IN THE CIRCUIT COURT OF THE TWENTY-SECOND JUDICIAL CIRCUIT McHENRY COUNTY, ILLINOIS Probate Division IN THE MATTER OF ) ) ) ) ) ) Case Number_______________________________ ______________________________________________ Alleged Disabled Person STATEMENT OF GUARDIAN AD LITEM TO RESPONDENT TO:_________________________________________________________________________________________ A petition has been filed in the Probate Division of the Circuit Court of the Twenty-Second Judicial Circuit, McHenry County, Illinois, asking that you be declared a disabled person and that a guardian be appointed for you. A copy of the petition has been, or will be, served upon you and another copy is attached to this statement for your information. I have been appointed by the judge as your Guardian ad Litem and have been directed to interview you and advise you of your rights in this proceeding. If a guardian is appointed, the guardian may be given the right to take control of your property and may be given the right to make personal decisions for you, including decisions such as the medical treatment you receive and the place where you live. You have certain rights in connection with this petition. You have the right to be present at the hearing. You have the right to be represented by a lawyer, either one you retain or one appointed by the Court. You have the right to demand a jury of six persons. You have the right to present evidence and to confront and cross-examine all witnesses. You have the right to ask that the hearing be closed to the public. You have the right to ask the judge to appoint one or more independent experts to examine you, and give an opinion of your need for a guardian. You have the right to tell the Court whom you prefer to have as your guardian. If you have any further questions before the hearing you may contact me by mail or telephone. NAME_______________________________________________________________________________________ ADDRESS___________________________________________________________________________________ CITY, STATE & ZIP___________________________________________________________________________ TELEPHONE_________________________________________________________________________________ I, the Guardian ad Litem, certify that on _____________________________________, 20______, I personally interviewed the respondent and informed him/her orally and in writing of the contents of the petition and his/her rights under 755 ILCS 5/11a-11 of the Probate Act, as amended, by reading the foregoing Statement of Guardian ad Litem to Respondent and the attached petition to him/her and by handing him/her a copy of said statement and petition. _____________________________________________________ Signature PR-STA1 Disabled Guardianship American LegalNet, Inc. www.FormsWorkflow.com