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STATE OF SOUTH CAROLINA COUNTY OF _____________________________ IN THE MATTER OF: ________________________________________ (Decedent) ) ) ) ) ) ) ) IN THE PROBATE COURT ORDER FOR APPOINTMENT OF GUARDIAN AD LITEM (GAL) CASE NUMBER : ___________________________ I HEREBY APPOINT _________________________________________ as Guardian Ad Litem to represent the interest(s) of _____________________________________________________________________________ in proceedings relating to the above matter. This Court has determined representation would be otherwise inadequate for the following reason(s): Minor (under the age of 18) Incapacitated Adult (alleged) Incapacitated Adult (adjudicated) Incarcerated Person (in state) Incarcerated Person (out of state) Unknown identity of heirs/devisees Unknown address of heirs/devisees Unborn heirs/devisees Other: _________________________________________________________________________________________ Executed this _____ day of ___________________________, 20____. , Probate Court Judge ACCEPTANCE I agree to serve as Guardian ad Litem in this matter. I am: Licensed to practice law in the State of South Carolina (SC Bar No. _________________) Family Member (list relationship): _____________________________________________ Other (list relationship): _____________________________________________________ Signature: Print Name: Address: Telephone (Work): (Home): (Cell): Email: FORM #130ES (1/2014) 62-1-403, 62-3-1305 American LegalNet, Inc. www.FormsWorkFlow.com