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Petition for Guardian Disabled Adult Packet Form. This is a Illinois form and can be use in Mclean Local County.
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Tags: Petition for Guardian Disabled Adult Packet, Illinois Local County, Mclean
STATE OF ILLINOIS
IN THE CIRCUIT COURT OF THE ELEVENT JUDICIAL CIRCUIT
MCLEAN COUNTY – IN PROBATE
In the Matter of the Estate of
)
)
)
A Disabled Person
No.
Hearing on petition set for
,
m., Room
County Courthouse
, Illinois
(Judge)
PETITION FOR GUARDIAN
, a reputable citizen of Illinois, on oath states:
1.
, whose place of residence is
(Address)
(City)
(County)
whose date of birth is
(State)
,
is disabled and incapable of managing his
(Estate)
because
(Person, or Estate and Person)
2.
Approximate value of the personal estate…………………………………….….$
Anticipated gross annual income and other receipts…………………………….$
3.
The names and post-office addresses of his nearest adult relatives are: (List spouse and children;
if none, parents, brothers and sisters; if none (nearest kindred)
Name
Relationship
Post-office Address
*If alleged disabled person is a nonresident add “owning real estate in this county” or
“owning no real estate in Illinois but owning personal estate in the county.”
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Petitioner asks that:
(a)
be adjudged as a disabled person;
Petitioner asks that:
(a)
(Name)
(Address)
(if an individual add) age
(City and State)
years,
, qualified and willing to act,
(Occupation)
be appointed as guardian of the
(Estate and / or Estate and Person)
of the disabled person;
(b)
(Name)
(Address)
, age
years,
,
qualified and willing to act, be appointed as guardian of the person of the disabled person; and
(c)
authorization to appraise goods and chattels issue to the following, qualified to act
(an or no)
(Petitioner)
Signed and sworn to before me
,
(Address)
(Notary Public)
(City)
Name
Attorney for Petitioner
Address
City
Telephone
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STATE OF ILLINOIS
IN THE CIRCUIT COURT OF THE ELEVENTH JUDICIAL CIRCUIT
COUNTY OF MCLEAN
IN THE INTERST OF
No.
Respondent
REPORT
ON PETITION FOR APPOINTMENT OF GUARDIAN
The Undersigned, on oath state:
1.
The nature and type of disability of the Respondent,
and impact of disability on Respondent’s ability to make decisions or to function independently is:
2.
My / our evaluations of Respondent’s mental, physical, and educational condition, adaptive behavior, and
social skills are:
These evaluations are based upon examination of Respondent on
(Date)
3.
In my / our opinion plenary / limited guardianship, both of the person and of the estate of Respondent, is
needed because:
4.
I / we recommend, as the most appropriate treatment or habilitation plan and living arrangement for
Respondent:
The reasons for this recommendation are:
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5.
Signature (s) of Person (s) performing evaluations (one of whom must be a licensed physician):
Licensed by the State of Illinois as
License No.
State of Illinois
SS.
County of McLean
Subscribed and sworn to before me this
day of
,
Attorney for Petitioner:
Address:
City:
Telephone:
Notes: 755 ILCS 5/11a
Sec. 11a-1. Developmental disability defined. "Developmental disability" means a disability which is attributable
to: (a) mental retardation, cerebral palsy, epilepsy or autism; or to (b) any other condition which results in
impairment similar to that caused by mental retardation and which requires services similar to those required by
mentally retarded persons. Such disability must originate before the age of 18 years, be expected to continue
indefinitely, and constitute a substantial handicap.
Sec. 11a-2. "Disabled person" defined. "Disabled person" means a person 18 years or older who (a) because of
mental deterioration or physical incapacity is not fully able to manage his person or estate, or (b) is a person with
mental illness or a person with a developmental disability and who because of his mental illness or developmental
disability is not fully able to manage his person or estate, or (c) because of gambling, idleness, debauchery or
excessive use of intoxicants or drugs, so spends or wastes his estate as to expose himself or his family to want or
suffering.
Sec. 11a-9. Report. (a) The petition for adjudication of disability and for appointment of a guardian should be
accompanied by a report which contains (1) a description of the nature and type of the respondent's disability and an
assessment of how the disability impacts on the ability of the respondent to make decisions or to function
independently; (2) an analysis and results of evaluations of the respondent's mental and physical condition and,
where appropriate, educational condition, adaptive behavior and social skills, which have been performed within 3
months of the date of the filing of the petition; (3) an opinion as to whether guardianship is needed, the type and
scope of the guardianship needed, and the reasons therefor; (4) a recommendation as to the most suitable living
arrangement and, where appropriate, treatment or habilitation plan for the respondent and the reasons therefor; (5)
the signatures of all persons who performed the evaluations upon which the report is based, one of whom shall be a
licensed physician and a statement of the certification, license, or other credentials that qualify the evaluators who
prepared the report.
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CIRCUIT COURT OF
JUDICIAL CIRCUIT, ILLINOIS
COUNTY, IN PROBATE
Estate of
) [Docket)
)
) [Page]
No.
OATH OF OFFICE
I,
, on oath state that I will discharge faithfully the
duties of the office of
Signed and sworn to before me
,
.
(Notary Public)
Name
Attorney For
Address
City
Telephone
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STATE OF ILLINOIS
IN THE CIRCUIT COURT OF THE ELEVENT JUDICIAL CIRCUIT
MCLEAN COUNTY – IN PROBATE
In the Matter of the Estate of
)
)
)
No.
A Disabled Person
ORDER OF ADJUDICATION OF DISABILITY AND APPOINTING GUARDIAN
On the verified petition of
a reputable citizen of this state, for the appointment of a guardian of the
of
(Estate and / or Person)
, whose residence is
(For Non-Resident of Illinois, Insert: owning real estate in this county or owning no real estate in Illinois but owning personal estate in this county)
the court finds: (1) summons has been served upon the alleged disabled person at least 14 days before the return day
designated therein by leaving a copy thereof with him personally and informing him of its contents, (2) no party has
demanded a jury, (3) and
qualified and willing to act, has presented
(Insert: his bond in the penal sum of $
or its acceptance of office)
Having considered the evidence, the court adjudges that
is a disabled person as defined in Section 11a-2 of the Probate Act, and that a guardian should be appointed for his
.
(Estate and / or Person)
It is ordered that
of the
is appointed guardian
of
, a disabled person,
(Estate and/or Person)
that the
is approved and that letters of guardianship issue upon filing of the oath.
(acceptance or bond)
Dated
,
ENTER:
(Judge)
Name
Attorney For
Address
City
Telephone
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