Approved, SCAO � PCS CODE: PTGTCS CODE: PMGCSTATE OF MICHIGANPROBATE COURTCOUNTY OF PETITION TO TERMINATE � MODIFYGUARDIANSHIP LEGALLY INCAPACITATED INDIVIDUAL � MINORFILE NO.In the matter of First, middle, and last name � Court ORIDate of birthRaceSexCurrent address of ward 1. � I am interested in this matter as en-USState relationship/interesten-US . � 2. � a. � The interested persons for the minor, their relationship to the minor, and their addresses are: en-USNAMEen-USRELATIONSHIPen-USADDRESS AND TELEPHONE NUMBERen-USParenten-USDOB en-US en-US en-USStreet addressen-USCityen-USStateen-USZipen-USTelephone No.en-USParenten-USDOB en-US en-USStreet addressen-USCityen-USStateen-USZipen-USTelephone No.en-USConservatoren-USStreet addressen-USCityen-USStateen-USZipen-USTelephone No.en-USGuardianen-USStreet addressen-USCityen-USStateen-USZipen-USTelephone No.en-USPerson with care/en-UScustody of minor*en-USStreet addressen-USCityen-USStateen-USZipen-USTelephone No.en-US*Also list persons who had principal care and custody of the minor during the 63 days preceding filing the petition. � � � b. � The minor is a member of an Indian tribe, or is eligible for membership in an Indian tribe. The name of the tribe is � � en-US en-US . � � The minor is not an Indian child as defined by MCR 3.002(12). � � It is unknown whether the minor is an Indian child as defined by MCR 3.002(12). � c. � If this guardianship is terminated, the minor child will be returned to � � � en-US en-US en-US . American LegalNet, Inc. www.FormsWorkFlow.com File No. � 3. � The incapacitated individual, whose telephone number is en-US en-US , has a guardian whose address is � en-US en-US and has � � a spouse � � adult child(ren) � � living parents � whose name(s) and address(es) are listed below. � � no spouse, adult child(ren), or parent(s). The names and addresses of presumptive heirs** are listed below. � � none of the above (must notify the Attorney General***). en-USNAMEen-USRELATIONSHIPen-USADDRESS AND TELEPHONE NUMBERen-USStreet addressen-USCityen-USStateen-USZipen-USTelephone no.en-USGuardianen-USStreet addressen-USCityen-USStateen-USZipen-USTelephone no.en-US**Presumptive heirs includes minor children, if any.en-US***Notify the Attorney General by sending a copy of this form to: Attorney General, Public Administration, PO Box 30755, Lansing, MI 48909. � 4. � The reasons why the court should take action are en-US � en-US en-US .en-USI REQUESTen-US that the court: � 5. � Terminate the guardianship. � 6. � Accept the guardian's resignation. � 7. � Remove the guardian who � has � has not � been suspended. � 8. � Appoint en-USName (type or print) Address � en-USCity State Zip Telephone no. � as successor guardian. � � 9. � Appoint en-USName (type or print) Address � en-USCity State Zip Telephone no. � as a temporary guardian pending appointment of a successor. � 10. � Modify the powers of the guardian as follows: en-US � en-US � en-US en-USI declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best of en-USmy information, knowledge, and belief. � en-USDate en-USAttorney signature � en-USPetitioner signature en-USName (type or print) Bar no. � en-USName (type or print) en-USAddress � en-USAddress en-USCity, state, zip Telephone no. � City, state, zip � Telephone no. en-USNOMINATION BY MINOR: � I am 14 years of age or older. I nominate en-USNameen-US as my guardian, who lives at � en-USAddress City State Zipen-US .en-US en-USDate � en-USSignature of minor American LegalNet, Inc. www.FormsWorkFlow.com