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Annual Report On Location Condition And Well Being Of Ward Form. This is a Texas form and can be use in Fort Bend Local County.
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Tags: Annual Report On Location Condition And Well Being Of Ward, Texas Local County, Fort Bend
Section 743
CAUSE NO. ________________
GUARDIANSHIP OF
§
IN THE COUNTY COURT
THE PERSON OF
§
AT LAW NO. _____ OF
_____________________________ §
FORT BEND COUNTY, TEXAS
ANNUAL REPORT ON LOCATION,
CONDITION, AND WELL-BEING OF WARD
I, the undersigned, represent that I am the guardian of the person of the above-named
Ward, and that my annual report to the Court for the period of __________________________
through ________________________________ is as follows:
1.
Name of Guardian:________________________________________________________
Guardian’s Address____________________________________________
____________________________________________________________
Telephone Number:(_____)_________________________________________________
Area Code
2.
Name of Ward:___________________________________________________________
Telephone No. (______)____________________________________________________
Area Code
Present Age of Ward:______________________________________________________
Date of Birth: ___________________________________________________________
Current Address of Ward:___________________________________________________
___________________________________________________
[If the Ward has died, please state the date and place of death and do not complete
the other sections.]
3.
Ward’s Residence is:
_____ Guardian’s Home
_____ Own Home
_____ Foster or Boarding Home
_____ Relative’s Home
Name/Address:_____________________________________________________
_____________________________________________________
_____________________________________________________
_____ Hospital or Medical Facility
_____ Nursing Home
Name/Address:_____________________________________________________
______________________________________________________
______________________________________________________
_____ Other:_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
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4.
Ward has been in present residence since (date):_________________________________
If moved within past year, state reason for change:_______________________________
________________________________________________________________________
________________________________________________________________________
5.
During the last 12 months the Guardian has seen the Ward ___________ times. The last
date the Guardian saw the Ward was __________________________________________
6.
Does Guardian have possession or control of the Ward’s estate?
________ Yes
________ No
I have received $____________ for the Ward’s benefit from _______________________
__________________________________________, the sum of $___________________
was spent directly for the Ward’s benefit in the following manner. (If more space is
needed, attach as statement): ________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
7.
During the past year the Ward’s mental health has:
______ Improved. Describe: ________________________________________________
______ Remained Unchanged
______ Deteriorated. Describe:______________________________________________
During the past year the Ward’s physical health has:
______ Improved. Describe: ________________________________________________
______ Remained Unchanged
______ Deteriorated. Describe: _____________________________________________
8.
During the past year the Ward has been treated or evaluated by the following:
(Please state the date service was rendered and the type of service received).
______ Physician: ________________________________________________________
______ Psychologist: ______________________________________________________
______ Psychiatrist: _______________________________________________________
______ Mental Health Provider: _____________________________________________
______ Social or Other Case Worker: _________________________________________
______ Dentist: __________________________________________________________
9.
Social Conditions: During the past year the Ward has participated in the following
activities: (Describe)
______ Recreational: ______________________________________________________
______ Educational: ______________________________________________________
______ Occupational: _____________________________________________________
______ None available or other: _____________________________________________
______ Refuses or Unable to Participate.
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10.
As Guardian, I rate my Ward’s living arrangements as:
______ Excellent
______ Average
______ Below average, explain ______________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
11.
As Guardian, I believe my Ward is:
______ Content with living situation.
______ Unhappy with living situation.
12.
As Guardian, I believe my Ward has the following unmet needs: ___________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
13.
State whether the Guardian’s powers should be:
______ Increased: ________________________________________________________
______ Decreased: ________________________________________________________
______ Remain unchanged.
14.
As Guardian, the bond premium has been paid for the next year?
________ Yes
________ No.
If no, explain:
______ The full bond has been paid into the Registry of the Court.
or
______ State the reason why the bond premium has not been ______________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
15.
Is there any other information that the Guardian desires to advise the Court of: ________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Date: ________________________
Name: _______________________________
Signature: ___________________________
Guardian (printed)
Name: _______________________________
Signature: ___________________________
Guardian (printed)
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THE STATE OF TEXAS
COUNTY OF _________________________
§
§
BEFORE ME, the undersigned authority, on this day personally appeared ____________
____________________________________ and _____________________________________,
who being first duly sworn, states on oath that the within and foregoing report is true, correct,
and complete statement of the present location, condition, and well-being of ________________
________________________, a minor or an incapacitated person, as of the date stated herein.
Signed: _________________________________________
Guardian
SWORN TO AND SUBSCRIBED BEFORE ME on this the _______ day of _______________
_______________________, 20______.
[Seal]
__________________________________________
Notary Public in and for
The State of Texas
Signed: _________________________________________
Guardian
SWORN TO AND SUBSCRIBED BEFORE ME on this the _______ day of _______________
_________________________, 20______.
[Seal]
__________________________________________
Notary Public in and for
The State of Texas
ORDER ACKNOWLEDGING REVIEW OF ANNUAL REPORT ON LOCATION,
CONDITION, AND WELL-BEING OF WARD
On this _______ day of ___________________, 20______, came on to be considered the
Report of the Condition, Welfare, and Well-Being of __________________________________,
Ward, and the Court having examined said report, it is therefore ORDERED entered of record.
SIGNED this _______ day of __________________________, 20______.
____________________________________
JUDGE, FORT BEND COUNTY, TEXAS
I:\probate\internet forms\annual report.doc
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