GN-3646, 05/18 Order and Notice for Hearing on Statement Requesting Removal of Rights and Transfer of Additional Powers to Guardian 24754.63, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF Name Date of Birth Amended Order and Notice for Hearing on Statement Requesting Removal of Rights and Transfer of Ad ditional Powers To Guardian Case No. A Statement Requesting Removal of Rights and Transfer of Additional Powers to Guardian has been filed by guardian. other interested person: THE COURT ORDERS: Notice, including notice concerning potential court action if circumstances are extraordinary, be given to all of the following: 1. The above-named ward. 2. The guardian. 3. County Department of Social Services or Human Services if ward is protectively placed or receives long-term support services as a public benefit. 4. Agent under wPower of Attorney for Health Care, if any. 5. Agent under wFinancial Durable Power of Attorney, if any. 6. Any other persons determined by the court: 7. To be heard on: NOTICE OF HEARING Date Time Location (Include Room Number) Court Official If you require reasonable accommodations due to a disability to participate in the court process, please call prior to the scheduled court date. Please note that the court does not provide transportation. DISTRIBUTION: 1. Court 2. Guardian ad Litem 3. s appointed agent under a power of a ttorney 4. Corporation Counsel 5. Social Worker/County Dept. of Human Services 6. Facility, if any 7. Other: American LegalNet, Inc. www.FormsWorkFlow.com