Nebraska State Court Form REQUIRED CC 16:2.116 New 11/15 Neb. Rev. Stat. §§ 30-2633, 30-2619, 30-2639, 30-2626, 30-2627, 30-2627(e) ORDER APPOINTING THE PUBLIC GUARDIAN AS TEMPORARY GUARDIAN AND TEMPORARY CONSERVATOR COUNTY, NEBRASKA Case No. IN THE COUNTY COURT OF IN THE MATTER OF Ward/Incapacitated Person/Protected Person ORDER APPOINTING THE PUBLIC GUARDIAN AS TEMPORARY GUARDIAN AND TEMPORARY CONSERVATOR The Petition for Appointment of Temporary Guardian and Temporary Conservator having come before the court, the court finds as follows: 1. Petitioner(s) is/are entitled to file the Petition pursuant to Neb. Rev. Stat. §§ 30-2633 and 30-2619. 2. Notice has been given to the Office of Public Guardian as required by law. 3. Venue in this county is proper. 4. Appointment of a temporary guardian and temporary conservator is necessary because of the following emergency: 5. The Public Guardian is entitled to temporary appointment pursuant to Neb. Rev. Stat. §§ 30-2626, 30-2627, 30-2630.01, and 30-2639 and should be appointed as temporary guardian and temporary conservator. 6. Bond is not required pursuant to Neb. Rev. Stat. § 30-2627(e). 7. Other: Page 1 of 2 Order Appointing the Public Guardian as Temporary Guardian and Temporary Conservator CC 16:2.116 New 11/15 American LegalNet, Inc. www.FormsWorkFlow.com IT IS THEREFORE ORDERED that the Public Guardian shall be appointed temporary guardian and temporary conservator of the estate of and Letters Appointing the Public Guardian as temporary guardian and temporary conservators shall be issued to the Public Guardian upon the filing of the following documents: 1. Acceptance; 2. The Public Guardian shall file the Notice of Designation of Deputy Public Guardian and Associate Public Guardians form (CC 16:2.96) with the court, indicating who the designated Associate Public Guardian is for this case. If the Associate Public Guardian changes, the Public Guardian shall file an updated Notice of Designation of Deputy Public Guardian and Associate Public Guardians form (CC 16:2.96) with the court, indicating who the new designated Associate Public Guardian is for this case. As a temporary guardian and temporary 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 estate without first giving notice to interested persons and obtaining an order of the court. The order may be entered without a hearing if all interested persons have waived notice of hearing or have executed their written consent to such compensation or sale and/or any other restrictions as determined to be appropriate by the court. 2. The Office of Public Guardian is prohibited from making ATM withdrawals or receiving cash back on debit transactions. 3. If any funds have been restricted by the court, the Public Guardian shall not make any withdrawals from the restricted account without a court order. 4. Other restrictions: DATED: BY THE COURT: County Judge PREPARED AND SUBMITTED BY: Page 2 of 2 Order Appointing the Public Guardian as Temporary Guardian and Temporary Conservator CC 16:2.116 New 11/15 American LegalNet, Inc. www.FormsWorkFlow.com