PROBATE COURT OF LUCAS COUNTY, OHIO JACK R. PUFFENBERGER, JUDGE IN THE MATTER OF THE GUARDIANSHIP OF__________________________________ CASE NO. ______________________ NOTICE OF HEARING FOR APPOINTMENT OF GUARDIAN OF ALLEGED INCOMPETENT PERSON [R.C. 2111.04] To ____________________________________________________________________________________ Address ________________________________________________________________________________ To ____________________________________________________________________________________ Address ________________________________________________________________________________ To _____________________________________________________________________________________ Address ________________________________________________________________________________ next of kin of __________________________________________________________ known to reside in this state. You are hereby notified that on the ____________ day of _____________________________, 20______, ___________________________________________________ filed in the Court an application for the appointment of a (limited) guardian of the (person and estate) of _________________________________________, an alleged incompetent. The application will be for hearing before the Probate Court in ___________________________________ To Spouse and Known Next of Kin ___________________________________, on the _________ day of ______________________, 20______, at ________________ o'clock ______.M. Witness my signature and the seal of the Court, this ______ day of ______________, 20_____ (Seal) Judge Jack R. Puffenberger By: Deputy Clerk FORM 17.4 NOTICE OF HEARING FOR APPOINTMENT OF GUARDIAN OF ALLEGED INCOMPETENT PERSON American LegalNet, Inc. www.FormsWorkFlow.com Amended: March 15, 2016 Discard all previous versions of this form (Reverse of Form 17.4) RETURN CASE NO. ______________ ________________County, Ohio ______________________,20__ Received this writ on the _______ day of _________________________, 20____, at ______o'clock_____.M. and on the _______ day of ________________________, 20_____, I served the same by (insert, "delivering", "leaving", or "sending") ___________________________ a true copy thereof (insert, "personally to", "at the Usual place of residence", or "by certified mail to the last known address of") _________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ ______________________________________ __________Fees________________________ Service and return, 1 name $______________ ________Additional names, at______________ ________Miles traveled, at ________________ ____________________________________________ Total $ ___________________ st ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ Sheriff ________________________________________ Deputy AFFIDAVIT OF SERVICE The State of Ohio, ___________________________ County. ________________________________________________________, being first duly sworn, says that on the __________ day of _____________________________, 20_____, the within notice was served by delivering a true copy thereof personally to _____________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ __________________________________________ Sworn to before me and signed in my presence, this ______ day of __________________________, 20____ __________________________________________ __________________________________________ FORM 17.4 NOTICE OF HEARING FOR APPOINTMENT OF GUARDIAN OF ALLEGED INCOMPETENT PERSON American LegalNet, Inc. www.FormsWorkFlow.com Amended: March 15, 2016 Discard all previous versions of this form