NOTICE/ORDER REGARDING GUARDIAN'S CARE PLAN/REPORT (ADULT) In the Interests of: First Name Middle Name Docket No. Commonwealth of Massachusetts The Trial Court Probate and Family Court Division Last Name Incapacitated Person NOTICE This Court has reviewed and accepted the Guardian's Care Plan/Report. Receipt and acceptance does not release the Guardian from fiduciary standards. ORDER THE GUARDIAN'S ANNUAL CARE PLAN/REPORT MUST BE FILED WITH THE COURT EACH YEAR ON THE ANNIVERSARY OF THE GUARDIAN'S APPOINTMENT UNTIL THE GUARDIANSHIP IS TERMINATED UNLESS OTHERWISE ORDERED BY THE COURT. The following question(s) must be completed or supplemented: An amended Guardian Care Plan/Report with this required information must be filed by: (date) . Failure to submit an amended report may result in a Show Cause hearing which may affect your appointment as Guardian. This matter is set for a hearing at the following time and location: Date: Time: : AM PM Probate & Family Court Location Date: JUSTICE OF THE PROBATE AND FAMILY COURT MPC 621 (1/16/13) American LegalNet, Inc. www.FormsWorkFlow.com page 1 of 1