1 2 3 4 5 6 7 8 9 10 11 IN THE SUPERIOR COURT OF THE STATE OF WASHINGTON IN AND FOR THE COUNTY OF KING In the Guardianship of: _____________________________, 12 13 14 An Incapacitated Person. ) ) ) ) ) ) ) ) Case No.: PETITION FOR APPROVAL OF BUDGET, DISBURSEMENTS (PT) COMES NOW _______________________,(name) the [ ] Full [ ] Limited 15 Guardian of the Estate and petitions the Court as follows: 16 1. Appointment of Guardian. _______________________(name) was appointed 17 Guardian of the Estate of the Incapacitated Person and immediately thereafter qualified by 18 filing an oath and obtaining bond in the amount ordered by this Court. Letters of 19 20 21 22 Guardianship were issued on __________________________(date). 2. Inventory. An inventory of the assets of the Incapacitated Person as of the date of appointment is filed separately. 3. Income and Current Expenses. The Incapacitated Person’s only income is as follows: 24 Interests/Dividends Social Security Pension (Including Veteran’s or Otherwise) Other $ $ $ $ 25 Total Monthly Income $ 23 26 GUARDIAN’S PETITION FOR APPROVAL OF BUDGET AND DISBURSEMENTS- 1 2005 REVISE GUARDIANSHIP FORMS American LegalNet, Inc. www.USCourtForms.com 1 The Guardian should have authority to receive the Incapacitated Person’s income to 2 be applied against the Incapacitated Person’s estimated expenses. The Guardian requests 3 approval of the following budget for the twelve-month period following the appointment 4 (fill in only those that apply): 5 6 7 8 9 10 11 12 Room and Board Medical Rent/Mortgage Personal and Incidental Expenses Food and Household Expenses Utilities Guardian Fees Attorney Fees and Costs Other Total Proposed Monthly Expenditures $ $ $ $ $ $ $ $ $ $ 4. Medical and Dental Expenses. The Guardian should be permitted to incur and pay any reasonable and necessary medical and dental expenses, which the Guardian determines to 13 be in the best interest of the Incapacitated Person. 14 5. Income Tax Payment/Accounting Fees. The Guardian may be required to file federal 15 income tax returns and pay income tax due on Guardianship income. The Guardian should 16 be permitted, and to pay fees for accounting services required in connection with the 17 preparation of income tax returns. 18 19 6. Bond. Bond has been obtained in the amount of $__________________. 7. Statement of Qualifications. The Guardian continues to be a suitable and fit fiduciary pursuant to the standards set forth in RCW 11.88.020. 20 8. Requests of Court. The Guardian requests that the Court enter an Order as follows: 21 a. Approval of Budget. Approving this proposed budget of the Guardian. 22 b. Income and Expenses. Authorizing the Guardian to continue receiving the 23 Incapacitated Person’s income to be applied against the expenses set forth above. 24 c. Reasonable Medical and Dental Expenses. Authorizing payment by the Guardian of 25 any reasonable and necessary medical and dental expenses, which the Guardian determines 26 to be in the best interest of the Incapacitated Person. GUARDIAN’S PETITION FOR APPROVAL OF BUDGET AND DISBURSEMENTS- 2 2005 REVISE GUARDIANSHIP FORMS American LegalNet, Inc. www.USCourtForms.com 1 d. Miscellaneous Expenses. Authorizing payment by the Guardian of miscellaneous 2 expenses in an amount not to exceed $50.00 per month without further order of the Court 3 for court fees and other miscellaneous expenses which the Guardian may incur during the 4 course of the administration of this Guardianship; and 5 6 7 8 e. Other Order. For any other Order that the Court deems appropriate. I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. Signed at ________________, Washington, ___________, ____200__. 9 10 Signature Printed Name Address Telephone/Fax Number City, State, Zip Code Email Address 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 GUARDIAN’S PETITION FOR APPROVAL OF BUDGET AND DISBURSEMENTS- 3 2005 REVISE GUARDIANSHIP FORMS American LegalNet, Inc. www.USCourtForms.com