File No. SURROGATE222S COURT- COUNTY17-A GUARDIANSHIP CITATIONTHE PEOPLE OF THE STATE OF NEW YORKBy the Grace of God Free and IndependentTO:A petition having been filed by , who is/aredomiciled at YOU ARE HEREBY CITED TO SHOW CAUSE before the Surrogate222s Court, County,at , New York , on , , at o222clock in the noon of that day, why letters of guardianship of the[ ] person[ ] property[ ] person and property[ ] limited guardianship of the propertyof should not be granted to ;why the appointment of as Standby Guardian of the[ ] person[ ] property[ ] person and property[ ] limited guardianship of the propertyof should not be granted;why the appointment of as First Alternate Standby Guardian of the[ ] person[ ] property[ ] person and property[ ] limited guardianship of the propertyof should not be granted;why the appointment of as Second Alternate Standby Guardian of the[ ] person[ ] property[ ] person and property[ ] limited guardianship of the propertyof should not be granted;and why a hearing [ ] should be held [ ] should not be held;and why the appearance of Respondent [ ] should be [ ] should not be required at the hearing;and why the guardian(s) of the person should not be authorized and empowered to make all decisions with respect to themedical and dental needs of the Respondent and to render consent to any medical procedures which are necessary to thehealth and welfare of the Respondent, unless the court directs otherwise. A health care decision may include a decision towithhold or withdraw life-sustaining treatment as .[State further relief requested]Dated, Attested and Sealed,HON., ,Surrogate(Seal) American LegalNet, Inc. www.FormsWorkFlow.com