FORM #526GC (1/2019) Page 1 of 2 62-5-303B, 62-5-403B STATE OF SOUTH CAROLINA ) ) COUNTY OF ) ) , ) an alleged incapacitated individual. ) PROBATE COURT USE ONLY , ) ) IN THE PROBATE COURT Petitioner(s), ) CASE NUMBER - GC - - vs. ) , ) MOTION TO BE RELIEVED AS COUNSEL Respondent(s). ) FOR ALLEGED INCAPACITATED INDIVIDUAL Movant: 1. The undersigned request(s) that this Court order ( check any that app ly ) that he/she be relieved as attorney for the alleged incapacitated individual . that he/she be appointed as Guardian ad Litem in the above - referenced matter. 2. Movant make s this Motion based on the following sworn statement: The alleged incapacitated individual no longer needs to utilize the services of the undersigned attorney and is incapable of communicating, with or without reasonable accommodations, his/her wishes, interests, or preferences regarding the appointment of a Guardian and/or Conservator. Specifically the undersigned attorney met with the alleged incapacitated individual time(s) and the following is a brief summary of where the meeting(s) took place and the observation which serve as the basis for the relief requested in this motion: WHEREFORE, the undersigned hereby swears and affirms to the foregoing and request an order as indicated above and for such other and further relief as is just and proper. Executed this day of , 20. SWORN to before me this day of Signature: , 20 . Print Name: Firm Name : Bar Number: Print Name: Address : Notary Public for: (State) Telephone : My Commission Expires: (Date) Email : American LegalNet, Inc. www.FormsWorkFlow.com FORM #526GC (1/2019) Page 2 of 2 62-5-303B, 62-5-403B ORDER FOR HEARING IT IS HEREBY ORDERED that a hearing on this matter be set for: DATE: TIME: PLACE: Pursuant to S.C. Code Ann. 62-1-401, THE MOVANT IS/ARE ORDERED to give notice of this hearing to all other interested persons by mailing or delivering his/her Notice of Hearing and any appropriate attachments to each of them at least twenty (20) days prior to the hearing date. PLEASE TAKE NOTICE that a copy of this order is neither a substitute for the Notice of Hearing, nor one . THE MOVANT IS FURTHER ORDERED to file his/her Proof of Delivery (FORM #120PC) of said Notice of Hearing no later than the hearing date. , Judge of Probate day of , 20 , South Carolina ORDER IT IS HEREBY ORDERED that (check all that apply): T he alleged incapacitated individual no longer needs to utilize the services of an attorney and is incapable of communicating, with or without reasonable accommodations, his/her wishes, interests, or preferences regarding the appointment of a g uardian and/or c onservator. T he attorney appointed for the alleged incapacitated individual be relieved of his/her duties. T he previously appointed attorney for the alleged incapacitated individual be appointed as Gu a rdian ad Litem for the alleged incapcitated individual. T he relief requested is denied. in the above-referenced matter. Written notice of this Order must be served as provided by Rule 5, SCRCP. IT IS SO ORDERED. , Judge of Probate day of , 20 , South Carolina Note: There is no charge for this Motion. American LegalNet, Inc. www.FormsWorkFlow.com