PROBATE COURT OF CUYAHOGA COUNTY, OHIO Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN THE MATTER OF THE GUARDIANSHIP OF ______________________________________ CASE NUMBER ______________________________________ APPLICATION FOR APPOINTMENT OF GUARDIAN OF MINOR [R.C. 2111.03(c)] Applicant, a resident of _____________________ County, Ohio hereby applies for the appointment of (himself) (herself) or some suitable person as guardian of the following minor, and represents that the applicant is not an administrator executor, or other fiduciary of an estate wherein the minor is interested. _________________________________________________________________________________________________________ Name of Minor Age Date of Birth Residence or Legal Settlement _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ Attached is a list of the next of kin of the minor (Form 15.0) A guardian is necessary because (R.C. 2111.06) ___________________________________________________________ _________________________________________________________________________________________________________ THE TYPE OF GUARDIANSHIP APPLIED FOR IS G Non-limited G Limited G Person and Estate G Estate Only G Person Only IF THE APPLICATION IS FOR LIMITED GUARDIANSHIP, The length (time period) of the guardianship requested is G Indefinite G Definite to ______________________ , 20 ______ . The limited powers requested are: ______________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ Applicant attaches affidavit pursuant to R.C. 3109.27 Applicant represents that grounds exist for the Court to exercise its jurisdiction. (Applies to guardianship of person only. R.C. 3109.22). The Applicant has (not) been charged with or convicted of a crime involving theft, physical violence, or sexual, alcohol or substance abuse except as follows (if applicable, state date and place of each charge or each conviction). ________________________________________________________________________________________________________ ______________________________________________________________________________________________________ Form 16.0 - Application for Appointment of Guardian of Minor 12/99 American LegalNet, Inc. www.FormsWorkflow.com The whole estate of said minor is estimated as follows: Personal property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ______________________ Real Estate .................................................. $ ______________________ Annual rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ______________________ Other annual income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Total $ ______________________ Applicant offers the attached bond in the amount of $ _______________________ I hereby certify that all the information and statements contained in this application and attached exhibits are correct to the best of my knowledge and belief. _______________________________________________ ______________________________________________ Attorney for Applicant Applicant _______________________________________________ ______________________________________________ Type or print name Type or print name _______________________________________________ ______________________________________________ Address Address _______________________________________________ ______________________________________________ City City State Zip State Zip _______________________________________________ ______________________________________________ Phone number (include area code) Phone number (include area code) _________________________________________________ Supreme Court Registration Number SELECTION OF GUARDIAN BY MINOR OVER FOURTEEN YEARS OF AGE The undersigned hereby selects ________________________________________________________________________ a resident of ______________________________________ County, Ohio, as Guardian of the (person and estate) and respectfully asks the Court to appoint ________________________________________________________________________ as Guardian. ________________________________________________________ Signature ________________________________ Date of Birth American LegalNet, Inc. www.FormsWorkflow.com PROBATE COURT OF CUYAHOGA COUNTY, OHIO Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN THE MATTER OF THE GUARDIANSHIP OF _______________________________________ CASE NUMBER:______________________________________ NEXT OF KIN OF PROPOSED WARD (R.C. 2111.04) (NOTE: Specify age and birthdate of each minor under 16 on the line containing the minor’s name. List the name and address of the minor’s parent, guardian, or custodian on the name and address line following the minor’s address.) Service Waived 1. G Relationship Birthdate of Minor Name ___________________________________________________ ___________________________ _____________ Address __________________________________________________________ Zip ______________________________ 2. G Name ___________________________________________________ ___________________________ _____________ Address __________________________________________________________ Zip ______________________________ 3. G Name ___________________________________________________ ___________________________ _____________ Address __________________________________________________________ Zip ______________________________ 4. G Name ___________________________________________________ ___________________________ _____________ Address __________________________________________________________ Zip ______________________________ 5. G Name ___________________________________________________ ___________________________ _____________ Address __________________________________________________________ Zip ______________________________ 6. G Name ___________________________________________________ ___________________________ _____________ Address __________________________________________________________ Zip ______________________________ 7. G Name ___________________________________________________ ___________________________ _____________ Address __________________________________________________________ Zip ______________________________ 8. G Name ___________________________________________________ ___________________________ _____________ Address __________________________________________________________ Zip ______________________________ 9. G Name ___________________________________________________ ___________________________ _____________ Address __________________________________________________________ Zip ______________________________ 10. G Name ___________________________________________________ ___________________________ _____________ Address __________________________________________________________ Zip ______________________________ _______________________________________________ _______________________________________________ Date Applicant Form 15.0 - Next of Kin of Proposed Ward American LegalNet, Inc. www.FormsWorkflow.com WAIVER OF NOTICE AND CONSENT We, the undersigned, do each of us hereby waive the issuing and service of notice, and voluntarily enter our appearance herein. We do hereby consent to the appointment of ___________________________________ or some suitable person as guardian of _____________________________________________ _____________________________________________________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ American LegalNet, Inc. www.FormsWorkflow.com PROBATE COURT OF CUYAHOGA COUNTY, OHIO Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN THE MATTER OF ___________________________________________________________ CASE NUMBER:______________________________________ AFFIDAVIT (R.C. 3109.23) State of Ohio, County of Cuyahoga, ss: To be filed only when guardianship of the person of a minor is sought. Affiant being first duly sworn, deposes and says: 1. That the child’s present address, the places where the child has lived within the last five years, and the names and present addresses of the person(s) with whom the child has lived during that period are: 2. That affiant has (has not) participated as a party, witness, or in other any capacity in any litigation concerning the custody of the child(ren) in this or any other state. 3. That affiant has (no) information of any custody proceeding concerning the child(ren) pending in a court of this or any other state. 4. That afiant has (no) knowledge of any person not a party to the proceedings who has physical custody of the child(ren) or claims to have custody or visitation rights with respect to the child(ren). If 2, 3, or 4 is answered in the affirmative, and the space afforded is insufficient for full explanation, please attach and incorporate herein any necessary information. Affiant realizes that __he has a continuing duty to inform the Court of any custody proceedings concerning the child(ren) in this or any other state of which affiant obtains information during the pendency of this proceeding. __________________________________________ Sworn to before me and subscribed in my presence this ____________ day of __________________________ , 20 _____ __________________________________________ Notary Public 16.1 Affidavit (ORC 3109.27) 03/08 American LegalNet, Inc. www.FormsWorkflow.com PROBATE COURT OF CUYAHOGA COUNTY, OHIO Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge IN THE MATTER OF ___________________________________________________________ CASE NUMBER:______________________________________ FIDUCIARY'S ACCEPTANCE GUARDIAN [R.C. 2111.14] I, the undersigned, hereby accept the duties which are required of me by law, and such additional duties as are ordered by the Court having jurisdiction. AS GUARDIAN OF THE ESTATE, I WILL: 1. Make and file an inventory of the real and personal estate of the ward within 3 months after my appointment. 2. Deposit funds which come into my hands in a lawful depository located within this state. 3. Invest surplus funds in a lawful manner. 4. Make and file an account biennially, or as directed by the Court. 5. File a final account within 30 days after the guardianship is terminated. 6. Inventory any safe deposit box of the ward. 7. Preserve any and all Wills of the Ward as directed by the Court 8. Expend funds only upon written approval of the Court. 9. Make and file a guardian’s report biennially, or as directed by the Court. AS GUARDIAN OF THE PERSON, I WILL: 1. Protect and control the person of my ward when necessary. 2. Provide suitable maintenance and education for my ward. 3. Provide such maintenance and education for my ward as the amount of his estate justifies if the ward is a minor and has no father or mother, or has a father or mother who fails to maintain or educate him/her. 4. Make and file a guardian’s report biennially, or as directed by the Court. 5. Obey all orders and judgments of the Court pertaining to the guardianship If I change my address or the ward’s address, I shall immediately notify Probate Court in writing. I acknowledge that I am subject to removal as such fiduciary if I fail to perform such duties, I also acknowledge that I am subject to possible penalties for improper conversion of the property which I hold as fiduciary. ________________________________________ Date _____________________________________ Fiduciary 15.2 Fiduciary's Acceptance - Guardian 12/99 American LegalNet, Inc. www.FormsWorkflow.com