IN THE SUPERIOR COURT OF THE STATE OF WASHINGTON IN AND FOR THE COUNTY OF KITSAP IN THE MATTER OF THE GUARDIANSHIP OF ________ Incapacitated Person. , No ___________ LETTERS OF GUARDIANSHIP (LTRGDN) DATE LETTERS EXPIRE_________________, 20_____ THESE LETTERS OF GUARDIANSHIP PROVIDE OFFICIAL VERIFICATION FO THE FOLLOWING On ______day of ___________________, 20___, the Court Appointed__________________________ to Serve as: ( ) Guardian of the Person ( ) Guardian of the Estate ( ) Full ( ) Full ( ) Limited ( ) Limited for _____________________________, the incapacitated person, in the above referenced matter. The Guardian has fulfilled all legal requirements to serve, including, but not limited to: Taking and filing the oath; filing any bond consistent with the Court's order; filing any blocked account agreement consistent with the Court's order; and appointing a resident agent for a nonresident Guardian. The Court, having found the Guardian duly qualified now makes it known _________________________ is authorized as the Guardian for _________________________ designated in the Court's order as referenced above. The next filing and reporting deadline is this matter is on ______ day of ___________________, 20____. THESE LETTERS ARE NO LONGER VALID ON _____________________, 20____. These letters can only be renewed by a Court order. If the Court grants an extension, new letters will be issued. WITNESS, the Hon. _______________________, Judge/Commissioner of the said Superior Court, and the seal of said Court hereto affixed this _______ day of ____________________, A.D. _____________. DAVID W. PETERSON, Clerk of the Superior Court By , Deputy STATE OF WASHINGTON County of Kitsap ) ) ) CERTIFICATE I, DAVID W. PETERSON, Clerk of the Superior Court of said County and State do hereby certify that the above and foregoing is a true and correct copy of Letters of Guardianship in the above-entitled case, and were on the ___ of ______________ , A.D. ____ , duly entered of record; and I further certify said Letters are still in full force and effect and have not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said Superior Court, this , A.D. . DAVID W. PETERSON, Clerk of the Superior Court By , Deputy day of American LegalNet, Inc. www.FormsWorkFlow.com