IN THE CIRCUIT COURT FOR FLORIDA IN RE: GUARDIANSHIP OF COUNTY, PROBATE DIVISION File No. Division PETITION BY GUARDIAN FOR ORDER DETERMINING IF PAYMENTS SHOULD BE MADE FOR WARD'S DEPENDENT Petitioner, 1. 2. years and who presently resides at Petitioner is the duly qualified and acting , alleges: guardian of the property of (the Ward). , whose age is , claims to be a dependent of the Ward within the meaning of Florida Statutes Section 744.397, because and requests aid and assistance from the property of the ward for the following purpose: Petitioner believes the estate of the Ward has the ability to pay for, provide or furnish such aid and assistance without unreasonably jeopardizing the care, support, education and maintenance of the Ward. 3. has requested that petitioner, as guardian of the property of the Ward, pay for, provide or furnish from the property of the Ward for the aid and assistance to the Ward's said dependent, the items and amounts set forth on the list attached hereto as Exhibit A. Petitioner requests that an order be entered determining: 4. If is a dependent of the Ward within the meaning of Section 744.397 and as such is entitled to receive aid and assistance from the Ward's property. Bar Form No. G-4.145 - 1 of 3 © Florida Lawyers Support Services, Inc. Revised January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 5. The amounts, if any, and to whom and at what intervals disbursements should be made by petitioner out of the Ward's property to pay for, provide or furnish aid and assistance to: 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 , . Petitioner Attorney for Petitioner Email Addresses: _______________________________________ _______________________________________ Florida Bar No. (address) Telephone: I CERTIFY that a copy hereof has been furnished to: by , on , . Attorney [Print or Type Names Under All Signature Lines] Bar Form No. G-4.145 - 2 of 3 © Florida Lawyers Support Services, Inc. Revised January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com SCHEDULE OF DEPENDENT'S REQUESTED EXPENDITURES DESCRIPTION AMOUNT EXHIBIT "A" Bar Form No. G-4.145 - 3 of 3 © Florida Lawyers Support Services, Inc. Revised January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com