IN THE CIRCUIT COURT FOR FLORIDA IN RE: GUARDIANSHIP OF COUNTY, PROBATE DIVISION File No. Division ORDER APPOINTING PLENARY GUARDIAN OF PERSON AND PROPERTY (Total Incapacity ­ Advance Directive) On the petition of of a plenary guardian of the person and property of for the appointment (the Ward), the Court finding that the Ward is totally incapacitated as adjudicated by order of this Court entered ADJUDGED as follows: 1. . 2. Upon taking the prescribed oath, filing designation of resident agent and acceptance and payable to the Governor of the State posting bond in the amount of letters of guardianship shall be issued. 3. The guardian must place the following property of the Ward: is qualified to serve and is hereby appointed plenary guardian of the person and property of , , and that it is necessary for a plenary guardian to be appointed for the person and property of the Ward, it is of Florida and to all successors in office, conditioned on the faithful performance of all duties by the guardian, in a restricted account in a financial institution designated pursuant to Florida Statutes Section 69.031. 4. The court finds that the Ward, prior to incapacity, appointed a health care surrogate pursuant to Florida Statutes Chapter 765. Such advance directive: (___) is superseded and the guardian shall exercise all delegable rights otherwise assigned to the health care surrogate. (___) shall remain in effect until further order of this court. (___) shall remain in effect to the following extent: ORDERED on , . . Circuit Judge Bar Form No. G-3.062 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com