STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE 20TH JUDICIAL CIRUCIT ST. CLAIR COUNTY, ILLINOIS- IN PROBATE In the Matter of the Estate of ) ) ) ) ) ) ) ) ) ) Case No.:______________________ Hearing on petition set for ________ _____________________, 20_____. __________a.m./p.m., Room______ County Courthouse Belleville, Illinois ____________________________ (Judge) ______________________________ A Disabled Person PETITION FOR GUARDIAN _________________________________________, a reputable citizen of Illinois, on oath states: 1. ________________________, whose place of residence is ______________________ (Address) ______________________________________________________________________________ (City) (County) (State) Whose date of birth is _______________________, _________ is disabled and incapable of managing his/ her _______________________________,______________________________ (Estate) (Person or Estate and Person) because; 2. Approximate value of the personal estate....................................$____________ Anticipated gross annual income and other receipts........................$____________ 3. The names and post office addresses of his/ her 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 as "owing real estate in this county" or "owning no real estate in Illinois buy owning personal estate in this county." 1 American LegalNet, Inc. www.FormsWorkFlow.com Petitioner asks that: (a) _____________________________be adjudged as a disabled person; Petitioner asks that: (a)_____________________________________________________________________ (Name) (Address) (City and State) (if an individual add) age__________ years, ____________________________, qualified and (Occupation) willing to act, be appointed as guardian of the ________________________________________ (Estate and/ or Estate and Person) of the disabled person; (b) _____________________________________________________________________ (Name) ____________________________________________________, (City and State) (Address) age ____________years, _____________________, (Occupation) 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 (an or no) qualified to act _________________________________________________________________ ______________________________________________________________________________ ______________________________ Petitioner Signed and sworn to before me ____________________________, 20____. ______________________________ Address ______________________________ City ____________________________________ Notary Public (Seal) Name Attorney for Petitioner Address City Telephone 2 American LegalNet, Inc. www.FormsWorkFlow.com