(Copy Receipt) (Clerk’s Date Stamp) SUPERIOR COURT OF WASHINGTON COUNTY OF SPOKANE In the Guardianship of: CASE NO. An Incapacitated Person ORDER APPROVING BUDGET, DISBURSEMENTS, AND INITIAL PERSONAL CARE PLAN (ORAUP) CLERK’S INFORMATION SUMMARY Due Date for Next Report and Accounting: Due Date For: FINDINGS OF FACT 1. Acts of Guardian. All acts required of the Guardian to date have been performed. 2. Notice. Notice has been properly provided to persons entitled to notice of this presentation. 3. Budget and Care Plan. The proposed Budget and Care Plan of the Guardian are reasonable and appropriate to the needs of the Incapacitated Person and should be approved. ORDERS 1. Approval of Initial Personal Care Plan. The Initial Personal Care Plan is hereby approved. #33B-ORDER APPROVING BUDGET, DISBURSEMENTS & INITIAL PERSONAL CARE PLAN PAGE 1 OF 4 Revised 3/07 American LegalNet, Inc. www.FormsWorkflow.com 2. Budget. 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: Room and Board Medical 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 payments. 4. Medical and Dental Expenses. The Guardian is authorized to incur and pay reasonable and necessary medical and dental expenses that the Guardian determines to be in the best interest of the Incapacitated Person. 5. Income Tax Payments; Accounting Fees. The Guardian is authorized to make 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 amount of $50.00 per month in connection with this guardianship. 7. Accounting Due Date. The Report and Accounting of the Guardian shall be filed and submitted to the Court for approval not later than (90 days after the first anniversary of the appointment of the Guardian). . The amount of the bond 8. Bond. Bond is currently set in the amount of $ shall not be changed shall be changed to $ . 9. Guardian Fees. The Guardian is allowed to advance a monthly fee up to $ . This advance is approved for the twelve months and ninety days thereafter, from the date of #33B-ORDER APPROVING BUDGET, DISBURSEMENTS & INITIAL PERSONAL CARE PLAN PAGE 2 OF 4 Revised 3/07 American LegalNet, Inc. www.FormsWorkflow.com appointment of the Guardian to . Such fees are subject to review and approval by the Court at the next regular accounting. No presumption that these fees will be approved as reasonable is created by this authorization for advance. Amounts shall be advanced only for actual services provided and costs actually incurred. Interim Guardian fees in the amount of $ for services rendered and administrative costs (DSHS cases only) of $ and between are reasonable and approved. DSHS cases: The above fees and costs are approved for payment as a monthly deduction from the incapacitated persons participation in the DSHS cost of care per WAC 388.79.030. Non-DSHS cases: The above fees are approved for payment from the guardianship estate assets. 10. Attorney Fees and Costs. Attorney fees in the amount of $ of $ and costs in the amount are hereby approved as reasonable. They shall be paid from the guardianship assets of the Incapacitated Person, from the participation of the Incapacitated Person as an exception to policy, or other: . 11. Other. . DATED AND SIGNED IN OPEN COURT THIS DAY OF , 20 . ________________________________ Judge/Court Commissioner Signature of Guardian/Attorney Printed Name of Guardian/Attorney, WSBA/CPG# Address City, State, Zip Code *Telephone/Fax Number Email Address #33B-ORDER APPROVING BUDGET, DISBURSEMENTS & INITIAL PERSONAL CARE PLAN PAGE 3 OF 4 Revised 3/07 American LegalNet, Inc. www.FormsWorkflow.com *Under GR 22 (b) (6), parties’ personal telephone number(s) are confidential information. If you do not want your personal phone number(s) on this public form, complete form #S2Sealed Confidential Information and file in the confidential file. #33B-ORDER APPROVING BUDGET, DISBURSEMENTS & INITIAL PERSONAL CARE PLAN PAGE 4 OF 4 Revised 3/07 American LegalNet, Inc. www.FormsWorkflow.com