STATE OF SOUTH DAKOTA ) IN CIRCUIT COURT ) COUNTY OF ________________ ) ____________ JUDICIAL CIRCUIT ***************************************************************************** In the Matter of the Guardianship of ) __GDN______________ ) , ) INITIAL ANNUAL FINAL OTHER a Minor Protected Person. ) GUARDIAN REPORT ***************************************************************************** I/We, ______________________________________ , the Guardian(s) of the above-named Individual, being duly sworn upon oath, state and affirm the following: The Court appointed Guardian(s) in the above-entitled case on _______________ (month) _____ (day), ________ (year). Unless this is an initial report, Guardian(s) last reporting period ended on ______________ (month) ______ (day), _________ (year). This report describes the status of the Individual and the efforts of his/her Guardian(s) from: _____________ (month), ___ (day), ______ (year) to ____________ (month), ___ (day), ______ (year). [Note that SDCL 29A-5-403 provides that a report can only cover a maximum of one year.] I/We further affirm the following as true and complete to the best of my/our knowledge: 1. The current mental, physical and social condition of the Individual is (describe in own words): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 2. The Individual's living arrangements are (describe physical location, persons in household-- and if institutionalized--the institution and whether you agree with the treatment/habilitation plan): _____________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ UJS-142 Guardian's Report Rev. 05/2016 American LegalNet, Inc. www.FormsWorkFlow.com 3. The professional services--medical, educational, vocational, and others--provided to the Individual include (describe the services, who provided them, when they were provided, and your opinion of whether they are adequate): _______________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 4. The nature of the Guardian's(s') contact, visits and activities with the Individual include: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 5. Should the guardianship continue in its current form, or should it be modified or terminated? (Check one): Current Form Modified Terminated Explain why: ________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 6. Any other information requested by the Court or useful in the opinion of the Guardian(s): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ UJS-142 Guardian's Report Rev. 05/2016 American LegalNet, Inc. www.FormsWorkFlow.com I/We request, pursuant to SDCL 29A-5-116, the reasonable compensation of $______________, to be paid from the above-named Individual's estate, because (if not requested, leave blank): _____________________________________________________________