IN THE CIRCUIT COURT FOR FLORIDA IN RE: GUARDIANSHIP OF COUNTY, PROBATE DIVISION File No. Division ORDER APPOINTING EMERGENCY TEMPORARY GUARDIAN On the petition of temporary guardian for for appointment of an emergency , an alleged incapacitated person, who is represented by counsel in these proceedings, and it appearing to the court that there is an imminent danger that the physical or mental health or safety of the alleged incapacitated person will be seriously impaired or that the property of that person is in danger of being wasted, misappropriated or lost unless immediate action is taken; and the court having jurisdiction and being fully advised; it is ADJUDGED as follows: 1. and is hereby appointed as emergency temporary guardian of the (the Ward). 2. Upon taking the prescribed oath, filing a designation of resident agent and acceptance and payable to the Governor of the State of posting bond in the amount of is qualified to serve of Florida and all successors in office, conditioned on the faithful performance of all duties by the guardian, letters of emergency temporary guardianship shall be issued to the emergency temporary guardian granting the following powers and duties: . 3. The Court is not aware whether the Ward has executed any valid advance directive pursuant to Chapter 765, Florida Statutes. If any such advance directive exists, the guardian shall exercise no authority over a health care surrogate until further order of this Court. 4. Unless further extended by order of this Court, the authority of the emergency temporary guardian will expire ninety (90) days after the date of this order, or when a guardian is appointed pursuant to Florida Statutes Section 744.344, whichever occurs first. ORDERED on , . Circuit Judge Bar Form No. G-3.060 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com