Petition For Appointment of Guardian For Disabled Person (Rev. 11/2/01) CCP 0200 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT-PROBATE DIVISION ESTATE OF ____________________________________________ Alleged Disabled Person } No. _________________________ Docket ______________________ Page Hearing on petition set for ___________________, _______ _________M. Room __________ Richard J. Daley Center Chicago, Illinois 60602 _______________________ q 2605 PETITION FOR APPOINTMENT OF GUARDIAN FOR DISABLED PERSON ________________________________________________________________________________ on oath states: 1. ____________________________________, whose date of birth is ______________________________________ and place of residence is _______________________________________________________________, is a disabled person. 2. The relationship and interest of the petitioner to the respondent is: ______________________________________________. 3. The reason for the guardianship is that the respondent is a disabled person due to _________________________________ __________________________________________________________________________________________, 4. and because of such disability*(a) lacks sufficient understanding or capacity to make or communicate responsible decisions concerning the care of the respondent's person *and (b) is unable to manage the respondent's estate or financial affairs. a. The approximate value of estate: Personal $ __________________________ Real $ __________________________ b. The anticipated gross annual income and other receipts of the respondent: $ ________________________________ 5. The names and post-office addresses of the respondent's guardian, if any, agent(s) appointed under the Illinois Power of Attorney Act, if any, and nearest relatives are listed on Exhibit A attached hereto. "Nearest relatives" means respondent's spouse, adult children, parents, and adult brothers and sisters, or if none, respondent's nearest adult kindred. 6. The name and address of the person with whom or the facility in which the respondent is residing is: _____________________________________________________________________________________________ Petitioner asks that _____________________________________________________ be adjudged a disabled person and *(a) ______________________________________________________________________________________ (name) (post-office address) _________________________________, age ______ years, ____________________, ______________________, (city and state) (relationship to respondent) (occupation) qualified and willing to act, be appointed as guardian of the respondent's _____________________________________ q 0002 (estate) q 0003 (estate and person) q 1002 q 1003 *(b) ______________________________________________________________________________________ (name) q 0001 q 1001 (person) (post-office address) _________________________________, age ______ years, ____________________, ______________________, (city and state) (relationship to respondent) (occupation) qualified to act, be appointed as guardian of the person only. Atty. No.: ______________ Name: __________________________________________ Firm Name: _____________________________________ ____________________________ Address: ________________________________________ City/State/Zip: ____________________________________ Telephone: _______________________________________ ______________________________________________ Address _________________________________________ Attorney for Petitioner: *Strike if not applicable. Signed and sworn to before me this Petitioner City/State/Zip ____________________________________ ______________ day of _________________________________________, _______ ____________________________________ Notary Public DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Print This Form For your protection and privacy, please press the Clear This Form button after you have printed the form. Clear This Form