Page 1 of 2 IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT IN AND FOR PINELLAS /PASCO COUNTY, FLORIDA , PROBATE DIVISION Case No. : - - GD - IN RE: THE INTEREST OF A developmentally disabled perso n. / SIMPLIFIED ANNUAL PLAN The undersigned, as the Guardian(s) Advocate of the above - named ward, report(s) to the court as follows: 1.) The name and address of all places the ward has resided during the preceding year. 2.) Why is this the best placement for the ward? 3.) List all profes sional medical/mental health treatment the ward has received during the past year (did the ward see a doctor, dentist, or mental health professional, if so when?): continue to need a guardian advocate? 5.) What personal and social services were provided for the ward in the past year (i.e., programs attended, vacations, in - home activities, out - of - the home activities, what does the ward like to do for entertainment or in his/her free time)? American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 6.) In the past year, how has the ward interacted with others, including the guardian(s) advocate and family members (if the ward is not able to interact, state why)? 7.) Should any of the rights previously delegated to the guardian(s) advocate be restored to the war d at this time? If so, identify the specific right(s) [such as to consent to medical treatment, to determine residence, to manage property, etc.] and explain why. Date Guardian Advocate Signature Address Phone Number Email I certi fy I have provided my attorney of record with a copy of this annual plan (if applicable) DELIVERY : The original copy of this Simplified Annual Plan must be filed with the Clerk of the Circuit Court: Mailing address : Pinellas County: 315 Court Street, Room 106, Clearwater, Florida, 33756 Pasco County: Paula S. O'Neil, Clerk & Comptroller, P.O. Box 338, New Port Richey, FL 34656 - 0338 ASSISTANCE : Pinellas County: Clerk of the Court, phone (727) 464 - 3321 or email Probate@mypinellasclerk.org Guardianship Division of the Circuit Court, phone (727) 582 - 7243 or email Probateoffice@jud6.org Pasco County: 727 - 847 - 8031 or visit http://www.pascoclerk.com/public - gen - contact - info.asp American LegalNet, Inc. www.FormsWorkFlow.com