IN THE CIRCUIT COURT FOR FLORIDA IN RE: GUARDIANSHIP OF COUNTY, PROBATE DIVISION File No. Division ANNUAL GUARDIANSHIP PLAN (GUARDIANSHIP REPORT) OF GUARDIAN OF PERSON (Minor Ward) , the guardian of the person of (the Ward), submits the following plan as the Annual Guardianship Report of this guardian: The Annual Guardianship Plan for the period beginning , and ending 1. , , shall be as follows: , The Ward's address at the time of filing this plan is . 2. During the preceding year, the Ward resided at (include dates, names, addresses and length of stay at each place): 3. It is intended that the Ward will reside at the following location for the current year: Bar Form No. G-4.019 - 1 of 3 � Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 4. preceding year: The following is a description of professional medical treatment given to the Ward during the NAME OF PHYSICIAN TREATMENT DATE 5. The plan for providing medical, mental health and rehabilitation services in the coming year, if appropriate, is as follows: 6. The social and personal services currently utilized by the Ward, if any, are as follows: 7. The following is a summary of the Ward's school progress report: Bar Form No. G-4.019 - 2 of 3 � Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 8. The following is a statement of the social activities of the Ward and a description of how well the Ward communicates and maintains interpersonal relationships: 9. A report from a physician who has examined the Ward no more than 180 days before the beginning of the applicable reporting period, containing an evaluation of the Ward's physical and mental condition, is attached. Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. Signed on this day of , . Guardian Attorney for Guardian Email Addresses: Florida Bar No. (address) Telephone: [Print or Type Names Under All Signature Lines] Bar Form No. G-4.019 - 3 of 3 � Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com