Nebraska State Court Form REQUIRED CC 16:2.121Rev. 11/15 Neb. Rev. Stat. §§ 30-2619.01, 30-2222(4), and Neb. Ct. R. § 6-1443.01(D) ORDER APPOINTING COURT VISITOR OR GUARDIAN AD LITEM WHEN THE PUBLIC GUARDIAN IS NOMINATED TO BE APPOINTED COUNTY, NEBRASKA Case No. IN THE COUNTY COURT OF IN THE MATTER OF Ward/Incapacitated Person/Protected Person ORDER APPOINTING COURT VISITOR OR GUARDIAN AD LITEM WHEN THE PUBLIC GUARDIAN IS NOMINATED TO BE APPOINTED , is appointed as: On the court's own motion, the Court Visitor in accordance with Neb Rev Stat. § 30-2619.01 and Neb. Ct. R. § 6-1443.01(D); or the Guardian Ad Litem in accordance with and Neb Rev Stat. § 30-2222(4) and Neb. Ct. R. § 6-1443.01(D) in the above captioned matter. The Court Visitor's or Guardian Ad Litem's address and phone number is: The court finds this appointment is necessary and for the limited purposes set forth below: · · To investigate the allegations made in the Petition for Appointment of Guardian and/or Conservator pursuant to Neb. Rev. Stat. § 30-2619.01. To complete the Court Visitor or Guardian Ad Litem Report (CC 16:2.93). This report shall contain all evidence relating to the alleged ward/incapacitated person/protected person, and their ability to make, communicate, or carry out responsible decisions concerning his or her person in regards to the factors set forth in Neb. Rev. Stat. § 30-2619.01. · · To determine if there is any other person available to act as the guardian and/or conservator other than the Public Guardian. If the Visitor or Guardian Ad Litem determines there is another person to serve as guardian and/or conservator other than the Public Guardian, the Visitor or Guardian Ad Litem shall determine the appropriateness of this person to serve as a guardian and/or conservator for the ward/incapacitated/protected person. Other: DATED: PREPARED AND SUBMITTED BY: Page 1 of 1 BY THE COURT: County Judge Order Appointing Court Visitor or Guardian Ad Litem When the Public Guardian has Been Nominated to be Appointed CC 16:2.121 Rev. 11/15 American LegalNet, Inc. www.FormsWorkFlow.com