COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Probate .Court Form No. 93 .... .. .. : Personal Status Report STATE OF VERMONT DISTRICT OF _______________________ :PROBATE COURT Calendar No. Plaintiff(s) IN RE THE ESTATE OF -against_______________________________ Index No. : JUDICIAL SUBPOENA :DOCKET NO. __________________ : PERSONAL STATUS REPORT : Defendant(s) I, ________________________________, guardian of : above named ward, after first being the ...................................................... sworn, do report to the court concerning the ward for the period from ____________ to ___________. 1. The current address, and living situation, of my ward is: _________________________________________________________________________ THE PEOPLE OF THE STATE OF NEW YORK 2. The current condition of my ward is: ___________________________________________ 3. TO The state of my ward’s health, and the medical and dental care being provided, re:______________________________________________________________________ ___________________________________________________________________________ GREETINGS: 4. My ward’s clothing resources, being laid and employment are: WE COMMAND YOU, that all business and excuses educationaside, you and each of you attend before _________________________________________________________________________ , the Honorable at the Court located at County of The following day a summary of , how I have carried out my the is of and and at any recessed in room 5. , on the 20 , at o'clock in powers noon,fulfilled my duties:__________________________________________________________________ or adjourned date, to testify and give evidence as a witness in this action on the part of the _________________________________________________________________________ 6. I r e c o mme n d t h a t t h e guardianship order be a me n d e d a s Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to follows:_________________________________________________________________ the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a __________________________________________________________________________ result of your failure to comply. 7. I recommend that the guardianship: ( ) Continue ( ) Not Continue For the following reasons: ____________________________________________________ Witness, Honorable , one of the Justices of the ________________________________________________________________________ Court in County, day of , 20 Dated_____________________________ ___________________________________ Guardian (Attorney must sign above and type name below) Subscribed and sworn to this ________ day of _________________, 20__. Attorney(s) for Before me, _________________________________ Notary Public Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com