___________________________________________ IN THE MATTER OF: o IN THE COURT OF COMMON PLEAS CHESTER COUNTY, PENNSYLVANIA o o ORPHANS COURT DIVISION o AN ALLEGED INCAPACITATED PERSON o NO. ORDER APPOINTING EMERGENCY GUARDIAN Pursuant to 20 Pa.C.S.A. 5513 _____________________________________________________ AND NOW, _______________________________, ________, following a hearing, I find that proper notice has been given to ___________________________________ _, the alleged incapacitated person (Respondent); that Respondent lacks capacity and is in need of a Guardian; and that failure to appoint an immediate Guardian will result in irreparable harm to the (person) (and) (estate) of Respondent. I therefore appoint _________________________ _______________ to be Guardian of the person and _____________________________________________ ___ to be Guardian of the estate of Respondent, and grant such Guardian(s) the f ollowing powers and duties: The Guardian shall post bond (with surety) as follows: This Order shall expire at ________________.M. on ______________________ _____ the _______________ day of __________________________________, _________, B Y THE COURT: ____________________________________ J American LegalNet, Inc. www.USCourtForms.com