1 2 3 4 5 6 7 8 IN THE SUPERIOR COURT OF STATE OF WASHINGTON IN AND FOR THE COUNTY OF KING 9 10 In the Guardianship of: ) ) ) ) ) ) ) ) 11 12 _____________________________, 13 14 An Incapacitated Person. Case No.: ORDER APPROVING BUDGET, AND DISBURSEMENTS (ORDF) (CLERK’S ACTION REQUIRED Paragraph 8) 15 16 FINDINGS OF FACT 1. Acts of Guardian. All acts required of the Guardian to date have been performed. 17 2. Notice. Notice has been properly provided to persons entitled to notice of this 18 presentation. 19 3. Budget. The proposed Budget is reasonable and appropriate to the needs of the 20 Incapacitated Person and should be approved. 21 ORDER 1. Approval of Budget. The Budget is hereby approved. 22 23 24 25 26 2. Disbursements. The Guardian is authorized to continue to receive the Incapacitated Person’s income and to apply the income and other resources toward the Incapacitated Person’s expenses as follows: Room and Board Medical $ $ ORDER APPROVING BUDGET, DISBURSEMENTS AND PERSONAL CARE PLAN-1 12/2005 REVISED GUARDIANSHIP FORMS American LegalNet, Inc. www.USCourtForms.com 1 2 3 4 5 6 Rent/Mortgage Personal and Incidental Expenses Food and Household Expenses Utilities Guardian Fees Other Total Proposed Monthly Expenditures $ $ $ $ $ $ $ 3. Outstanding Obligations of the Estate. The Guardian shall be authorized to arrange payment schedules with the creditors of the guardianship estate for delinquent and past due 7 payments. 8 4. Medical and Dental Expenses. The Guardian is authorized to incur and pay reasonable 9 and necessary medical and dental expenses that the Guardian determines to be in the best 10 interest of the Incapacitated Person. 11 5. Income Tax Payments; Accounting Fees. The Guardian is authorized to make 12 13 14 payments for income tax due as required, and to pay fees for accounting services required in connection with the preparation of income tax returns. 6. Miscellaneous Expenses. The Guardian is authorized to pay all expenses incurred by way of fees of the Clerk of the Court, together with additional expenses incurred up to the 15 amount of $50.00 per month in connection with this guardianship. 16 7. Accounting Due Date. The Report and Accounting of the Guardian shall be filed and 17 submitted to the Court for approval not later than __________ (90 days after the first 18 anniversary of the appointment of the Guardian). 19 8. Bond. Bond is currently set in the amount of $ _________. The amount of the bond 20 [ 21 22 ] shall not be changed [ ] shall be changed to $ _________. All funds under the care, custody or control of the Guardian in excess of the bond shall be placed in a blocked financial account. A receipt for said blocked account shall be filed with this court no later than 30 days after entry of this order. 23 9. Guardian Fees. The Guardian fees in the amount of $ _________ for services rendered 24 and $_________ for costs incurred between ___________ and __________ are reasonable 25 and approved. They shall be paid from the guardianship assets of the Incapacitated Person. 26 The Guardian is allowed to advance a monthly fee for the next twelve months following the ORDER APPROVING BUDGET, DISBURSEMENTS AND PERSONAL CARE PLAN-2 12/2005 REVISED GUARDIANSHIP FORMS American LegalNet, Inc. www.USCourtForms.com 1 date of appointment of the Guardian up to $ _________ per month, subject to review and 2 approval by the Court at the next regular accounting. No presumption that these fees will be 3 approved as reasonable is created by this authorization for advance. Amounts shall be 4 advanced only for actual services provided, and costs actually incurred. 5 6 10. Attorney Fees and Costs. Attorney fees in the amount of $_________and costs in the amount of $ _________ are hereby approved as reasonable. They shall be paid from the guardianship assets of the Incapacitated Person, from the participation of the Incapacitated 7 Person as an exception to policy, or other: ______________________________________. 8 11. Other._________________________________________________________________ 9 __________________________________________________________________________ 10 _________________________________________________________________________. 11 12 Dated and Signed in Open Court this ____Day of _______________, 200__. _____________________________ Judge/Court Commissioner 13 14 15 16 17 18 Presented by: Signature Printed Name Address Telephone/Fax Number City, State, Zip Code Email Address 19 20 21 22 23 24 25 26 ORDER APPROVING BUDGET, DISBURSEMENTS AND PERSONAL CARE PLAN-3 12/2005 REVISED GUARDIANSHIP FORMS American LegalNet, Inc. www.USCourtForms.com