Approved, SCAO JIS CODE: OAG STATE OF MICHIGAN PROBATE COURT COUNTY OF FILE NO. ORDER REGARDING APPOINTMENT OF TEMPORARY GUARDIAN OF INCAPACITATED INDIVIDUAL In the matter of 1. Date of hearing: THE COURT FINDS: 2. Notice of hearing was given to the incapacitated individual. 3. The individual is not in need of a guardian. Judge: , an alleged incapacitated individual Bar no. 4. The individual does not have a guardian, an emergency exists, and no other person appears to have the authority to act in the circumstances. A showing has been made that the individual is incapacitated. 5. The appointed guardian is not effectively performing his/her guardianship duties, and the welfare of the incapacitated individual requires immediate action. 6. There is no qualified, suitable individual willing to act as temporary guardian, and the appointment of a nonprofit corporation as temporary guardian is in the best interest of the adult. A personal bond must be filed. 7. Other: IT IS ORDERED: 8. The petition for appointment of temporary guardian is 9. Name (type or print) Address City granted. denied on the merits. dismissed/withdrawn. , whose address and telephone number are , State Zip Telephone no. is appointed temporary guardian of the adult and shall qualify by filing an acceptance of appointment. Personal bond at $ must be filed. The temporary guardian is not permitted to act until letters of guardianship are issued. 10. The temporary guardian shall have the following powers and responsibilities only: 11. This temporary guardianship shall terminate on Date . 12. IT IS FURTHER ORDERED: Date Attorney name (type or print) Address Bar no. City State Zip Telephone no. Judge Do not write below this line - For court use only MCL 700.5312, MCL 700.5313, MCR 5.403(C) PC 632 (9/13) ORDER REGARDING APPOINTMENT OF TEMPORARY GUARDIAN OF INCAPACITATED INDIVIDUAL American LegalNet, Inc. www.FormsWorkFlow.com