Nebraska State Court Form REQUIRED ORDER APPOINTING PUBLIC GUARDIAN AS GUARDIAN AND CONSERVATOR Page 1 of 5IN THE MATTER OF Ward/Incapacitated Person/Protected Case ORDER APPOINTING PUBLIC GUARDIAN AS GUARDIAN AND CONSERVATOR The Petition for Appointment of Guardian and Conservator having come before the court, the court finds as follows: an incapacitated person, pursuant to the provisions of the Last Will and Testament of , parent or spouse of said incapacitated person, which Will was admitted to probate in this court and there are no less restrictive alternatives than the appointment of a guardian for the Upon clear and convincing evidence presented to the court, there is a sufficient basis for theappointment of the conservator for and there are noless restrictive alternatives than the appointment of a conservator for the above-namedprotected person.Appointment of 7.Proper notice has been given to the Office of Public Guardian. CC 16:2.115 New 10/15 American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 58.The petitioner has acted in good faith and due diligence to identify a guardian and/or conservatorwho would serve in the best interest of the ward/incapacitated person/protected person.9.The appointment of the Office of Public Guardian is necessary and does not exceed thecaseload limitations as set forth by statute.10.The Court Visitor or Guardian ad Litem report has provided supporting evidence that no personis available for appointment as guardian and/or conservator, all options available to support theindividual in the least restrictive manner possible have been explored, and guardianship and/orconservatorship is a last resort.11.There is no other alternative than to appoint the Office of Public Guardian. The court finds clear and convincing evidence that a full guardianship is necessary and is theleast restrictive alternative. The Public Guardian is granted all powers conferred uponguardians by law which are listed below:i.Selecting the ward's place of abode within or without this state;ii.Arranging for medical care for the ward;iii.Protecting the personal effects of the ward;iv.Giving necessary consent, approval, or releases on behalf of the ward;v.Arranging for training, education, or other habilitating services appropriate for theward;vi.Applying for private or governmental benefits to which the ward may be entitled;vii.Instituting proceedings to compel any person under a duty to support the ward or topay sums for the welfare of the ward to perform such duty, if no conservator has beenappointed;viii.Entering into contractual arrangements on behalf of the ward, if no conservator hasbeen appointed; andix.Receiving money and tangible property deliverable to the ward and applying suchmoney and property to the ward's expenses for room and board, medical care,personal effects, training, education, and habilitating services, if no conservator hasbeen appointed, or requesting the conservator to expend the ward's estate bypayment to third persons to meet such expenses. American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 5This is a limited guardianship. The Public Guardian, as guardian, shall have the followingauthorities and responsibilities (acting together with the ward or singly):Selecting the ward's place of abode within or without this state;Arranging for medical care for the ward;Protecting the personal effects of the ward;Giving necessary consent, approval, or releases on behalf of the ward;Arranging for training, education, or other habilitating services appropriate for theward;Applying for private or governmental benefits to which the ward may be entitled;Instituting proceedings to compel any person under a duty to support the ward or topay sums for the welfare of the ward to perform such duty, if no conservator has beenappointed;Entering into contractual arrangements on behalf of the ward, if no conservator hasbeen appointed;Receiving money and tangible property deliverable to the ward and applying suchmoney and property to the ward's expenses for room and board, medical care,personal effects, training, education, and habilitating services, if no conservator hasbeen appointed, or requesting the conservator to expend the ward's estate bypayment to third persons to meet such expenses.Other: 12. The Public Guardian is entitled to appointment pursuant to Neb. Rev. Stat. 247 30-2639, 30-2627and 30-4112 and should be appointed as guardian and conservator. The Public Guardian isauthorized and ordered to obtain an Acknowledgment of Financial Institution completed by eachfinancial institution holding any assets or accounts titled in any manner in the name of the protectedperson along with a printout of all assets and account numbers in each financial institution, whichshall be filed in these proceedings. 13. If any funds are ordered restricted, the Public Guardian is further authorized and ordered to open an account at a financial institution with the restriction that no withdrawals can be made without a American LegalNet, Inc. www.FormsWorkFlow.com Upon completion of the filing requirements above and sending the appropriate forms to all interested persons, etters will be issued which will appoint the Public Guardian as guardian and conservator. The Public Guardian shall deliver to each financial institution where the incapacitated person/protected person has accounts/assets a copy of the Letters Appointing the Public Guardian as Guardian and Conservator and file with the court an Acknowledgment from the Financial Institution that they received the Letters along with a printout of all assets and account numbers in each financial institution. The Public Guardian shall thereafter be entitled to deal with such assets. This form shall be filed within 10 days. Failure to file this form will result in a suspension of your authority. Page 4 of 5 court order. To show the court that they complied with this restriction, the Public Guardian shall file with the court a Proof of Restricted Account form within 10 days of this order. 14. Bond is not required per Neb. Rev. Stat. 24730-2627(e). 15.Training: For good cause shown training is waived. The Public Guardian and the AssociatePublic Guardians have already taken the training.16.The Public Guardian shall file the Notice of Designation of Deputy Public Guardian andAssociate Public Guardians form (CC 16:2.96) with the court indicating who the designatedAssociate Public Guardian is for this case. If the Associate Public Guardian changes, thePublic Guardian shall file an updated Notice of Designation of Deputy Public Guardian andAssociate Public Guardians form (CC 16:2.96) with the court indicating who the newdesignated Associate Public Guardian is for this case.IT IS THEREFORE ORDERED that the Public Guardian is appointed guardian and conservator of the estate of and Letters of Guardianship and Conservatorship shall be issued to the upon the filing of the following documents: 1.Acceptance of Appointment;2.General Information Form.3.Address Information Form; 4. Acknowledgment of Financial Institution with a printout of all assets in each financial institution; 5.Proof of restricted funds form for any assets the court has ordered to be held in a restricted;6.Inventory, Affidavit of Due Diligence, and Certificate of Mailing form;7.Budget that pursuant to Neb. Ct. Rule 247 6-1433.02(D) is for informational purposes only;8.Personal and Financial Information for Guardianships and Conservatorships form. American LegalNet, Inc. www.FormsWorkFlow.com Page 5 of 5 As a guardian and conservator the Public Guardian is ordered to comply with the following restrictions: 1.The Public Guardian shall not pay compensation to themselves from assets or income of the ward/incapacitated person/protected person, nor sell real property of the estatewithout first giving notice to interested persons and obtaining an order of the court. Toobtain an Order, the Public Guardian must first file an application, give notice tointerested persons, then have a hearing date scheduled. The order may be enteredwithout a hearing if all interested persons have waived notice of hearing or have executedtheir written consent to such com