Defendant(s) : ...................................................... »» How is a proceeding for a guardian started? WHAT YOU NEED TO KNOW BEFORE FILING A PETITION THE PEOPLE OF THE YORK TO APPOINT A GUARDIAN STATE OF NEW Any person interested in the individual's welfare may complete a Petition for Appointment of GuardFOR AN INCAPACITATED ADULT ian of Incapacitated Individual (form PC 625) and TO »» What is a guardian? file it, along with the filing fee, with the probate court where the individual resides or is presently located. The guardian ad litem will: 1) explain the hearing procedure and the individual's rights during the hearing. 2) inform the individual of the name of anyone seeking appointment as guardian; and 3) inform the court of his or her determinations about the individual's wishes. »» Is a lawyer necessary? »» Can the individual get a guardian A guardian is a person appointed by a probate GREETINGS: responsibility to immediately in an emergency? court and given power and No, but a lawyer can be helpful, especially if make certain decisions about the care of WE COMMAND YOU, If an emergency exists, the judge may appoint a someone objects to the appointment of a guardian, another individual. These decisions might that all business and excuses being laid aside, you and each of you attend before , the Honorable at the temporary guardian to serve until a hearing on the authority you are asking toCourt be given, or the person include treatment decisions or where the you the petition can be held. County of If the individual has a located at are asking to be appointed guardian. individual should live. reduced life expectancy due to advanced illness,day of in room , on the , 20 , at o'clock in the noon, and at any recessed »» Can mediation in used for disagreements ALTERNATIVES TO A FULL GUARDIAN the guardian or adjourned date, to testify and give evidence as a witness be this action on the part of the may have the power to make an about a guardianship? informed decision on behalf of the individual regarding receiving, continuing, discontinuing, The following five alternatives must be planned or refusing medical treatment. The duties of a by the individual before he or she becomes Certain disagreements about a request for a guardian are listed in statute.failure to comply with this subpoena is punishable as a contempt ofcourt ifand will make you liable to mentally incapable of making the decisions. guardian may be mediated outside the court all Your parties agree a maximum penalty if judge order the party on whose behalf this subpoena was issued for to attend mediation or ofa$50 and all damages sustained as a A full guardian can make all decisions for the 1. Health Care Power of Attorney parties to attend mediation. The court clerk can tell result of your failure to comply. individual. A limited guardian, can only make Also called a patient advocate designation you if mediation services are available in your court. decisions for the individual that the court allows. or a durable power of attorney for health Witness, Honorable , one of the »» What happens when the court accepts a Justices of the care. This document enables a person to »» When can the court appoint a guardian? Court in County, day ofpetition for filing? , 20 name an agent (called a patient advocate) to make his or her health care decisions The court can appoint a guardian when it finds After the petition is accepted for filing, the court will when not capable or not competent to do so. the person is a legally incapacitated individual appoint a guardian ad litem to visit the individual to The document may cover any type of health and determines that a guardian is necessary. (Attorney must sign and to make explain the guardianship proceedings above and type name below) care decision including guidance to the recommendations to the court as a result of the visit. agent about the type and extent of health »» What is a "legally incapacitated individual"? care desired. It can also include authority to A legally incapacitated individual is an adult the It is important for you to cooperate with the guardian withhold or to withdraw life support services. Attorney(s) for court finds to be so impaired by mental illness, ad litem. The guardian ad litem does not have the mental deficiency, physical illness or disability, 2. Do-Not-Resuscitate Order authority to make decisions for the individual. The chronic use of drugs, chronic intoxication, or A do-not-resuscitate order is a document individual may have to pay for the guardian ad litem. other cause, that he or she lacks the understanddirecting that the patient named in the order If necessary, the court may also order the individual ing or capacity to make or communicate informed to be examined by a Office andor a mental health physician P.O. Address not be resuscitated if the patient's decisions. professional. spontaneous respiration and circulation stop in a setting outside a nursing home, hospital, »» Is a guardian needed for an individual who »» What will the guardian ad litem do? or mental health facility owned or operated by Telephone No.: may be legally incapacitated? the Department of Community Health. The patient must sign the document in the The guardian ad litem will personally visit the Facsimile No.: A guardian might not be necessary if someone presence of his/her attending physician and individual and explain to the Address: the nature, individual E-Mail else already has legal authority to make two adult witnesses. purpose, and legal effects of the appointment of a decisions for the person and there are no Mobile Tel. No.: guardian. problems with the decisions they are making. American LegalNet, Inc. www.USCourtForms.com Defendant(s) : ...................................................... If the patient is an adherent of a religious 4. Representative Payee 5. Joint Ownership denomination or a PEOPLE OF THE STATE OF NEW YORK A representative payee is appointed by a Joint ownership involves certain assets to be THE church whose members depend upon spiritual means through prayer government agency to receive, manage, and held by two or more persons and may entitle any alone for healing, the adult patient may sign spend government benefits for a beneficiary. of the owners to have control and management TO a do-not-resuscitate order that meets This is most often done for Social Security of the assets. special statutory requirements and that does benefits. The beneficiary may request a not require the signature of an attending representative payee, but usually the agency Some of the assets that can be held in joint physician. requires one when the beneficiary is no ownership are real estate, bank accounts, GREETINGS: longer able to manage benefits. corporate stocks, and mutual funds. A joint 3. Power of Attorney owner can apply the funds of an account for the A power of attorney is aWE COMMANDby document signed YOU, that all business and excuses being courtaside, you This each of you attend before A payee is approved by the agency and there disabled co-owner without laid action. and a competent the Honorable another person person giving is no court involvement. The representative can involve the loss of sole control over the , at the Court the power to manage some or all of his or her payee's authority is limited to the governfunds by the disabled person and can result in located at County of affairs. The document must be signed by a dishonest20 of ,funds by the co-owner. in room , on the day of , use at o'clock in the noon, and at ment funds for which he or she is the payee. any recessed notary in the presence of at least one or adjourned date, to testify and give evidence as a witness in this action on the part of the witness. 5. Special Services for the Aging The following five alternatives do not need to be planned by the individual before he or she becomes Many communities have voluntary services A power of attorney is durable if it remains mentally incapable of making the decisions. available upon request to help the aging with valid even if the maker of the power of their financial affairs. Services may include Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to attorney later becomes disabled or incapaci1. Limited Guardian depositing and writing checks, balancing the party on whose behalf this sustained as paying bills, preparing insurtated. A durable power of attorney is the subpoena was issued for a maximum penalty of $50 and all damages checkbooks, a A guardian who makes only those decisions for result of your failure to comply. means for a mentally competent adult to the individual that the court allows. ance claims, preparing tax information and grant a person (called an agent) authority to counseling, and applying for public benefits act for him/her if incapacity occurs. It usually 2. Conservator Witness, Honorable , one of the Justices of theand counseling. affects property decision-making but may Court in County, day of A conservator 20a person appointed by probate , is affect health care decisions. See the Health The Commission on Aging and the Family court and given power and responsibility for the Care Power of Attorney stated in item 1. Independence Agency provide these estate (financial assets and property) of an adult services in many communities as well as (called a protected individual). 4. Trust church organizations. A person capable of (Attorney must sign above and type name below) A trust may be a substitute for a conservator asking for or accepting the services must If an individual has property such as real estate, and a will. The trust expresses the desires of request the services to receive them. large bank accounts, or stock that he or she can the maker (called a settlor) about the no longer manage, it may be appropriate to file Attorney(s) for management of his or her assets during his a petition for a conservator. See separate or her lifetime and when physically or instructions on Conservatorship Proceedings. mentally unable to manage the assets. 3. Protective Order Under a trust, assets are owned by the trust When only a single transaction affecting the Office and required, the and managed by the trustee for the benefit of property of a disabled person isP.O. Address the persons to be protected. The trust also probate court may enter a protective order for names the individuals to whom the assets this one time matter. will go upon the settlor's death. A trustee Telephone No.: frequently is the maker of the trust at first At a hearing, the court may authorize, direct, or Facsimile No.: and usually names a relative to be the ratify any contract, trust, or other transaction E-Mail Address: successor. Professional trustees often relating to that person's financial affairs or estate Mobile Tel. No.: Approved, SCAO serve in this highly responsible position. PC 666 (11/02) without appointing a conservator or a guardian. American LegalNet, Inc. www.USCourtForms.com