Approved, SCAO JIS CODE: PTD STATE OF MICHIGAN PROBATE COURT COUNTY OF In the matter of 1. I, Name (type or print) State interest/relationship PETITION TO TERMINATE MODIFY GUARDIAN FOR DEVELOPMENTALLY DISABLED INDIVIDUAL FILE NO. , an individual with a developmental disability , am interested in this matter and make this petition as . 2. The developmentally disabled individual's address and telephone number are City State Address . Zip Telephone no. 3. The guardian's address is . City State Zip 4. The developmentally disabled individual's presumptive heirs are: (Attach a separate sheet if more space is needed.) NAME Street address City Street address City Street address City State Zip Telephone no. State Zip Telephone no. State Zip Telephone no. ADDRESS AND TELEPHONE NUMBER RELATIONSHIP AGE / DOB (if minor) 5. The reasons why the court should take action are . I REQUEST that the court: 6. Terminate a. all part of the plenary guardian of the individual. b. all part of the partial guardian of the individual. 7. Accept the resignation of the a. plenary guardian of the individual. estate. b. partial guardian of the individual. estate. c. standby guardian. (SEE SECOND PAGE) USE NOTE: If this form is being filed in the circuit court family division, please enter the court name and county in the upper left-hand corner of the form. estate. estate. Do not write below this line - For court use only MCL 330.1604, MCL 330.1634, MCL 330.1637 PC 677 (9/12) PETITION TO TERMINATE/MODIFY GUARDIAN FOR DEVELOPMENTALLY DISABLED INDIVIDUAL American LegalNet, Inc. www.FormsWorkFlow.com 8. Remove the a. plenary guardian of the b. partial guardian of the c. standby guardian, who has has not 9. Appoint City Name individual individual been suspended. estate, estate, Address State Zip Telephone no. as of the 10. Appoint City temporary guardian individual. Name successor partial guardian successor plenary guardian estate. Address State Zip Telephone no. as standby guardian of the 11. Modify the powers of the individual. plenary guardian estate. partial guardian of the individual estate as follows: I declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best of my information, knowledge, and belief. Date Attorney signature Name (type or print) Address City, state, zip Telephone no. Bar no. Petitioner signature Name (type or print) Address City, state, zip Telephone no. American LegalNet, Inc. www.FormsWorkFlow.com