) IN CIRCUIT COURT ) COUNTY OF _________________ ) __________ JUDICIAL CIRCUIT ) ****************************************************************************** In the Matter of the ______________________ ) ____GDN________________ ) of ___________________________________, ) PETITION FOR RESIGNATION ) a Minor Protected Person. ) ****************************************************************************** I, __________________________ , the ( Guardian, Conservator, Guardian & Conservator ) for the above-mentioned Individual, being duly sworn upon oath, state and affirm the following: 1. I was appointed by the Court on _________________ (month), ___ (day), ________ (year). 2. I provide the following assistance, services, and protection to the Individual (please detail): ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 3. I request the Court's permission for resignation because (explain in detail): _____________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 4. To serve as my successor, I propose: _________________________________, ______________, (Full Legal Name) (Mailing Address) (DOB, or Tax ID if business) (Phone Number) STATE OF SOUTH DAKOTA _____________________________________________________, ___________________________. UJS-153 Petition for Resignation and Consent Rev. 05/2016 American LegalNet, Inc. www.FormsWorkFlow.com 5. My proposed successor is suitable, pursuant to SDCL 29A-5-110, and is also capable of providing an active and suitable program of guardianship and/or conservatorship for the above-mentioned Individual. These capabilities are provided below (explain in detail): ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 6. My proposed successor is willing to uphold the same duties and responsibilities as the Court vested in me in my Order of Appointment for the benefit of the above-mentioned Individual. My proposed successor's signature (or the signature of an agent thereof) to this Petition and Affidavit only indicates the willingness of my proposed successor to serve in a similar capacity. 7. Attached is my Final Report and/or Accounting, if required and not waived by the Court. I swear or affirm under oath that the information I provided in this Petition for Resignation and Affidavit is true and correct to the best of my knowledge. I affirm that this Petition for Resignation and Affidavit is brought in the best interests of the above-named Individual. I also affirm that I have mailed a copy of this Petition and Consent to those parties listed in SDCL 29A-5-410. Dated ______________ ___ , ________ (month) (day) (year) _______________________________________ Petitioner'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-153 Petition for Resignation and Consent Rev. 05/2016 American LegalNet, Inc. www.FormsWorkFlow.com ) IN CIRCUIT COURT ) COUNTY OF _________________ ) __________ JUDICIAL CIRCUIT ****************************************************************************** In the Matter of the ______________________ ) ____GDN________________ ) of __________________________________, ) CONSENT ) (TO SERVE AS SUCCESSOR a Minor Protected Person. ) FOR RESIGNEE) ****************************************************************************** STATE OF SOUTH DAKOTA ) ) COUNTY OF ______________________ ) I, _____________________________________ , being first duly sworn, state as follows: (Full Legal Name of Consenting Successor or Agent) STATE OF SOUTH DAKOTA 1. I am qualified to serve as the Successor to _____________________________, based on the requirements set out in SDCL 29A-5-110. (Name of Resignee) 2. I have reviewed the Resignee's Petition for Resignation to which this Consent attaches. 3. I affirm and attest that the capabilities the Resignee attributed to me (or my principal, if an agent) for providing an active and suitable program of guardianship and/or conservatorship in Part 5 of the Petition for Resignation, are true and correct. 4. I hereby freely and voluntarily, and not as a result of any threat or premise, consent to serve as the Succe