PETITION FOR THE APPOINTMENT OF AN EMERGENCY GUARDIAN AND/OR CONSERVATOR FOR A PROPOSED WARD INSTRUCTIONS I. Specific Instructions 1. This form is to be used for filing a Petition for the Appointment of an Emergency Guardian and/or Conservator for a Proposed Ward pursuant to O.C.G.A. §§ 29-4-14 and/or 29-5-14. 2. In determining if this Court is the proper place to bring this action, Petitioner(s) should consult Georgia law, including but not limited to, Chapters 4, 5 and 11 of Title 29, as applicable. 3. Regarding the need for the pre-hearing appointment of an Emergency Guardian/Emergency Conservator, O.C.G.A. §§ 29-4-15 (c) (5) and 29-5-15 (c) (5) provide as follows: If the court determines that there is probable cause to believe that the Proposed Ward is in immediate need of an emergency guardian, the court shall appoint a pre-hearing emergency guardian to serve until the emergency hearing, with or without prior notice to the Proposed Ward, but only if the threatened risk is so immediate and the potential harm so irreparable that any delay is unreasonable and the existence of the threatened risk and potential for irreparable harm is certified by the affidavit of a physician licensed to practice medicine under Chapter 34 of Title 43, a psychologist licensed to practice under Chapter 39 of Title 43, or a licensed clinical social worker. However, pending the emergency hearing, the court shall order that no withdrawals may be made from any account on the authority of the Proposed Ward's signature without the court's prior approval and that the emergency conservator shall not expend any funds of the Proposed Ward without prior court approval. 4. Further, if a pre-hearing emergency guardian/emergency conservator is appointed to serve until the emergency hearing, then such guardian and/or conservator shall, prior to the issuance of Letters of Emergency Guardianship/Emergency Conservatorship, take an oath and post such bond as the court may require. 5. In any case involving the creation of a Conservatorship when the Proposed Ward owns real property in Georgia, a certificate of creation of conservatorship will be completed by the Clerk of the Probate Court and filed with the Clerk of the Superior Court of each county in which the Proposed Ward owns real property within thirty (30) days of the date of such order. GPCSF 11 [i] Eff. July 2016 American LegalNet, Inc. www.FormsWorkFlow.com 6. The burden of proof is on the Petitioner to present clear and convincing evidence that the Proposed Ward lacks sufficient capacity to make or communicate significant responsible decisions concerning his or her health or safety and is in need of a guardianship AND/OR that there is an immediate, clear, and substantial risk of death or serious physical injury, illness, or disease unless an emergency guardian is appointed and/or that the Proposed Ward lacks sufficient capacity to make or communicate significant responsible decisions concerning the management of his or her property and is in need of a conservatorship AND that there is an immediate, substantial risk of irreparable waste or dissipation of the estate unless an emergency conservator is appointed. 7. The Certificate to the Secretary of State page is to be used only when a determinative finding has been made that the Proposed Ward's voting rights should be removed due to the lack of capacity of the ward. The order of the Court must be modified to reflect that this right was removed. The certificate must be mailed to the Secretary of State. 8. The Certificate to the GBI page shall be used in all cases where a Guardianship and/or Conservatorship is/are established. Individuals so listed in this database will be prohibited from obtaining a weapons carry license. In the event the ward's rights are restored, such restoration of rights shall be sent to the GBI, so the database can be updated. Only the Certificate needs to be sent to the GBI and not the Guardianship Order. 9. According to Probate Court Rule 5.6 (A) unless the court specifically assumes the responsibility, it is the responsibility of the moving party to prepare the proper citation and deliver it properly so that it can be served according to law. All pages after the Notice regarding Uniform Probate Court Rule 5.6 (A) are to be completed by the moving party, unless otherwise directed by the court. 10. An oath must be administered by a Probate Judge or Clerk (the oath cannot be administered by a notary public). Use Georgia Probate Court Supplement 4 for the oath. The oath is not included in this form. Georgia Probate Court Standard Form 53, Commission to Administer Oath, can be used if the oath is to be administered by a court outside the State of Georgia. II. General Instructions General instructions applicable to all Georgia Probate Court Standard Forms are available in each Probate Court or at www.gaprobate.gov, labeled GPCSF 1. GPCSF 11 [ii] Eff. July 2016 American LegalNet, Inc. www.FormsWorkFlow.com IN THE PROBATE COURT OF _______________________ COUNTY STATE OF GEORGIA IN RE: ___________________________________, PROPOSED WARD ) ) ) ) ESTATE NO. ____________ PETITION FOR APPOINTMENT OF AN EMERGENCY GUARDIAN AND/OR EMERGENCY CONSERVATOR FOR A PROPOSED WARD [NOTE: Unless there are two or more Petitioners, the affidavit beginning on page 11 must be completed by a physician, psychologist, or licensed clinical social worker and based on an examination within fifteen (15) days prior to the filing of this Petition.] The Petition of ___________________________________________________________, whose relationship to the above-named Proposed Ward is__________________________, whose domicile is ____________________________________________________________________, Street Street City City County County State State Zip Code Zip Code and mailing address is ___________________________________________________________, AND [initial either (a) or (b) below] ______ (a) The Petition of ______________________________________________________, whose relationship to the above Proposed Ward is ___________________________, whose domicile is_____________________________________________________, Street Street City County City State County State Zip Code Zip Code and mailing address is _________________________________________________. OR ______ (b) Attached hereto as pages 11 and 12 and made a part of this Petition is the completed affidavit of ____________, a physician, psychologist licensed to practice in Ge