PP-204 (P) (1/1/86) STATE OF MAINE COUNTY PROBATE COURT DOCKET NO. Upon hearing at which the above-named incapacitated person (was) (was not) present, or after legal opportunity for hearing, the Court finds that a qualified agency has been presented to this Court to be appointed Public Guardian of the named person; that no suitable private guardian is available and willing to assume the responsibilities of guardianship; that venue is proper; that the required notices have been given or waived; that the named person is incapacitated; that if the named person did not attend the hearing, inquiry was made as to whether he/she wished to do so; that this appointment is necessary or desirable as a means of providing continuing care and supervision of the person of the incapacitated person, and that this appointment is 18-A MRSA 247 5-304. The Court hereby appoints whose address is as FULL/LIMITED (strike one) guardian of said (Name and Address of Incapacitated Person) incapacitated person, and directs issuances of Letters of Guardianship to said guardian. (1) If this is a LIMITED GUARDIANSHIP, the following limitations apply: 1 ADJUDICATION OF INCAPACITY AND APPOINTMENT OF PUBLIC GUARDIAN OF INCAPACITATED PERSON In Re: Incapacitated Person American LegalNet, Inc. www.FormsWorkFlow.com PP-204 (P) (1/1/86) Page 2 of 2 mental and adaptive limitations or other conditions for the following reasons: (3) The Public Guardian shall review the case of the above-named incapacitated person annually and a report of each review shall be filed with the Court. 2 Dated Judge of Probate 1 See 18-A MRSA 247 5-105. 2 See 18-A MRSA 247 5-607(2) MARP American LegalNet, Inc. www.FormsWorkFlow.com