FORM #581GC (01/2019) Page 1 of 2 62-5-716 STATE OF SOUTH CAROLINA ) ) COUNTY OF ) ) ) IN THE MATTER OF: ) PROBATE COURT USE ONLY , ) ) IN THE PROBATE COURT a ward/protected person ) ) CASE NUMBER - GC - - ) ) APPLICATION FOR REGISTRATION AND ) RECOGNITION OF GUARDIANSHIP AND/OR ) CONSERVATORSHIP ORDER(S) FROM ANOTHER STATE This Application for Registration and Recognition of Guardianship and/or Conservatorship Order(s) from Another State and Sworn Statement are submitted pursuant to S.C. Code Ann. 247 62-5-716 of the South Carolina Adult Guardianship and Protective Proceedings Jurisdiction Act. 1. I,, was appointed as the: Guardian of the person; Guardian of the property; Conservator; Other: for an adult in the State of on the day of , 20. 2. I hereby file with this Court certified, exemplified, or authenticated copies of the following documents: The foreign order(s) of appointment and any subsequent orders issued by the foreign court, including the provisional order of transfer; Reports of examiner(s); The foreign letters or other documents evidencing or affecting my authority to act as guardian and/or conservator; Any bond(s) filed with the appointing foreign court; All reports of guardian, inventories and annual accountings filed with the appointing foreign court; Other: 3. By signing this form I declare that to the best of my knowledge, information, and belief: a. No petition for appointment of a temporary guardian, guardian, temporary conservator and/or conservator is pending for the ward or protected person in another jurisdiction; b. The interstate guardianship and/or conservatorship order remains in force; c. There are no circumstances that might lead to the revocation or variation of the guardianship and/or conservatorship order by the appointing foreign court; and d. The statutorily required notice to the foreign appointing court of intent to register was given on the day of , 20. American LegalNet, Inc. www.FormsWorkFlow.com FORM #581GC (01/2019) Page 2 of 2 62-5-716 VERIFICATION ge, information and belief. Petitioner: Executed this day of , 20. SWORN to before me this day of Applicant's Signature: , 20 . Print Name: Address: Print Name: Preferred Telephone: Notary Public for: Secondary Telephone: (State) Email: My Commission Expires: (Date) Relationship to the Protected Person/Ward : Co-Petitioner: Executed this day of , 20. SWORN to before me this day of Co - Applicant's Signature: , 20 . Print Name: Address: Print Name: Preferred Telephone: Notary Public for: Secondary Telephone: (State) Email: My Commission Expires: (Date) Relationship to the Protected Person/Ward : Executed this day of , 20. Attorney Signature: Print Name: Firm Name: Bar Number: Address: Telephone: Email: Attorney for: American LegalNet, Inc. www.FormsWorkFlow.com