LORAIN COUNTY PROBATE COURT JUDGE JAMES T WALTHER GUARDIANSHIP OF ___________________________________________________________ CASE NO. ______________________________ APPLICATION FOR APPOINTMENT OF GUARDIAN OF ALLEGED INCOMPETENT [R.C.211.03] Applicant represents to the court that___________________________________________ aged _____ years, Resides or has a legal settlement at _______________________ in ______________________ County, Ohio And that the prospective ward is incompetent by reason of (R.C.2111.01(D)) ________________________ ______________________________________________________________________________________ A Statement of Expert Evaluation is attached (Form 17.1) A list of Next of Kin of Proposed Ward is also attached (Form 15.0) The whole estate of the prospective ward is estimated as follows: Personal Property Real Estate Annual Rents Other Annual Rents $ __________________________ $ __________________________ $ __________________________ $ __________________________ Applicant represents that the applicant is not an administrator, executor or other fiduciary of the estate wherein the alleged incompetent is interested. Applicant offers the attached bon in the amount of $ __________________. Applicant further represents that a guardian of the alleged incompetent is necessary in order that the ward the wardīs property may be taken proper care of and asks that a guardian be appointed. TYPE OF GUARDIANSHIP APPLIED FOR IS (check the applicable boxes) non-limited limited person and estate estate only person only If limited guardianship is applied for, the limited powers requested are ________________________________________________________________________________________ ________________________________________________________________________________________ FORM 17.0- APPLICATION FOR APPOINTMENT OF GUARDIAN (AN ALLEGED INCOMPETENT) American LegalNet, Inc. www.FormsWorkFlow.com The time period requested is indefinite definite to __________________________________________ ________________________________________________________________________________________ Applicantīs relationship to alleged incompetent is _______________________________________________ _______________________________________________________________________________________ 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.) ________________________________________________________________________________________ ________________________________________________________________________________________ ____________________________________ Attorney of Applicant ____________________________________ Applicant ____________________________________ Type of Print Name ____________________________________ Type or Print Name ____________________________________ Address ____________________________________ Age ____________________________________ City State Zip ____________________________________ Address ____________________________________ Phone number (include area code) ____________________________________ City State Zip ____________________________________ Attorney Registration Number ____________________________________ Phone number (include area code) FORM 17.0-APPLICATION FOR APPOINTMENT OF GUARDIAN (AS ALLEGED INCOMPETENT) American LegalNet, Inc. www.FormsWorkFlow.com