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Petition For Appointment Of Guardian For Disabled Person Form. This is a Illinois form and can be use in Lake Local County.
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Tags: Petition For Appointment Of Guardian For Disabled Person, Illinois Local County, Lake
IN THE CIRCUIT COURT OF THE NINETEENTH
JUDICIAL CIRCUIT, LAKE COUNTY, ILLINOIS
PROBATE DIVISION
Estate of
Hearing on Petition set for
_____________________,
Lake County Courthouse
Waukegan, Illinois
_______________ am/pm
Courtroom ___________
)
)
) No.
)
Alleged Disabled Person
PETITION FOR APPOINTMENT OF
GUARDIAN FOR DISABLED PERSON
Petitioner _________________________________________, hereby certifies:
1.
Respondent _________________________, whose date of birth is _______________ and place of
residence is _________________________________*, is a disabled person.
___________________________________________________________________________________
2.
The relationship to and interest of the Petitioner to the Respondent is:
___________________________________________________________________________________
The reasons for this guardianship is that the respondent is a disabled person due to:
___________________________________________________________________________________
___________________________________________________________________________________
and because of such disability:**_________________________________________________________
___________________________________________________________________________________
3.
4.
a. The approximate value of estate: Personal $_______________ Real$_______________
b. The anticipated gross annual income and other receipts of the Respondent are $_________________
5.
The names and post-office addresses of the Respondent’s guardians and nearest relatives, if any, are (list
spouse and adult children; if none, the Respondent’s parents and adult brothers and sisters; if none,
nearest kindred):
Name
Relationship
Post Office Address
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
6.
The name and address of the person with whom, or the facility in which the Respondent is residing is:
___________________________________________________________________________________
Petitioner asks that:
a. ______________________________ be adjudged a disabled person;
b. _________________________________________________________________________________
(name)
(address)
age ________ years _________________________ qualified and willing to act; be appointed as
(occupation)
guardian of the Respondent’s, ___________________________________________________________
(estate)
(estate and person)
171P-69 page 1 of 2 9/00
2002 © American LegalNet, Inc.
c. __________________________________________________________________________________
(name)
(address)
age ____________ years _____________________________ qualified and willing to act; be appointed
(occupation)
as guardian of the person only;
d. The guardianship be for the limited purpose of:
____________________________________________________________________________________
____________________________________________________________________________________
The undersigned certifies that the statements set 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.
Name
Attorney for
Address
City & Zip
Telephone
Atty. No.
__________________________________________
Petitioner
Address __________________________________
City _____________________________________
*
If alleged disabled person is a nonresident add “owning real estate in the county” or “owning no real estate in
Illinois but owning personal estate in this county”.
** (a) Lacks sufficient understanding or capacity to make or communicate responsible decisions concerning the care of the
Respondent’s person;
(b) Is unable to manage the Respondent’s estate or financial affairs.
171P-69 page 2 of 2 Rev 9/00
2002 © American LegalNet, Inc.
