This document (RTF format) is available for download here

CAUSE NUMBER ________________

IN THE MATTER OF:

THE GUARDIANSHIP OF [PERSON OR ESTATE] OF NAME

AN INCAPACITATED PERSON

IN THE COUNTY COURT NUMBER _____

[COUNTY] COUNTY, __________

APPLICATION FOR APPOINTMENT OF TEMPORARY GUARDIAN
[Name], (“Applicant”) applies for the appointment of a temporary guardian over the person named below and over [his or her] estate. In support of this appointment, Applicant shows the Court as follows:

1. IDENTITY OF THE PROPOSED WARD
1.1 The name of the person over whom a temporary guardianship is desired is: [Name].
1.2 [He or She] is an adult [male or female].
1.3 [He or She] is [Age] years old and was born on [Birthdate].
1.4 [He or She] presently resides at [Address County, __________].
1.5 [His or her] social security number is [Number].
1.6 The proposed ward is a person of unsound mind as evidenced by the statement of the proposed ward’s physician, which is attached to this application as Exhibit “A”.
1.7 Exhibit “A” is incorporated in this application by reference as if duly recited at length in this application.

2. KIND OF GUARDIANSHIP
2.1 Applicant seeks a temporary guardianship of the person of the proposed ward and of [his or her] estate.
2.2 The Applicant’s name and address is: [address].
2.3 Applicant is related to the proposed ward as follows:
[or]
2.3 Applicant is not related to the ward and is a private professional guardian and complied with the requirements of Section 697 of the __________ Probate Code.

3. NEED FOR TEMPORARY GUARDIANSHIP
3.1 The facts that show just cause and establish the legal requirements entitling the Applicant to obtain a temporary guardianship are as follows:
a. the immediate appointment of a temporary guardian is necessary because the proposed ward is afflicted with [description of disease]; and
b. the proposed ward is mentally incompetent to care for [himself or herself] or to manage [his or her] property and financial affairs.
3.2 It is necessary for the proposed ward to be under the continuous supervision of professional nurses and doctors.
3.3 There is an immediate danger that the proposed ward’s [for example: spouse, children, creditors, etc. will remove the proposed ward’s property from [his or her] home or are refusing to take the proposed ward to a proper health care facility so that needed medical treatment may be obtained].
3.4 The requested term, if known for the guardianship is [term].
3.5 The name and address of any person whom the applicant knows to hold a power of attorney signed by the proposed ward and a description of the type of power of attorney is as follows, if any:
[Describe the power of attorney, attorney’s name and property covered by the power]
3.6 The proposed ward is not presently in a custodial court ordered decree or guardianship. [Name and address] is presently caring for the proposed ward.

[For Minors] 4. PARENTS OF THE PROPOSED WARD
4.1 [State the identity of the parents and their whereabouts. If the parents are deceased state: Both parents of proposed ward are deceased.]

5. IDENTITY OF PROPOSED TEMPORARY GUARDIAN
5.1 The Applicant, who seeks to be appointed temporary guardian over [Name], proposed ward, resides at [Address, County, __________] and is the [relationship, for example: [daughter] of the proposed ward.
5.2 [If applicable, state that the proposed temporary guardian is a private professional guardian who has complied with the requirements of Section 697 of the __________ Probate Code.]

6. QUALIFICATION OF PROPOSED GUARDIAN
6.1 Applicant is not disqualified by law or otherwise ineligible to serve as guardian and is a suitable person to act as a temporary guardian of the proposed ward.

7. VENUE
7.1 This Court has venue of this proceeding because the proposed ward resides in [Name] County, __________.
7.2 The proposed ward has lived in the county for a sufficient time to establish any necessary jurisdiction and venue requirements needed to confer jurisdiction in this Court.

8. IDENTITY OF PROPERTY OF PROPOSED WARD
8.1 The estate of the proposed ward consists of a property value set forth in the approximate amount of $[Amount].
8.2 A partial listing of the estate is attached as Exhibit “B,” which is incorporated in this application as if duly recited at length.

9. LISTING OF SPECIFIC POWERS REQUESTED BY
TEMPORARY GUARDIAN
9.1 Applicant requests the following specific powers as a temporary guardian over [Name], proposed ward.
9.2 These powers are reasonable and necessary to protect the interests of the proposed ward’s person and estate:
a. To sign any and all medical authorizations or releases for the proposed ward;
b. To authorize, select, incur and pay for any and all medical and nursing home expenses incurred by the proposed ward with funds out of the proposed ward’s estate;
c. To sell real or personal property of the proposed ward in order to pay for medical or nursing home expenses incurred by the proposed ward;
d. To apply for all private insurance, public benefits, federal, state, or local government benefits in order to pay for the cost of medical and nursing home expenses incurred by the proposed ward;
e. To make all decisions regarding the proposed ward’s living accommodations (e.g. nursing home facilities) and to execute all agreements, releases, authorizations, and contracts necessary to provide the proposed ward with such living accommodations;
f. To take any and all actions necessary to collect, preserve and protect the estate of proposed ward, including the filing of civil suit for possession and/or damages to the property belonging to the estate and the filing of criminal charges if necessary;
g. To incur whatever costs may be necessary to collect, preserve and protect the assets of the estate, including storage fees, attorney fees, court costs and any other costs involved;
h. To execute and deliver any instruments necessary to collect, preserve and protect the assets of the estate;
i. To take possession and prepare an accounting of all assets of the estate;
j. To sue or defend lawsuits on behalf of the estate, and to pay probate court costs, attorney fees and all necessary expenses; and
k. [list any other specific powers that the temporary guardian desires].

PRAYER
Applicant requests that the Court appoint [Name], Applicant, as Temporary Guardian of [Ward’s Name], the proposed ward and of the estate of [Ward’s Name] and grant Applicant the specific powers listed above, and that the appointment continue for such period of time as the Court may deem in the best interests of the proposed ward or until the temporary appointment is made permanent, should the Court determine that a permanent guardian is necessary.
Respectfully Submitted,

______________________________
[Law Firm Name]

By ____________________________

______________________________
[Attorney’s Name]

Attorney for Applicant
[Attorney’s Address]
[Telephone Number]
[Facsimile Number]
[Bar Card Number]

________________________
Applicant