United States, and (2) appointment is necessary to avoid harm to the adult or significant dissipation of the property of the adult, or to obtain or provide funds or other property needed for the support, care, education, health, or welfare of the adult, or of an individual who is entitled to the adult's support, and protection is necessary or desirable to provide funds or other property for that purpose.
The court may appoint a conservator or order a protective arrangement instead of conservatorship for a minor if:
(1) The minor owns funds or other property requiring management or protection that cannot otherwise be provided; or(2) it would be in the minor's best interests, and the minor has or may have financial affairs that may be put at unreasonable risk or hindered because of the minor's age, or appointment is necessary or desirable to provide funds or other property needed for the support, care, education, health, or welfare of the minor.The court may also order a protective arrangement instead of conservatorship that restricts access to an individual or an individual's property by a person that the court finds:
(1) Through fraud, coercion, duress, or the use of deception and control, caused, or attempted to cause, an action that would have resulted in financial harm to the individual or the individual's property; and(2) poses a serious risk of substantial financial harm to the individual or the individual's property.(1) Information about the person filing this petition (the petitioner.) (b) Principal residence:. . ..(c) Current street address (if different):. . ..(d) Relationship to respondent:. . ..(e) Interest in this petition:. . ..(f) Telephone number (optional):. . ..(g) Email address (optional):. . ..(2) Information about the individual alleged to need protection (the "respondent"). Provide the following information to the extent known. (c) Principal residence:. . ..(d) Current street address (if different):. . ..(e) If petitioner anticipates respondent moving, or seeks to move respondent, proposed new address:. . ..(f) Does respondent need an interpreter, translator, or other form of support to communicate with the court or understand court proceedings? If so, please explain:. . . . . . ..
(g) Telephone number (optional):. . ..(h) Email address (optional):. . ..(3) People who are required to be notified of this petition. State the name and address of the people listed in Appendix A. . . ..
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(4) Existing agents. State the name and address of any person appointed as an agent under a power of attorney for finances or power of attorney for health care, or who has been appointed as the individual's representative for payment of benefits. . . ..
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(5) Action requested. State whether petitioner is seeking appointment of a guardian, a conservator, or a protective arrangement instead of an appointment. . . ..
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(6) Order requested or appointment requested. If seeking a protective arrangement instead of a guardianship or conservatorship, state the transaction or other action you want the court to order. If seeking appointment of a guardian or conservator, state the powers petitioner requests the court grant to a guardian or conservator. . . ..
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(7) State why the appointment or protective arrangement sought is necessary. Include a description of the nature and extent of respondent's alleged need. . . ..
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(8) State all less restrictive alternatives to meeting respondent's alleged need that have been considered or implemented. Less restrictive alternatives could include supported decision making, technological assistance, or the appointment of an agent by respondent including appointment under a power of attorney for health care or power of attorney for finances. If no alternative has been considered or implemented, state the reason why not. . . ..
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(9) Explain why less restrictive alternatives will not meet respondent's alleged need. . . ..
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(10) Provide a general statement of respondent's property and an estimate of its value. Include any real property such as a house or land, insurance or pension, and the source and amount of any other anticipated income or receipts. As part of this statement, indicate, if known, how the property is titled (for example, is it jointly owned?). . . ..
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(11) For a petition seeking appointment of a conservator. (Skip this section if not asking for appointment of a conservator.)(a) If seeking appointment of a conservator with all powers permissible under this state's law, explain why appointment of a conservator with fewer powers (i.e., a "limited conservatorship") or other protective arrangement instead of conservatorship will not meet the individual's alleged needs. . . ..
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(b) If seeking a limited conservatorship, state the property petitioner requests be placed under the conservator's control and any proposed limitation on the conservator's powers and duties. . . ..
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(c) State the name and address of any proposed conservator and the reason the proposed conservator should be selected. . . ..
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(d) If respondent is twelve years of age or older, state the name and address of any person respondent nominates as conservator. . . ..
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(e) If alleging a limitation in respondent's ability to receive and evaluate information, provide a brief description of the nature and extent of respondent's alleged limitation. . . ..
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(f) If alleging that respondent is missing, detained, or unable to return to the United States, state the relevant circumstances, including the time and nature of the disappearance or detention and a description of any search or inquiry concerning respondent's whereabouts. . . ..
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(12) For a petition seeking appointment of a guardian. (Skip this section if not asking for appointment of a guardian.) (a) If seeking appointment of a guardian with all powers permissible under this state's law, explain why appointment of a guardian with fewer powers (i.e., a "limited guardianship") or other protective arrangement instead of guardianship will not meet the individual's alleged needs. . . ..
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(b) If seeking a limited guardianship, state the powers petitioner requests be granted to the guardian. . . ..
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(c) State the name and address of any proposed guardian and the reason the proposed guardian should be selected. . . ..
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(d) State the name and address of any person nominated as guardian by respondent, or, in a will or other signed writing or other record, by respondent's parent or spouse or domestic partner. . . ..
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(13) Attorney. If petitioner, respondent, or, if respondent is a minor, respondent's parent is represented by an attorney in this matter, state the name, telephone number, email address, and address of the attorney(s). . . ..
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SIGNATURE
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Signature of Petitioner Date
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Signature of Petitioner's Attorney if Date
Petitioner is Represented by Counsel
APPENDIX A:
People whose name and address must be listed in subsection (3) of this petition, if they are not the petitioner.
Respondent's spouse or domestic partner, or if respondent has none, any adult with whom respondent has shared household responsibilities in the past six months;
Respondent's adult children, or, if respondent has none, respondent's parents and adult siblings, or if respondent has none, one or more adults nearest in kinship to respondent who can be found with reasonable diligence;
Respondent's adult stepchildren whom respondent actively parented during the stepchildren's minor years and with whom respondent had an ongoing relationship within two years of this petition;
Any person responsible for the care or custody of respondent;
Any attorney currently representing respondent;
Any representative payee for respondent appointed by the social security administration;
Any current guardian or conservator for respondent appointed in this state or another jurisdiction;
Any trustee or custodian of a trust or custodianship of which respondent is a beneficiary;
Any veterans administration fiduciary for respondent;
Any person respondent has designated as agent under a power of attorney for finances;
Any person respondent has designated as agent under a power of attorney for health care;
Any person known to have routinely assisted the individual with decision making in the previous six months;
Any person respondent nominates as guardian or conservator; and
Any person nominated as guardian by respondent's parent or spouse or domestic partner in a will or other signed writing or other record.
Added by 2019 c 437,§ 603, eff. 1/1/2021.