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Petition For Termination Of A Guardian And-Or Conservator Form. This is a Massachusetts form and can be use in Probate And Family Court Statewide.
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Tags: Petition For Termination Of A Guardian And-Or Conservator, MPC 203, Massachusetts Statewide, Probate And Family Court
PETITION FOR TERMINATION OF A
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
GUARDIANSHIP AND/OR
CONSERVATORSHIP
In the Interests of:
Division
Middle Name
First Name
Last Name
Incapacitated Person/Protected Person/Respondent
1. The Petitioner is:
The Incapacitated Person;
The Protected Person;
The
Guardian(s)
Conservator(s) of the Incapacitated and/or Protected Person.
A person interested in the welfare of the Incapacitated and/or Protected Person. State nature of interest:
2. Information about the Incapacitated and/or Protected Person:
Age:
Name:
Primary Language:
Last Name
M.I.
First Name
English
Other:
Primary Phone #:
Current Address
(Address)
is
(Apt, Unit, No. etc.)
(City/Town)
(State)
(Zip)
is not alleged intellectually disabled
Proposed address if termination is allowed
(Address Line 1)
Same as Above or
(Apt, Unit, No. etc.)
the following address:
(City/Town)
(State)
(Zip)
3. Information about the Petitioner (complete only if Petitioner is not the Incapacitated and/or Protected Person):
1) Name:
First Name
(Address)
Last Name
M.I.
(Apt, Unit, No. etc.)
(City/Town)
(State)
(Zip)
Relationship to Respondent:
Primary Phone #:
An attachment to this petition provides information on additional co-petitioners.
4. This Court entered a Decree and Order of Appointment of:
A Guardian appointing
on
Name
A Conservator appointing
.
(date)
on
Name
.
(date)
and said Decree(s) are still valid and in full force and effect.
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5.
As to the Guardianship, the Petitioner(s) states:
The Guardianship should be terminated for the following reason (choose one):
The Incapacitated Person no longer meets the standard for establishing the guardianship.
A Medical Certificate for Termination of Guardianship dated with an examination having taken place
within 30 days of the filing of the petition or, if the Incapacitated Person is alleged to be mentally
retarded, a clinical team report dated with an examination having taken place within 180 days of the filing
of the petition:
is filed with this Petition or is on file with the Court: Docket No.
OR
is not filed with this Petition and is not on file with this Court.
If a Medical Certificate or Clinical Team Report is not filed with this Petition, or on file with this Court, you
must immediately file and present a motion requesting that the Court permit it to be filed late or waive the
filing requirement. An affidavit must accompany the motion explaining why it is impossible to file a Medical
Certificate or Clinical Team Report with this Petition.
Other:
6.
As to the Conservatorship, the Petitioner(s) states:
The Conservator should be terminated for the following reason (choose one):
The Protected Person has attained the age of majority or is otherwise emancipated.
The Protected person is no longer disabled or no longer needs the protection or assistance of a Conservator.
A Medical Certificate for Termination of Conservatorship dated with an examination having taken place
within 30 days of the filing of the petition unless the Protected Person is or was a minor at the time of
appointment or, if the Protected person is alleged to be mentally retarded, a clinical team report dated
with an examination having taken place within 180 days of the filing of the petition:
is filed with this Petition or is on file with the Court: Docket No.
OR
is not filed with this Petition and is not on file with this Court.
If a Medical Certificate or Clinical Team Report is not filed with this Petition, or on file with this Court, you
must immediately file and present a motion requesting that the Court permit it to be filed late or waive the
filing requirement. An affidavit must accompany the motion explaining why it is impossible to file a Medical
Certificate or Clinical Team Report with this Petition.
The Protected Person's inability to manage property and business affairs has been resolved as follows:
The assets of the Conservatorship are insufficient to warrant continued management. The remaining assets are
describe as follows:
Other:
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7. Does the Respondent have, in the
Commonwealth or elsewhere, :
If yes, a copy of the
document is:
Yes and the person's information is listed at Q.4
A document nominating a Guardian?
Attached
No
Information/Explanation:
(If a Petition has been filed but not
allowed, please list Court and
Docket Number of pending case)
Unavailable
Uncertain
Yes and the person's information is listed at Q.4
A current Guardian?
Attached
No
Unavailable
Uncertain
Yes and the person's information is listed at Q.4
A current Conservator?
Attached
No
Unavailable
Uncertain
Yes and the person's information is listed at Q.4
A Representative Payee?
Attached
No
Unavailable
Uncertain
Yes and the person's information is listed at Q.4
A Health Care Agent?
Attached
No
Unavailable
Uncertain
Yes and the person's information is listed at Q.4
A Durable Power of Attorney/Agent?
Attached
No
Unavailable
Uncertain
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8. Respondent
is
is not
entitled to benefits from the Department of Veterans Affairs or
Uncertain.
WHEREFORE, PETITIONER REQUESTS THAT THIS HONORABLE COURT:
Terminate the Guardianship.
Terminate the Conservatorship and authorize the Conservator to transfer title to all assets of the estate to
the Protected Person or distribute the assets as follows:
In addition, I request that the Court:
9. Does Respondent have any assets, e.g. bank accounts, property?
Yes
No
Description of Assets, e.g. Bank Accounts, Property, Insurance, Pensions
DO NOT INCLUDE NAMES OF INSTITUTIONS OR ACCOUNT NUMBERS
Uncertain. If Yes, identify:
Estimated Value of Property
Total
An attachment to this petition provides additional information.
10. Does Respondent have any anticipated income?
Yes
No
Description of Income, e.g. Social Security, Interest
DO NOT INCLUDE NAMES OF INSTITUTIONS OR ACCOUNT NUMBERS
Uncertain. If Yes, identify:
Amount of Anticipated
Monthly Income or Receipts
Total
An attachment to this Petition provides additional information.
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)
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I assent to the foregoing Petition:
Print Name
Signature
Date
Date
Date
Attorney for Petitioner:
(Print name)
(Address)
(City/Town)
(Apt, Unit, No. etc.)
(State)
(Zip)
Primary Phone #:
B.B.O. #
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