Order Appointing Special Guardian Of An Incapacitated Person
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Order Appointing Special Guardian Of An Incapacitated Person Form. This is a Massachusetts form and can be use in Probate And Family Court Statewide.
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Tags: Order Appointing Special Guardian Of An Incapacitated Person, MPC 622, Massachusetts Statewide, Probate And Family Court
Docket No.
ORDER APPOINTING SPECIAL
GUARDIAN OF AN
INCAPACITATED PERSON
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Division
In the Interests of:
Middle Name
First Name
Last Name
Incapacitated Person
After hearing the Court finds that:
The appointed Guardian
is not effectively performing
First Name
M.I.
Last Name
the duties of a Guardian and the appointment as Guardian has been suspended or terminated by separate Order. It is
necessary to appoint a Special Guardian because the welfare of the Incapacitated Person requires immediate action.
The Court appoints the following person as Special Guardian:
First Name
(Address)
M.I.
(Apt, Unit, No. etc.)
Last Name
(City/Town)
(State)
(Zip)
Primary Phone #:
The Special Guardian may exercise only the powers specified in this Order. The powers of the Special
Guardian are:
All and only those powers granted to the Guardian in the most recent Decree and Order of the Court dated
except as may be limited by the following:
As follows:
The Court orders the following:
1.
The Court has appointed counsel for the Incapacitated Person. (See Separate Order Appointing Counsel.)
2. The Special Guardian shall serve:
without surety on his, her or their bond because:
it is in the best interest of the Incapacitated Person as there are minimal assets under management
by the guardian or because:
MPC 622 (5/30/11)
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Docket No.
In the Interests of:
First Name
Middle Name
Last Name
language in a Durable Power of Attorney or Health Care Proxy waives the Guardian's bond or requests
a waiver of any necessity of sureties on a bond.
with personal or corporate sureties on his/her/their bond in the amount of $
pursuant to G.L. c. 190B, ยง 5-307.
NO LETTERS OF SPECIAL GUARDIANSHIP FOR A PROTECTED PERSON SHALL ISSUE
UNTIL THE BOND IS FILED AND APPROVED.
3. The Special Guardian's appointment shall expire 90 days from today's date or on
.
(date)
If this date is more than 90 days from the date of appointment, the Court finds the following circumstances warrant the
longer period of appointment:
4.
The parties shall comply with a stipulation or agreement dated
which is filed with the Court and expressly made a part of this order.
5.
A
at
6.
hearing shall be held on this matter on
a.m.
p.m. at the
Probate and Family Court.
Other:
Date
JUSTICE OF THE PROBATE AND FAMILY COURT
MPC 622 (5/30/11)
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