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Petition For Removal Of A Guardian Form. This is a Massachusetts form and can be use in Probate And Family Court Statewide.
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Tags: Petition For Removal Of A Guardian, MPC 221, Massachusetts Statewide, Probate And Family Court
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
PETITION FOR
REMOVAL OF A GUARDIAN
Division
In the Interests of:
Middle Name
First Name
Last Name
Incapacitated Person
1. The Petitioner is:
the Incapacitated Person
OR
a person interested in the welfare of the Respondent. State the nature of interest:
2. Information about the Incapacitated and/or Protected Person:
Name:
Age:
(Address)
Primary Language:
Respondent
is
Last Name
Middle Name
First Name
(City/Town)
(Apt, Unit, No. etc.)
English
Other:
(State)
(Zip)
Primary Phone #:
is not intellectually disabled.
3. Information about the Petitioner:
1) Name:
First Name
(Address)
Last Name
M.I.
(City/Town)
(Apt, Unit, No. etc.)
Primary Phone #:
(State)
(Zip)
Relationship to Respondent:
An attachment to this petition provides information on additional co-petitioners.
4. This Court entered a Decree and Order of Appointment of Guardian appointing:
on
Name
,
(date)
and said Decree is still valid and in full force and effect.
5.
The Petitioner(s) requests the following Guardian(s):
(hereafter "Guardian") be removed for the following reasons:
,
name(s)
The Guardian is incapacitated or disabled.
The Guardian is being investigated or has charges pending for assault and battery on and/or neglect of
the Incapacitated Person.
The Guardian is unfit or unsuitable to serve for the following reasons:
MPC 221 (5/30/11)
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Other:
WHEREFORE, PETITIONER REQUESTS THAT THIS HONORABLE COURT REMOVE THE ABOVE-NAMED GUARDIAN
AND FURTHER REQUESTS:
Any co-guardian(s) remain in office;
The appointment of a successor guardian or co-guardian as prayed for in a separate Petition for Appointment of
Guardian for an Incapacitated Person which is on file with the Court.
Other:
SIGNED UNDER THE PENALTIES OF PERJURY
I affirm or swear under oath that I have read the foregoing Petition and that the statements set forth therein are true
and correct to the best of my knowledge.
Date:
Signature of Petitioner
Date:
Signature of Co-Petitioner (If applicable)
I assent to the foregoing Petition:
Print Name
Signature
Date
Date
Date
Date
Attorney for Petitioner:
(Print name)
(Address)
(City/Town)
(Apt, Unit, No. etc.)
(State)
(Zip)
Primary Phone #:
B.B.O. #
MPC 221 (5/30/11)
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