IN THE CIRCUIT COURT FOR FLORIDA IN RE: File No. COUNTY, PROBATE DIVISION Division ORDER DETERMINING LIMITED INCAPACITY On the Petition to Determine Incapacity filed herein with respect to (the Ward), the Court having taken testimony, having considered the reports of the Examining Committee, having considered all alternatives to guardianship, and being fully advised in the premises, finds, based on the clear and convincing evidence presented, as follows: 1. The Ward suffers from incapacities of the following nature and scope: 2. The areas in which the Ward lacks capacity to make informed decisions about care and treatment services or to meet the essential requirements for the Ward's physical or mental health or safety are: 3. The specific legal disabilities to which the Ward is subject (the rights the Ward is incapable of exercising) are: ) to marry ( ) to vote ) to contract ( ) to travel ) to sue and defend lawsuits ( ) to have a driver's license ) to determine his or her residence ( ) to seek or retain employment ) to personally apply for government benefits ) to manage property or to make any gift or disposition of property ) to make decisions about his or her social environment or other social aspects of his or her life ( ) to consent to medical and mental health treatment ( ( ( ( ( ( ( Bar Form No. G-2.061 - 1 of 2 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 4. After consideration of reasonable alternatives to guardianship, the Court finds that no alternative will sufficiently address the problems and needs of the Ward. 5. It is in the best interests of the Ward that a limited guardian of the property of the Ward be appointed; accordingly it is ADJUDGED as follows: 1. is hereby determined to be incapacitated and a limited guardian should be appointed to provide for the welfare and safety of the Ward. 2. 3. The Ward is incapable of exercising the rights specified in paragraph 3. The Ward shall retain those rights set forth in Florida Statutes Section 744.3215(1), and all other rights except those the Court has hereinabove adjudged that the Ward is incapable of exercising. 4. A copy of this Order shall be served on the Ward and the Ward's attorney by the clerk and a certificate attesting to such service promptly filed in this proceeding. ORDERED on , . Circuit Judge Bar Form No. G-2.061 - 2 of 2 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com