In the matter of First, middle, and last name 1. þ Date of hearing: Judge: Bar no. THE COURT FINDS: þ 2. þ Notice of hearing was given to or waived by all interested persons. þ 3. þ þ a. þ A petition to þ þ modify þ the guardianship was filed with this court and should be þ granted. þ denied. þ þ b. þ On the court222s own motion, the guardianship should be þ terminated. þ modified. 4. þ The guardian þ þ should be removed and a successor appointed. þ should be permitted to resign and a successor appointed. þ has died or become disabled and a successor must be appointed. 5. þ The individual þ continues to require a guardian based on the same criteria found by the court on the original petition. þ þ is no longer in need of a guardian. þ is in need of a standby guardian. þ 6. þ There is no qualified, suitable individual willing to act as guardian and the appointment of a professional guardian is in the þ best interest of the individual. A bond must be filed. IT IS ORDERED: þ 7. þ Name of guardian is þ removed þ permitted þ to resign as Type (plenary, partial, standby) . þ þ S/he shall file with this court and serve on the interested persons a final account no later than Date . þ þ The Type (plenary, partial, standby) guardian is discharged. The matter is þ closed. þ not closed. þ 8. Name Address þ City State Zip Telephone no. is appointed successor þ plenary þ partial þ temporary þ guardian of the þ individual þ estate and qualifies by filing þ an acceptance of appointment. þ Bond at $ must be filed. þ The guardian is not permitted to act until letters of guardianship are issued. After qualification, the guardian shall þ comply with all relevant requirements under the law. þ þ The temporary guardian shall serve until Date with the following powers: þ þ þ (SEE SECOND PAGE) American LegalNet, Inc. www.FormsWorkFlow.com File No. þ 9. þ Name Address þ City State Zip Telephone no. is appointed þ þ standby guardian. þ successor standby guardian. þ In case of death, incapacity, or resignation of the initially appointed guardian or an emergency situation during the absence þ and unavailability of the initially appointed guardian, the standby guardian shall file þ þ an acceptance of appointment þ þ bond in the amount of $ þ and shall assume the powers and duties of the initially appointed guardian. After qualification, the standby guardian shall þ comply with all relevant requirements under the law. þ 10. þ The guardianship is modified as follows: þ þ þ þ þ þ þ 11. þ The guardian is authorized to execute an application to admit the individual named above to þ Name of facility . þ 12. þ The petition is þ granted. þ denied on the merits. þ dismissed/withdrawn. þ 13. þ Other: Date þ Judge Attorney name (type or print) Bar no. Address City State Zip Telephone no. American LegalNet, Inc. www.FormsWorkFlow.com