Nebraska State Court Form CC 16:2.223 New 11/15 REQUIRED ACCEPTANCE OF APPOINTMENT OF TEMPORARY GUARDIAN Neb. Rev. Stat. § 30-2626(a), Neb. Ct. R. § 6-1443(A) IN THE COUNTY COURT OF COUNTY, NEBRASKA IN THE MATTER OF Case # Ward/Incapacitated Person ACCEPTANCE OF APPOINTMENT OF TEMPORARY GUARDIAN I, ( name of guardian(s)) , accept appointment as temporary guardian of , and swear that I will perform, according to law, (name of ward/incapacitated person) all duties for the ward/incapacitated person as temporary guardian. Date Signature(s) of Guardian(s) Print or Type Name of Guardian(s) Bar Number and Firm Name (attorneys only) Street Address/P.O. Box of Guardian(s) City/State/ZIP Code of Guardian(s) Phone of Guardian(s) E-mail Address of Guardian(s) Page 1 of 1 Acceptance of Appointment of Temporary Guardian CC 16:2.223 New 11/15 American LegalNet, Inc. www.FormsWorkFlow.com