PR-REP3: Revised 2/01/2017 Page 1 of 2 Disabled Guardianship IN THE CIRCUIT COURT OF THE 17TH JUDICIAL CIRCUIT BOONE COUNTY, ILLINOIS Probate Division IN THE MATTER OF THE GUARDIANSHIP OF ) ) ) ) ) ) Disabled Person ) Case Number ANNUAL REPORT NOW comes the Guardian of the person named in the caption hereto and shows unto the Court: 1. An Order was entered on , finding said person to be a disabled adult, and appointing the undersigned Guardian of the person. 2. The last Annual Report to the Court was made on . 3. The ward222s current mental, physical and social condition is: 4. * The ward has no minor or adult dependant children. 5. The ward222s present living arrangement, a description and address of every residence where the ward lived during the reporting period and length of stay at each place is: 6. A summary of medical, educational, vocational and other professional services given the ward is: 7. A summary of the guardian222s visits with and activities on behalf of the ward is: 8. * The undersigned guardian recommends continued guardianship. * Check only if applicable American LegalNet, Inc. www.FormsWorkFlow.com PR-REP3: Revised 2/01/2017 Page 2 of 2 Disabled Guardianship 9. Other information which may be useful to the Court is: All which is respectfully submitted. By: Guardian222s Signature STATE OF ILLINOIS ) ) SS COUNTY OF BOONE ) , being first duly sworn on oath states that he/she as guardian of the above named person is authorized to execute this Report, has read the foregoing Report by him/her subscribed, knows the contents thereof and that the same are true in substance and in fact. SUBSCRIBED and sworn to before me this day of , 20 Guardian222s Signature NOTARY PUBLIC GUARDIAN CONTACT INFORMATION Name: Address: City, State, Zip: Phone: Email Address: American LegalNet, Inc. www.FormsWorkFlow.com