IN THE COURT OF CHANCERY OF THE STATE OF DELAWARE } IN THE MATTER OF _________________________________ A DISABLED PERSON C.M. __________________ PETITION TO INITIATE MONTHLY WITHDRAWAL Petition of _____________________________________, (co) Guardian(s) of ________________________________, respectfully represents: Petitioner was appointed Guardian by Order dated_____________________. Petitioner is duly qualified and is acting as such Guardian. 1. The net assets of the estate consist of cash on deposit in the sum of $_______________ in _______________________________________________. 2. Petitioner has found that the disabled person has ongoing monthly Expenses in the amount of $________________ for ________________________ __________________________________________________________________ __________________________________________________________________ as evidenced by the attached copies. 3. Petitioner respectfully prays the Court to authorized the initiation of a Monthly withdrawal from the guardianship account at _______________________ In the amount of $_____________ without further Order of the Court. 4. The income from all other sources is inadequate to provide for the above named expenses. Guardian__________________________ Guardian__________________________ Address___________________________ Address___________________________ _________________________________ __________________________________ Phone____________________________ Phone_____________________________ The above named Guardian(s) having been duly sworn, deposes and says that the facts above recited are true and correct. Sworn to and subscribed before me _____________________________ Notary ____________________ Date American LegalNet, Inc. www.FormsWorkFlow.com IN THE COURT OF CHANCERY OF THE STATE OF DELAWARE } IN THE MATTER OF C.M. _________________ _________________________________ A DISABLED PERSON ORDER The foregoing petition having been considered by the Court, IT IS ORDERED this _________day of ____________________, _______ That ________________________Guardian of __________________________, is hereby authorized to implement a monthly withdrawal in the amount of $_______,without further Order of this Court, from the ______________account of the Disabled Person, on deposit with _______________and to deposit the same into the guardianship checking account, also to be held with_________________, for the payment of the monthly costs for the care of the disabled at _____________________________ and for the additional expenses of ________________. This withdrawal amount shall be in effect until further Order of this Court. _______________________________ Master American LegalNet, Inc. www.FormsWorkFlow.com