1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 IN THE SUPERIOR COURT OF THE STATE OF WASHINGTON IN AND FOR THE COUNTY OF KING In the Guardianship of: ______________________________, An Incapacitated Person. ) ) ) ) ) ) ) Case No.: NOTICE OF DEATH OF INCAPACITATED PERSON (NT) (CLERK'S ACTION REQUIRED) The Guardian hereby notifies the Court and interested parties that the above-named Incapacitated Person died on ____________________(date of death) in _________________________ ,(location of death) Washington. At the time of death, the Incapacitated Person was _____ years of age, and was receiving custodial care at ______ _______________________________________________________________________. The Guardian will file and present to the Court and interested parties a Final Report and Accounting within 90 days of the death, as required by State law. I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. Signed at ________________, Washington, ___________, ____20__. Signature Address City, State, Zip Code Printed Name Telephone/Fax Number Email Address NOTICE OF DEATH OF INCAPACITATED PERSON - 1 7/2012 GUARDIANSHIP FORMS American LegalNet, Inc. www.FormsWorkFlow.com