FORM #512GC (01/2019) 62-5-108 Page of 3 STATE OF SOUTH CAROLINA ) ) COUNTY OF ) ) ) IN THE MATTER OF: ) PROBATE COURT USE ONLY , ) ) IN THE PROBATE COURT an alleged incapacitated individual. ) ) CASE NUMBER - GC - - ) PROBATE COURT INSTRUCTIONS ) FOR MOTION FOR EMERGENCY RELIEF ) AND HEARING PURSUANT TO ) S.C. CODE ANN. 247 62 - 5 - 108 1. This Motion is to be used only where immediate and irreparable injury or damage to the health, safety, or welfare of an alleged incapacitated individual (A.I.I.), or substantial economic loss to the A.I.I., is likely and imminent before a temporary or permanent hearing may be scheduled. If this is not an emergency as described below, but there is a need for action to be taken before a permanent hearing may be scheduled, please use Form #513GC and follow the Instructions on page 1 of that form. 2. The emergency Motion must be filed at the same time as a (a) Summons and Petition, (b) Motion and Order for Appointment of an Attorney if none retained, and (c) Motion and Order for Appointment of Guardian ad Litem (GAL) if none previously appointed. Examples of emergencies for which the court may accept a motion for emergency relief are as follows: imminent loss of federal or state assistance such as Medicaid, Medicare, Social Security income, Supplemental Security Income, VA benefits. b. Kidnapping or false imprisonment of A.I.I., or transport of A.I.I. out of the state of South Carolina. c. Inability or refusal of A.I.I. to give informed consent to emergency medical procedures. dinability to provide for own mental and physical needs which requires a guardian to seek immediate treatment. e. Need for or loss of housing or nursing home care for A.I.I.; provided, however, homelessness by itself is not an emergency. f. Unauthorized transfer of assets of A.I.I. including unauthorized transfer by agent pursuant to power of attorney. g. Inability of A.I.I. to take immediate action necessary to preserve assets. h. Inability of A.I.I. to prosecute or defend legal actions, or execute legal documents. marriage. 3. Evidence of the suitability and creditworthiness of the proposed guardian, conservator, or other fiduciary must be provided in a written credit report and criminal background check from the state of residence of the proposed guardian, conservator, or other fiduciary, and must be submitted with the Motion. 4. If the Motion includes a request for the freezing or restriction of assets, information as to specific bank accounts of the A.I.I. must be provided. 5. An emergency hearing must be scheduled within ten (10) days of the issuance of the Ex Parte Order or as otherwise ordered by the court. I HAVE READ AND UNDERSTAND THESE INSTRUCTIONS: Executed this day of , 20 . Petitioner/Movant American LegalNet, Inc. www.FormsWorkFlow.com FORM #512GC (01/2019) 62-5-108 Page of 3 STATE OF SOUTH CAROLINA ) ) COUNTY OF ) ) IN THE MATTER OF: ) , ) an alleged incapacitated individual. ) ) PROBATE COURT USE ONLY ) ) IN THE PROBATE COURT , ) CASE NUMBER - GC - - Petitioner(s), ) vs. ) NOTICE OF AND MOTION FOR , ) EMERGENCY RELIEF AND HEARING Respondent(s). ) I move for emergency relief to protect the welfare or assets of , an alleged incapacitated individual (A.I.I.), and request a hearing on , 20, at a.m./p.m., or at such date and time as the Court orders, for: Appointment of emergency guardian, conservator, or other fiduciary. Removal of existing guardian, conservator, or other fiduciary, and appointment of a successor. Appointment or removal of Guardian ad Litem. An emergency protective order. Immediate and irreparable injury, loss, or damage will result before notice can be served on adverse parties and a hearing held pursuant to S.C. Code Ann. 247 62-5-108(B) as shown by the following facts: If an emergency guardianship or protective order related to the welfare of the A.I.I. is requested, a affidavit dated within the last thirty (30) days is attached. Executed this day of , 20. Signature: Print Name: Address: Preferred Telephone: Secondary Telephone: Email: Relationship to the a lleged incapacitated individual : Attorney Signature: Print Name: Firm Name: Bar Number: Address: Telephone: Email: Attorney for: American LegalNet, Inc. www.FormsWorkFlow.com FORM #512GC (01/2019) 62-5-108 Page of 3 STATE OF SOUTH CAROLINA ) COUNTY OF ) ) IN THE MATTER OF: ) , ) an alleged incapacitated individual. ) ) PROBATE COURT USE ONLY ) ) IN THE PROBATE COURT , ) CASE NUMBER - GC - - Petitioner(s), ) vs. ) EX PARTE ORDER FOR , ) EMERGENCY RELIEF AND Respondent(s). ) NOTICE OF HEARING The Court has jurisdiction over the parties and subject matter, and venue is proper. affidavit filed with the Court and the factual allegations made, the request for emergency order and hearing is granted; denied. If granted, pending the emergency hearing IT IS ORDERED: 1. The physical welfare of the alleged incapacitated individual (A.I.I.) requires emergency relief as follows: is appointed Guardian with all of the rights and duties in S.C. Code Ann. 247 62-5-304A(B); is appointed Limited Guardian to make decisions about the custody and residence; consent to medical or other professional care, counsel, treatment, or service, access medical records; and/or other:. 2. The assets of the A.I.I. require emergency protection as follows: is appointed Conservator with all of the rights and duties in S.C. Code Ann. 247 62-5-422(A); is appointed Limited Conservator to have access to the A.I.I.provided, however, if this box is checked no disbursements may be made without written court approval; apply for, receive and manage money and property with the exception of ; institute and maintain proceedings to protect money and property; other:. 3. is appointed Guardian ad Litem with all of the rights and duties in S.C. Code Ann. 247 62-5-106. 4. a Protective Order is entered as follows: . 5. A fiduciary bond in the amount of $ is required. NOTICE OF EMERGENCY HEARING Date: Time: Place: Petitioner shall serve this Order and Notice of Emergency Hearing on the A.I.I., the attorney and GAL for the A.I.I., and adverse parties immediately after issuance. , Judge of Probate Executed this day of , 20. , South Carolina American LegalNet, Inc. www.FormsWorkFlow.com