IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT____________________ In the Matter of the Protective Proceeding of ) ) ) ) ) ) ) Minor Date of Birth. CASE NO. ACCEPTANCE OF APPOINTMENT AS GUARDIAN OF A MINOR AND ACKNOWLEDGEMENT OF DUTIES I, , accept the duties of guardian of the minor named above. I have read and understand the duties and powers of a guardian in Alaska Statute 13.26.167. I agree to perform, according to the law, the duties of guardian as provided in the guardianship order. I further understand that I must file an Annual Report on Guardianship of a Minor (form PG640) every year until the guardianship ends. Date Guardian's Signature Mailing Address City State Daytime Telephone ZIP PG-630 (2/17)(cs) ACCEPTANCE OF APPOINTMENT AS GUARDIAN OF A MINOR AND ACKNOWLEDGEMENT OF DUTIES Probate Rule 15(c) & (d) AS 13.26.162 and 13.06.100 American LegalNet, Inc. www.FormsWorkFlow.com