PR-PET3: Revised 12/01/06 Disabled Guardianship IN THE CIRCUIT COURT OF THE 17th JUDICIAL CIRCUIT BOONE COUNTY, ILLINOIS Probate Division IN THE MATTER OF ) ) ) Alleged Disabled Person ) Case Number PETITION FOR APPOINTMENT OF TEMPORARY GUARDIAN FOR DISABLED PERSON hereby certifies: 1. On , 20, a petition was filed herein for the appointment of a guardian of the of , an (Estate and Person, Estate, Person) alleged disabled person whose date of birth is and whose place of residence is (Address) (City) (County) (State) 2. A temporary guardian is necessary for the welfare and protection of the respondent because: 3. Petitioner is to the alleged disabled person. (State relationship and interest to respondent) 4. The name and address of the respondent222s * (a) Guardian (b) Agent under the Durable Power of Attorney Law is 5. The names and addresses of the respondent222s nearest relatives are as follows: (if none, respondent222s nearest adult kindred known to Petitioner) Spouse and Adult Children: Name Address Relationship to respondent 6. The name and address of the person with whom, or the facility in which the respondent is residing is: 7. (a) Approximate value of respondent222s personal estate: $ (b) Approximate value of respondent222s real estate: $ (c) The anticipated gross annual income and other receipts of the respondent are: $ 8. Petitioner asks that (Name) (Address) (City and State) years, , qualified and willing to act, be appointed (age) (Occupation) as temporary guardian of the of the alleged disabled person. (Estate and Person, Estate, Person) *Strike either (a) or (b) Name Attorney for Address City, State Zip Telephone Petitioner222s Signature Email The undersigned certifies that the statements s et forth in this instrument are true and correct, except as to matters therein stated to be on information and belief and as to such matters the undersigned certifies as aforesaid that he/she verily believes the same to be true. American LegalNet, Inc. www.FormsWorkFlow.com