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Petition For Finding Of Incapacity Or Appointment Of Guardian Or Successor Guardian Form. This is a South Carolina form and can be use in Probate Court Statewide.
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Tags: Petition For Finding Of Incapacity Or Appointment Of Guardian Or Successor Guardian, 530PC, South Carolina Statewide, Probate Court
STATE OF SOUTH CAROLINA
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COUNTY OF:
IN THE MATTER OF:
IN THE PROBATE COURT
PETITION FOR FINDING
CASE NUMBER:
INCAPACITY
APPOINTMENT OF
GUARDIAN
SUCCESSOR GUARDIAN
Applicant/Petitioner:
Address:
Telephone:
I.
ALL PETITIONERS MUST COMPLETE THIS SECTION.
1.
Nature of interest of undersigned:
2.
Information -- Allegedly Incapacitated Person
Name:
Date of Birth
Address:
City/State/Zip:
Telephone:
To my knowledge, above named
To my knowledge, above named
3.
Age:
DOES
DOES
DOES NOT have a health care power of attorney.
DOES NOT have a living will (Declaration of a Desire for a
Natural Death.)
Venue for this proceeding in this county because the subject:
resides in this county.
is present in this county.
is admitted to an institution pursuant to an order of a court of competent jurisdiction in this county.
4.
Information—Family of allegedly incapacitated person, including dates of birth of minors. If there are no
minors, so state.
Relationship to
Name
Date of Birth
Address
Incapacitated
Person
(use additional sheet if necessary)
FORM #530PC (2/2004)
62-5-301, 62-5-302, 62-5-303, 62-5-304, 62-5-305
62-5-307, 62-5-309, 62-5-310, 62-5-311
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5.
II.
The nature and degree of incapacity is as follows:
COMPLETE THIS SECTION IF APPOINTMENT IS SOUGHT.
1.
Is it your belief that the allegedly incapacitated person is in need of a guardian/successor guardian as a
means of providing continuing care and supervision of the person of said incapacitated person?
YES
NO If no, please explain.
2.
The extent to which the guardian should be permitted to give consents or approvals that may be
necessary to enable the allegedly incapacitated person to receive medical or other professional care,
counsel, treatment or services is as follows:
3.
The nature and extent of the care, assistance, protection, or supervision which is necessary or desirable
for the allegedly incapacitated person under the circumstances is as follows:
4.
Has a guardian appointed by a Will accepted such appointment?
NO
YES If yes, please explain.
5.
I request the appointment of:
Name:
Address:
Telephone (O):
(H):
E-mail:
whose priority for appointment as guardian for the subject is as follows:
a person nominated to serve as guardian by the allegedly incapacitated person
an attorney-in-fact appointed by the allegedly incapacitated person pursuant to Section 62-5-501
spouse of the allegedly incapacitated person
adult child of the allegedly incapacitated person
parent of the allegedly incapacitated person
other relative of the allegedly incapacitated person (Specify):
nominated by the person who is caring for the allegedly incapacitated person or paying benefits to
him/her
Other (specify)
6.
Is it necessary to appoint a temporary guardian for the subject until a hearing can be held on this
Petition?
NO
YES If yes, please state reasons.
FORM #530PC (2/2004)
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III.
ALL PETITIONERS MUST COMPLETE THIS SECTION.
1.
I request that the Court set a time and place of hearing on this Petition and that the Court determine that
the above person is incapacitated.
2.
I request that the Court determine that the need for the appointment of a guardian is proper, and that the
Court appoint
as the guardian for the above
person: and that Letters of Guardianship be issued to the guardian.
3.
The following persons are required by statute to be given notice of the time and place of hearing on this
Petition: (SCPC 5-309)
Name
Address
Relationship
VERIFICATION
The undersigned, being sworn states: That the facts set forth in the foregoing statement are true to the best of the
undersigned’s knowledge, information and belief.
SWORN to before me this
day of
, 20
Notary Public for South Carolina
My Commission Expires:
Signature:
Name:
Address:
E-mail:
Telephone (O):
(H):
Attorney:
Address:
E-mail:
Telephone (O):
QUALIFICATION AND STATEMENT OF ACCEPTANCE
I accept this appointment and agree to perform the duties and discharge the trust of the office of Guardian of the
incapacitated person of
.
SWORN to before me this
day of
, 20
Notary Public for South Carolina
My Commission Expires:
FORM #530PC (2/2004)
Signature:
Name:
Address:
E-mail:
Telephone (O):
(H):
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