PROBATE COURT OF _____________ COUNTY, OHIO GUARDIANSHIP OF __________________________________________________________ CASE NO. ______________________________ APPLICATION FOR APPOINTMENT OF GUARDIAN OF ALLEGED INCOMPETENT [R.C. 2111.03] 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…………………$________________________ Other annual income…………$________________________ 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 bond in the amount of $____________________. Applicant further represents that a guardian of the alleged incompetent is necessary in order that □ the ward □ the ward’s 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) Eff. Date March 1, 2008 American LegalNet, Inc. www.FormsWorkflow.com CASE NO. ___________________ The time period requested is □ indefinite □ definite to ___________________________ _______________________________________________________________________. Applicant’s 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 for Applicant Applicant __________________________________ ____________________________________ Type or Print Name Type or Print Name __________________________________ ____________________________________ Address Age __________________________________ ____________________________________ City Address State Zip __________________________________ ____________________________________ Phone number (include area code) City State Zip __________________________________ ____________________________________ Attorney Registration Number Phone number (include area code) FORM 17.0 – APPLICATION FOR APPOINTMENT OF GUARDIAN (AN ALLEGED INCOMPETENT) American LegalNet, Inc. www.FormsWorkflow.com Eff. Date March 1, 2008 American LegalNet, Inc. www.FormsWorkflow.com