Colorado > Statewide > Probate
Petition For Appointment Of Guardian For Adult JDF 841 - Colorado
| Petition For Appointment Of Guardian For Adult Form. This is a Colorado form and can be used in Probate Statewide . |
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District Court Denver Probate Court ___________________ County, Colorado Court Address: In the Interest of: COURT USE ONLY Case Number: Respondent Attorney or Party Without Attorney (Name and Address): Phone Number: FAX Number: E-mail: Atty. Reg. #.: Division Courtroom PETITION FOR APPOINTMENT OF GUARDIAN FOR ADULT 1. The Petitioner is a person interested in the welfare of the Respondent. or the Respondent. This is a Petition for appointment of a: Permanent Guardian. (§15-14-304(1) and (2), C.R.S.) Emergency Guardian (not to exceed 60 days). (§15-14-312, C.R.S.) 2. Information about the Petitioner: Name: Street Address: Mailing Address, if different: City: Email Address: State: Zip Code: Home Phone #: Work Phone #: Relationship to Respondent: 3. Information about the Respondent: Name: Street Address: Mailing Address, if different: City: Home Phone #: State: Zip Code: County of Residence: Age: Date of Birth: If this appointment is made, the Respondent's residence will change to: JDF 841 R8/11 PETITION FOR APPOINTMENT OF GUARDIAN FOR ADULT Page 1 of 6 American LegalNet, Inc. www.FormsWorkFlow.com 4. Information about the Respondent's spouse or adult who has resided with the Respondent for more than six months in the last year: Name: Street Address: Mailing Address, if different: City: Email Address: State: Zip Code: Home Phone #: Work Phone #: Relationship to Respondent: 5. Venue for this proceeding is proper because the Respondent resides in this county. is present in this county. (Check this box only if requesting an Emergency Guardian.) (§15-14-108(2), C.R.S.) is admitted to an institution pursuant to an order of a court of competent jurisdiction sitting in this county. (Attach copy of order.) 6. An appointment of a guardian for the Respondent has been previously made. A Power of Attorney exists for financial or medical matters. (Attach a copy.) address is: (Attach copy of Order.) 7. The agent`s name and mailing 8. A valid designated beneficiary agreement exists. (Attach a copy of the agreement to the Petition.) designated beneficiary's name and address is: The 9. The Respondent is unable to effectively receive or evaluate information or both, make or communicate decisions to such an extent that the individual lacks the ability to satisfy essential requirements for physical health, safety, or self-care, even with appropriate and reasonably available technological assistance. (§15-14102(5), C.R.S.) 10. The Respondent's identified needs cannot be met by less restrictive means, including use of appropriate and reasonably available technological assistance. 11. Guardianship is necessary due to the following disabilities or impairments: Physician's letter attached. JDF 841 R8/11 PETITION FOR APPOINTMENT OF GUARDIAN FOR ADULT Page 2 of 6 American LegalNet, Inc. www.FormsWorkFlow.com 12. Petitioner requests the powers and duties to be unlimited/unrestricted or limited/with restrictions. The requested limitations/restrictions on the Guardian's powers and duties, if any, are as follows: 13. Petitioner Guardian. or is, 21 years of age or older, nominates himself/herself and requests to be appointed as Petitioner nominates the following person, who is 21 years of age or older, to be appointed as Guardian. Name: Street Address: Mailing Address, if different: City: Email Address: State: Zip Code: Home Phone #: Work Phone #: 14. The nominated Guardian has priority for appointment because he/she is: (§15-14-310, C.R.S.) a Guardian currently acting for the Respondent in Colorado or elsewhere. beneficiary agreement. an agent under a medical power of attorney. nominated in writing by Respondent, including nomination in a durable power of attorney or designated an agent under a general durable power of attorney. the spouse of the Respondent. the parent of the Respondent. an adult child of the Respondent. an adult with whom Respondent has resided for more than six months immediately before the filing of this Petition. other: 15. The Respondent nominated the following person as Guardian, but the Petitioner does not seek that person's appointment for the following reason: Name: Street Address: Mailing Address, if different: City: Email Address: JDF 841 R8/11 Relationship to Respondent: State: Zip Code: Home Phone #: Work Phone #: Page 3 of 6 American LegalNet, Inc. www.FormsWorkFlow.com PETITION FOR APPOINTMENT OF GUARDIAN FOR ADULT 16. It is necessary to appoint an Emergency Guardian for the Respondent because complying with the normal procedures for the appointment of a Guardian will likely result in substantial harm to the Respondent's health, safety, or welfare and no other person appears to have authority and willingness to act in the circumstances. (§15-14-312, C.R.S.) The nature of the emergency is as follows: 17. Information about adult children and parents. None (If none, list an adult relative that can be found with reasonable efforts, such as a brother, sister, aunt, uncle, etc.) Name: Street Address: Mailing Address, if different: City: Email Address: Name: Street Address: Mailing Address, if different: City: Email Address: Name: Street Address: Mailing Address, if different: City: Email Address: State: Zip Code: Home Phone #: Work Phone #: State: Zip Code: Home Phone #: Work Phone #: Relationship: State: Zip Code: Home Phone #: Work Phone #: Relationship: Adult Child or Parent Relationship: Adult Child or Parent 18. Information about each person currently responsible for primary care and custody of the Respondent, including the Respondent's treating physician: None Name of Treating Physician: Street Address: Mailing Address, if different: City: Name of Caregiver Street Address: Mailing Address, if different: City: JDF 841 R8/11 Phone #: State: Zip Code: Email Address: Phone #: State: Zip Code: Email Address: Page 4 of 6 American LegalNet, Inc. www.FormsWorkFlow.com PETITION FOR APPOINTMENT OF GUARDIAN FOR ADULT 19. The Name: following person is the Legal Representative for the Respondent not otherwise designated above. (Representative payee, trustee, custodian of a trust, etc. §15-14-102(6), C.R.S.) Type of Legal Representative: Email Address: Phone #: Mailing Address: City: State: Zip Code: 20. The Guardian may receive compensation. The hourly rates to be charged, any amounts to be charged pursuant to a published fee schedule, including the rates and basis for charging fees for any extraordinary services, and any other bases upon which a fee charged to the estate will be calculate
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