1 IN THE COURT OF CHANCERY OF THE STATE OF DELAWARE IN THE MATTER OF: , A person with a disability : : : : C.M. # FINAL ORDER FOR APPOINTMENT OF GUARDIAN OF THE PERSON AND PROPERTY WHEREAS, on a hearing was held on the guardianship petition ; WHEREAS, Petitioner is the of (hereinafter called with a disa bility interested party(ies) has/have waived notice and consented (agreed) to or has/have received notice through certified mail on the appointment of as guardian of the person and property of the person with a disability ; WHEREAS, , Esquire, the previously appointed attorney ad litem for the person with a disability , has filed his/her report; WHEREAS, the Court having reviewed the p etition and affidavits, considered the medical report, and considered the statements made and evidence presented at the hearing, finds that is a person with a disability by reason of mental or physical incapacity. By reason th ereof , such person is unable to properly manage and/or care for his/her person and American LegalNet, Inc. www.FormsWorkFlow.com 2 property without a guardian and is in danger of substantially endangering his/her health , becoming subject to abuse by other persons , becoming the victim of designing person s and/or is in danger of dissipating or losing such property by becoming the victim of designing persons. IT IS HEREBY ORDERED, this day of , 20, as follows: 1. is hereby appointed guardian of the perso n and property of , a person with a disability . 2. Before entering upon his/her duties as guardian pursuant to this Order, shall execute a bond to be taken in the name of the State of Delaware in the amount of $ with/without surety as a condition for the faithful performance of his/her duties as guardian, and shall be filed within seven days of the date of this Order. No copy of the final order will be released until the bond is filed. Any person o r entity presented with a valid order from the Court may use that order as proof that the bond has been executed and filed. 3. The guardian appointed herein is granted such powers, rights and duties which are necessary to protect, manage and care for the pers on and property of the person with a disability as provided for in 12 Del. C., Ch. 39. 4. The guardian is authorized to apply to become, or continue to act, as the representative payee for social security benefits. American LegalNet, Inc. www.FormsWorkFlow.com 3 5. The guardian shall file an annual update an d medical statement with the Register in Chancery every year , which is due on or before the first business day of the calendar quarter in which the guardian was appointed. The annual update and medical statement shall include the current mailing address o f both the person with a disability and the guardian, and a current medical statement from an approved medical practitioner setting forth the current medical status of the person with a disability and addressing the need for continued guardianship. 6. The gua rdian is required to pay $ to , Esquire, within thirty (30) days of the date of this order, for his/her services as the attorney ad litem for the person with a disability . The attorney ad litem is hereby discharged from furt her service as attorney for the person with a disability . 7. The Register in Chancery of this Court is appointed agent of the guardian to accept service of process on behalf of the guardian as to any claim arising out of the guardianship if, by reason of the cannot be served. 8. In the event of the death of the person with a disability , the guardian shall notify the Office of Register in Chancery within ten (10) days. 9. If the person with a disability becomes Medicaid qu alified, the guardian shall provide proof of that qualification and a copy of any signed trust instrument American LegalNet, Inc. www.FormsWorkFlow.com 4 10. An order from the Court of Chancery is required to authorize the opening of any safe deposit box of the person with the disability and to sell or encumber any real property of the person with a disability . 11. The guardian is relieved of the requirement of opening a guardianship account, filing an inventory and filing annual accountings. However, if the person with a disability earns more than $1,000.00 in any given month, other than Social Security benefits, th e guardian shall report the earnings to the Court within thirty days for further review. If, in the future, the guardian come s into possession of additional funds or property belonging to the person with a disability or the person with a disability becomes gainfully employed, the guardian shall notify the Court and account for such funds or property as the Court may then direct. Chancellor/Vice Chancellor/Master American LegalNet, Inc. www.FormsWorkFlow.com