IN THE CIRCUIT COURT OF THE TWELFTH JUDICIAL CIRCUIT WILL COUNTY, ILLINOIS - IN PROBATE IN RE THE ESTATE OF _____________________________________________ Name of disabled adult CASE NO: __________________________ Respondent, A Disabled Adult ACCEPTANCE OF OFFICE OF GUARDIAN OF THE PERSON OF A DISABLED ADULT I, _____________________________________________, hereby accept the office of Guardian of the Name of guardian Person of ___________________________________________________________________________________. Name of disabled adult By accepting this office, I understand that I must abide by the duties and responsibilities required by law as set forth in the Illinois Probate Code at 755 ILCS 5/11a-17, which specifically include the following: Initial each: __________ I understand that I am under a duty to annually report to this court about the health and welfare of the disabled adult. I acknowledge that I must be in court for my first report on _______________________, 20_____, at ________ a.m. and understand that if I fail to appear this court may, at its discretion; remove me as guardian, sanction me, and/or sentence me to a period in jail for contempt of court. __________ I understand that I may not force the disabled adult to stay in a nursing home or residential care facility without specific approval by this court. __________ I understand that I am responsible for the health and welfare of the disabled adult. __________ I understand that I must report any change of my address and/or the ward's address within fourteen (14) days of my move to this Court. ____________________________________________________ (Signature of guardian) Person/Attorney Who Prepared Form: Name: __________________________________________________ Address: ________________________________________________ City and Zip: ____________________________________________ Phone: _________________________________________________ ARDC #: _______________________________________________ ANDREA LYNN CHASTEEN, CLERK OF THE CIRCUIT COURT OF WILL COUNTY American LegalNet, Inc. www.FormsWorkFlow.com 127 (Revised 12/16)