Superior Court of Washington County of ___________________ In the Guardianship of: __________________________, Incapacitated Person No. _________________________ Letters of Guardianship (LTRGDN) Letters expire on (date): _________________ These Letters of Guardianship provide official verification of the following: On (date) ___________________, the Court appointed (name) _______________________ to serve as: Guardian of the Person Guardian of the Estate Full Full Limited Limited for (name) _____________________________________, an incapacitated person. The Guardian has fulfilled all legal requirements to serve, including, but not limited to: taking and filing the oath; filing the 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 the appointed Guardian is authorized as the Guardian for the incapacitated person. The next filing and reporting deadline in this matter is on (date) ________________. These Letters expire and are no longer valid on the date in the caption. These Letters can only be renewed by a new court order. If the court grants an extension, new Letters will be issued. Witness the Honorable __________________________ of Superior Court, and the seal of the Court affixed on (date) ______________________________. _______________, Clerk of ________________ County Superior Court By:__________________________, Deputy Clerk State of Washington ) )ss. County of ___________________ ) I, _______________________, Clerk of the Superior Court of ________________ County, Washington State, certify that this document represents true and correct Letters of Guardianship in the above entitled case, entered on (date) __________________________. Letters of Guardianship (LTRGDN) - Page 1 of 2 GDN 04.0250 (01/2013) RCW 11.88.127 American LegalNet, Inc. www.FormsWorkFlow.com These Letters remain in full force and effect until the date the Letters expire, as provided above. The seal of the Superior Court has been affixed and witnessed by my hand on (date) ____________________. _____________________, Clerk of ________________ County Superior Court By: __________________________, Deputy Clerk Letters of Guardianship (LTRGDN) - Page 2 of 2 GDN 04.0250 (01/2013) RCW 11.88.127 American LegalNet, Inc. www.FormsWorkFlow.com