, MARYLANDCIRCUIT ORPHANS' COURT FOR City/County Case No.Located at Court Address In the Matter of Name of minor ANNUAL REPORT OF GUARDIAN OF MINOR (Md. Rule 10-206(f)) ANNUAL REPORT OF , GUARDIAN OF THE PERSON OF , WHO IS A MINOR 1. The name and permanent residence of the minor are: . 2. The minor currently resides or is physically present in:002 own home002 hospital or medical facility relative's homefoster or boarding home Relationshipguardian's home other (If other than minor's permanent home, state the name and address of the place where the minor lives . 3. The minor has been in the current location since . If the person has movedDate thin the past year, the reasons for the change are: . 4. The physical and mental condition of the minor is as follows: . 5. During the past year, the minor's physical or mental condition has changed in the following respects: 6. The minor is presently receiving the following care: . 7. I have applied funds as follows from the estate of the minor for the purpose of support, care, or education: . CC-GN-014 (Rev 11/2017) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 8. The plan for the minor's future care and well-being, including any plan to change the person's location, is:. 9. I have no serious health problems that affect my ability to serve as guardian. I have the following serious health problems that may affect my ability to serve as guardian: . 10. This guardianship I should be continued. should not be continued, for the following reasons: . 11. My powers as guardian should be changed in the following respects and for the following reasons: . 12. The court should be aware of the following other matters relating to this guardianship: . I solemnly affirm under the penalties of perjury that the contents of this document are true to the best of my knowledge, information, and belief. Date Guardian's Signature Guardian's Name (typed or printed) Address City, State, Zip Telephone Date Co-Guardian's Signature Co-Guardian's Name (typed or printed) Street Address or Box Number City and State Telephone Number CC-GN-014 (Rev 11/2017) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com