COURT Statement of Right to Discharge Guardian or Modify Guardianship Order COUNTY OF ...................................................... UNITED STATES OF AMERICA : STATE OF ILLINOIS 81 828 (Rev. 12/04) Index No. COUNTY OF DU PAGE IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT : IN THE MATTER OF : Plaintiff(s) -against- Calendar No. JUDICIAL SUBPOENA : Case Number : : DISABLED PERSON Defendant(s) : ...................................................... File Stamp Here STATEMENT OF RIGHT TO DISCHARGE THE PEOPLE OFGUARDIAN OF NEW YORK THE STATE OR MODIFY GUARDIANSHIP ORDER As theTO of a proceeding in the 18th Judicial Circuit Court, you have been adjudged a disabled person and a result guardian has been appointed for you. The duties of your guardian have also been determined in this proceeding. If, at any time hereinafter, you should find that your capacity to perform the tasks necessary for the care of your person or management of your estate have changed so as to warrant the discharge of your guardian or the modification GREETINGS: of your guardian's duties, you may petition the Court for an order of discharge or modification. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before YOU MAY COMMUNICATE YOUR REQUEST FOR DISCHARGE OR MODIFICATION BY ANY WRIT, the Honorable at the Court TEN MEANS, INCLUDING AN INFORMAL LETTER. located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed Any request date, to testify and Presiding Judge — Chancery Division or adjourned should be sent to: give evidence as a witness in this action on the part of the 18th Judicial Circuit Court DuPage County Judicial Center Wheaton, Illinois 60189-0707 Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose directed to mail a copy of this statement to the above-named disabled person at the The Circuit Court Clerk isbehalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to petition resident address set forth in thecomply. filed herein. Date: Witness, Honorable Court in County, ENTER day of , one of the Justices of the JUDGE , 20 CERTIFICATE OF MAILING I, CHRIS KACHIROUBAS, Clerk of the 18th Judicial Circuit Court(Attorney must sign above andcopyname below) do hereby certify that a type of this statement was mailed to the above-named disabled person at the address set forth in the petition on file in this office. Name Attorney(s) for DuPage Attorney No. Date Attorney For: Address OfficeCIRCUIT COURT CLERK and P.O. Address City Phone By: Telephone No.: CLERK DEPUTY Facsimile No.: E-Mail Address: CHRIS KACHIROUBAS, CLERK OF THE 18TH JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60189-0707 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com