) IN CIRCUIT COURT ) COUNTY OF _________________ ) __________ JUDICIAL CIRCUIT ****************************************************************************** In the Matter of the Guardianship of ) ____GDN________________ ) ___________________________________, ) PETITION FOR HEARING ON ) GUARDIAN REPORT a Minor Protected Person. ) ****************************************************************************** I, __________________________ , an Interested Person in the above-captioned matter, being duly sworn upon oath, state and affirm the following: 1. I am an Interested Person, as defined in SDCL 29A-5-102(5), because (describe your relationship to the Individual, or, if applicable, note you are the Individual): _____________ ___________________________________________________________________________ 2. The Order of Appointment in this matter was entered on ______________ (month), _____ (day), __________ (year). 3. I request a Court hearing on the Report of the Guardian(s) in this matter covering the period: ___________ (month), ___ (day), _____ (year) to ____________ (month), ___ (day), _____ (year). 4. The reason(s) why I seek a hearing on said Report are as follows (describe in detail): ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ UJS-144 Petition for Hearing on Guardian Report Rev. 05/2016 American LegalNet, Inc. www.FormsWorkFlow.com STATE OF SOUTH DAKOTA I swear or affirm under oath that the information I provided in this Petition for Hearing on Guardian Report is true and correct to the best of my knowledge. I swear or affirm that I have not filed this Petition for any malicious, delaying, or other improper purpose, and that I have filed it in the best interests of the Individual. Dated ______________ ___ , ________ (month) (day) (year) _______________________________________ Interested Person's Signature (Sign only in front of Notary or Clerk) ____________________________________ Mailing Address ____________________________________ City, State, and Zip Code ____________________________________ Phone Number ____________________________________ E-mail Address Signed and sworn to before me on this ______ day of _________________, ________. (SEAL) ___________________________________ Notary Public/Deputy Clerk of Courts Commission Expires: UJS-144 Petition for Hearing on Guardian Report Rev. 05/2016 American LegalNet, Inc. www.FormsWorkFlow.com