JDF 742 SC 9 / 18 ORDER APPOINTING GUARDIAN AD LITEM Page 1 of 2 District Court Denver Probate Court County, Colorado Court Address: In the Interest of: In the Matter of the Estate of: COURT USE ONLY Case Number: Division Courtroom ORDER APPOINTING GUARDIAN AD LITEM 1. Upon the c ourt's own motion; stipulation of the parties; motion of (appointee) is appointed as g uardian ad l item for the following person . : Street A ddress: City: State: Zip Code: Mailing A ddress, if different: City: State: Zip Code: Primary Phone: Alternate P hone: Email Address: Attorney Registration #: 2. This o rder is entered pursuant to s ection: 15 - 10 - 403(5) in a trust, estate, or judicially supervised settlement matter - appointment of a g uardian ad l item to represent the interests of a minor, an incapacitated, protected, unborn, or unascertained person, or a person whose identity or address is unknown. The reason for the appointment is as follows: 15 - 14 - 115 in a matter regarding a person under disability - appointment of a g uardian ad l item to represent the interests of a respondent or an incapacitated or protected person. The reason for the appointment is as follows: American LegalNet, Inc. www.FormsWorkFlow.com JDF 742 SC 9 / 18 ORDER APPOINTING GUARDIAN AD LITEM Page 2 of 2 3. The g uardian ad l ite duty is: to investigate and prepare specific written recommendations regarding: the allegations of incapacity or of the need for financial protection. the appropriateness of limitations to the g uardianship/ c onservatorship. the appropriateness/qualifications of the nominee. issues raised in the v r eport. issues raised in the g c r eport. issues raised by the appropriateness of termination of the g uardianship/ c onservatorship. other to advocate for and repr esent the best interests of the above named person regarding the following issues: Other: 4. The appointee must have access to all relevant information regarding the r espondent in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other privacy laws, without further order, authorization or release. Relevant information includes, but is not limited to the following records, reports, and evaluations: medical, psychiatri c, psychological, drug, alcohol, law enforcement, social services, school, financial, and estate planning. This o rder provides the authority to release such information to the appointee regardless of the original source of information. The appointee must not disclose this information inappropriately. 5. The g uardian ad l item must prepare a written report, including recommendations. The report must be filed and served upon interested persons at least 10 calendar days before the hearing for which the repor t was prepared If no hearing is currently set, the report must be filed within 30 calendar days from the date of appointment. The report must be filed and served upon interested persons by (date). 6. Unless otherwise ordered by the c ourt, the g uardian a d l item appointment is automatically terminated 30 days after the hearing at which the report is considered. If the hearing is waived, appointment is terminated 30 days after the report is filed. Other (explain) 7. The appointee must be compensa ted by: The captioned estate. The maximum hourly rate is set at $. The State of Colorado because all responsible parties are indigent (JDF 208 completed). (See CJD 04 - 05) Person to be determined by the c ourt at a later date. Other (expl ain) 8. Acceptance of this appointment requires the appointee to comply with Chief Justice Directive s 04 - 05 or 04 - 06 . Failure to comply may result in termination of the appointment and/or removal from the appointment lis t. Next appearance is on (date), at (time), in (division). Date: Judge Magistrate Registrar American LegalNet, Inc. www.FormsWorkFlow.com