Docket No.: ______________ State of New Jersey Camden County Surrogates Court In the matter of the Standby Guardianship of: APPLICATION FOR ___________________________________, A Minor } AKA: _____________________________ CONFIRMATION I, ___________________________by way of application for confirmation of their appointment as Standby Guardian, say: 1. The applicant was designated as Standby Guardian by the parent/custodian of the minor on ____/____/____ 2. The applicant was appointed as Standby Guardian by order of the Camden County Surrogates Court on ____/____/____ 3. Pursuant to the order, the applicants authority is activ by certainated triggering events listed in the order of appoint. tmen4. One or more of the triggering events has occurred. achAtted is a determination of Incapacity or Debilitation or a Death Certificate, as appropriate. N.J.S. 3B: 12 73 (c) 5. The applicant assumed guardianship duties on ____/____/____, subsequent to the triggering event(s) 6. The applicant seeks confirmation pursuant to N.J.S. 3B: 12 73 (c) and (d) Wherefore, the applicant sees judk gment confirming their appointment as Standby Guardian. ____/____/____ The allegations in this application are true to the best of my knowledge and belief. ______________________________ (Signature) (Guardian Name) Subscribed and sworn to this_______________ ________ day of ____________, _________ before me ______________________________ (Notary) S7.DOC Page 1 of 1