Request For Waiver Of Personal Appearance
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Request For Waiver Of Personal Appearance Form. This is a New Hampshire form and can be use in Probate Court Statewide.
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Tags: Request For Waiver Of Personal Appearance, NHJB-2168-P, New Hampshire Statewide, Probate Court
THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us
Court Name:
Guardianship of
Case Name:
Case Number:
(if known)
REQUEST FOR WAIVER OF PERSONAL APPEARANCE;
WRITTEN STATEMENT (RSA 464-A:8, II)
I/We,
, represent that the
, does not express a
proposed ward,
desire to attend the hearing concerning the finding of incapacity and appointment of a guardian of the
person and estate, or the person, or estate. I/We certify that a copy of this document has been
provided to the parties who have filed an appearance for this case or who are otherwise interested
parties.
Date
Petitioner(s) or Counsel for the proposed ward
PHYSICIAN'S AFFIDAVIT (RSA 464-A:8,II)
I,
1.
, M.D., under oath, hereby depose and say:
,
located at
2.
I am a medical physician at
.
The proposed ward,
, is a
patient at
3.
.
In my opinion, the proposed ward should be excused from attending the hearing concerning
the finding of incapacity and appointment of a guardian of the person and estate, or the
person, or estate, because:
his/her overall physical, emotional or psychological condition is such that he/she is likely to
suffer harm if required to attend; and/or
he/she has no ability to understand the nature and consequences of the proceedings.
Date
Physician Signature (must be in presence of notarial officer)
State of
, County of
This instrument was acknowledged before me on
by
Date
My Commission Expires
Affix Seal, if any
Physician
Signature of Notarial Officer / Title
ORDER
REQUEST FOR WAIVER OF PERSONAL APPEARANCE IS:
Date
Page 1 of 1
DENIED
Judge
NHJB-2168-P (06/04/2008)
(formerly AOC-218-003)
GRANTED
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