251 2018 Nevada Supreme Court Page 1 of 7 226 Order Appointing Guardian(s) (Adult) COURT CODE: Your Name: Address: City, State, Zip: Telephone: Email Address: DISTRICT COURT COUNTY, NEVADA In the Matter of the Guardianship of the: PersonEstatePerson and Estateof: (name of adult who has a guardian) A Protected Person.CASE NO.: DEPT: ORDER APPOINTING GUARDIAN(S) OVER ADULT This matter came before the Court for hearing on (date of hearing) . Petitioner (first guardian222s name) , was present representing HIMSELF/HERSELF 226OR226 WITH COUNSEL, (attorney222s name; or 223n/a224 if none) . Petitioner (second guardian222s name) , was present representing HIMSELF/HERSELF 226OR226 WITH COUNSEL, (attorney222s name; or 223n/a224 if none) . Proposed Protected Person (adult222s name) , WAS PRESENT 226OR226 WAS NOT PRESENT and is represented by counsel, (attorney222s name) . It appearing to the satisfaction of the Court that notice is sufficient; and It appearing by clear and convincing evidence that it is necessary to appoint a guardian for the proposed protected person; American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 7 226 Order Appointing Guardian(s) (Adult) IT IS HEREBY ORDERED AND DETERMINED BY THE COURT as follows: 1.(Adult protected person222s name) , date ofbirth (date) , is a resident of the State of .2.The Proposed Protected Person is an adult who needs the appointment of a guardian.This request is supported by recent documentation demonstrating the need for aguardianship.3.Notice has been served upon the adult, the spouse and/or any living relative, or thepublic guardian, if necessary, and/or any other persons or agency having the care,custody and control of the adult.4.It is necessary and in the best interest of the Protected Person that Petitioner(s) beappointed as Guardian(s). The following is/are appointed to act as Guardian(s) of the PERSON 226OR226 ESTATE 226OR226 PERSON AND ESTATE and shall have the power and authority as may be necessary for the benefit of the above named Protected Person until further order of this Court: N/A First Guardian: Street Address City, State, Zip: Telephone: Second Guardian: Address City,State, Zip: Telephone: The Guardian(s) shall participate in the guardianship training class, if offered, through 226OR226 N/A.Pursuant to NRS 159.081, the Guardian(s) shall file a written report on the condition ofthe Protected Person every year between the anniversary date of and forthe first report and each year thereafter. This obligation continues until theguardianshipof the person ends 226OR226 N/A American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 7 226 Order Appointing Guardian(s) (Adult) 7.Bond is: Not applicable. Reserved pending the filing of the inventory. Ordered in the amount of $. Waived. A blocked account is ordered in lieu of bond. 8.Inventory: This is a person only guardianship; no estate is involved. The Guardian(s) shall file an inventory of all of the property of the Protected Person which comes to the possession, or knowledge of the Guardian(s) by (date) . 9.Accounting: This is a person only guardianship; no estate is involved. Summary administration of the estate is granted. An annual accounting is not required until assets exceed the statutory threshold for summary administration. A verified account of the estate of the Protected Person shall be made and filed annually by (date) , and must be filed within 60 days of this date and each year thereafter. This obligation continues until the guardianship of the estate ends. 10.Pursuant to NRS 159.0593: There is clear and convincing evidence that the Protected Person is a person with a mental defect who is prohibited from possessing a firearm pursuant to 18 U.S.C. 247922 (d)(4) or (g) or (4). A Record of the Order containing this filing shall betransmitted to the central repository for Nevada Records of Criminal History,along with a statement that the record is being transmitted for inclusion in eachappropriate database of the National Instant Criminal Background Track System. The Protected Person222s right to possess a firearm is not affected.11.Pursuant to NRS 159.0594: The Protected Person lacks the requisite understanding to vote or otherwise participate in the election process and shall be removed from the voting records. The Protected Person222s right to vote is not affected. American LegalNet, Inc. www.FormsWorkFlow.com Page 4 of 7 226 Order Appointing Guardian(s) (Adult) 12.All powers are reserved to the Protected Person except for the following powers, whichare granted to the Guardian(s): Powers over Person (Court to check applicable powers granted to Guardian(s)) To oversee, maintain and/or approve the placement of the Protected Person in theappropriate, least restrictive, and financially feasible care facility.Only in the event that provisions of NRS Chapter 433A DO NOT apply, to approveplacement of the Protected Person in a secured facility, with the assistance lawenforcement and/or REMSA if needed.To hire or discharge care givers as deemed necessary in the discretion of theGuardian.To authorize any medical care the Protected Person may require.To change the mailing address of the Protected Person.To make informed decisions regarding the Protected Person222s health care, to includeconsultations on treatment plans, consents and admissions, consents for residentialplacements, consents for medications, and treatments recommended by medical providers,and the authority to make related decisions for the benefit of the Protected Person.The Guardian(s) is/are the Protected Person222s personal representative for purposes ofthe Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and any applicable regulations. The Guardian(s) of the person has/have authorityto obtain information from any government agency, medical provider, business,creditor or third party who may have information pertaining to the Protected Person222shealth care or health insurance.To ensure that housing and care arrangements provide the Protected Person with anappropriate level of safety, well-being, health and maintenance.To ensure that the Protected Person has access to family members and persons ofnatural affection, and those persons and family members have access to the ProtectedPerson in a manner that ensures an appropriate level of safety and well-being for theProtected Person.To obtain neuropsychological examination to determine areas of defects andcapacities.Other: American LegalNet, Inc. www.FormsWorkFlow.com Page 5 of 7 226 Order Appointing Guardian(s) (Adult) Powers over Estate (Court to check applicable powers granted to Guardian(s)) Permission to sell, donate, distribute, dispose of and/or abandon personal property tomaintain the integrity of the Protected Person222s estate.Permission to freeze, access, utilize funds from, transfer and/or close any and all ofthe Protected Person222s bank accounts and any and all other accounts at any financialinstitution, whether solely or jointly held, for the benefit of the Protected Person.Permission to redirect and/or become the representative payee for Social Securityincome, and similar income, if any, for the benefit of the Protected Person.Permission to obtain credit reports from any credit-reporting bureau to ascertain thestatus of any credit card accounts and/or lines of credit and activity on any suchaccounts.Permission to obtain tax information, tax returns and/or any necessary documentsfrom the Internal Revenue Service for the benefit of the Protected Person.Permission to investigate, apply for and/or consent to services for which the ProtectedPerson may be eligible.Permission to access, drill, open, inventory, remove the contents of, and/or close anysafe deposit box, whether solely or jointly held by the Protected Person.Other: 13.Pursuant to NRS 159.074, a copy of this order must be served personally or by mail uponthe Protected Person no later than 5 days after the date of the appointment of theGuardian. A notice of entry of the order must be filed with the Court.14.The relatives required to be served and identified by petitioner as having been servedpursuant to NRS 159.047(2) et se