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Petition For Guardianship Of Person And-Or Estate - Washington
| Petition For Guardianship Of Person And-Or Estate Form. This is a Washington form and can be used in Superior Court Pierce Local County . |
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 INFORMATION CONCERNING A GUARDIANSHIP FOR A CHILD UNDER 18 (This section to be filled out only if guardianship is sought with respect to a minor): Mother's name, phone number and address:__________________________________________ Father's name, phone number and address:___________________________________________ Mother/Father has has not signed a written consent for this guardianship. ALLEGED INCAPACITATED PERSON INFORMATION: The name, age, address of present residence, and post office address of the Alleged Incapacitated Person are: 1. Name: ________________________________________________________ 2. Age: ________________________________________________________ ) Case No.: In the Guardianship of: ) ) PETITION FOR GUARDIANSHIP OF ) PERSON AND/OR ESTATE (RCW 11.88.030) ________________________________________, ) ) An Alleged Incapacitated Person. ) Clerk's code: (PTAPGD) ) IN THE SUPERIOR COURT OF THE STATE OF WASHINGTON IN AND FOR THE COUNTY OF PIERCE 3. Present Residence:________________________________________________________ 4. Post Office Address:________________________________________________________ A guardian should be appointed as to the estate of the child. PETITION FOR GUARDIANSHIP Page 1 of 6 REV 02/08 American LegalNet, Inc. www.FormsWorkFlow.com A guardian should be appointed as to the person of the child. (If this box is checked the following 1 2 3 (The proposed guardian and all other adult persons living in the Guardian's household understand 4 5 6 7 8 NATURE AND DEGREE OF ALLEGED INCAPACITY: 9 10 11 12 13 14 15 16 17 18 6. Other Personal Property: 19 20 21 22 3. Washington State Assistance 23 24 25 4. Other: Approximate Total Monthly Income: $____________________________ /month $____________________________ /month $_____________________ $______________________________ $_________________ Total Approximate Value of Assets is: DESCRIPTION/VALUES OF PROPERTY: The approximate value and the description of the property owned by the Alleged Incapacitated Person is: 1. Real Property: $______________________________ The nature and degree of the alleged incapacity are as follows: 1. Nature of Alleged Incapacity: _________________________________________________ 2. Degree of Alleged Incapacity: _________________________________________________ that they may be required to undergo a criminal and child protective services background check before an order appointing guardian may be entered. The guardian and all other adult members in his or her household must sign an authorization to release CPS records.) The child is is not a member of an Indian tribe nor a child of a member of an Indian tribe. additional information must be provided: Name, address and date of birth of the proposed Guardian and all other adult persons living in the Guardian's household): ______________________________________________________________________________ Tribal Name and Address is:________________________________________________________ 2. Stock, Mutual Funds and Bonds: $______________________________ 3. Mortgages and Notes: 4. Bank Accounts 5. Furniture: $______________________________ $______________________________ $______________________________ There are periodic compensation, pension, insurance, and allowances as follows: 1. Social Security Benefits: 2. Veterans Benefits $____________________________ /month $____________________________ /month PETITION FOR GUARDIANSHIP Page 2 of 6 REV 02/08 American LegalNet, Inc. www.FormsWorkFlow.com EXISTING OR PENDING GUARDIANSHIPS: 1 There 2 3 4 5 6 7 8 9 10 1. Name of Nominee: ___________________________________________ DOB: _____________ 11 12 13 14 RELATIVES: 15 16 17 18 19 20 21 22 23 24 25 The name and addresses, and the nature of the relationship of the persons most closely related by blood or marriage to the Alleged Incapacitated Person are as follows: 1. Name: Address: Relationship: 2. Name: Address: Relationship: 3. Name: Address: Relationship: ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ 2. Address: _____________________________________________________________________ 3. Telephone Number: ____________________________________________________________ 4. Relationship to Alleged Incapacitated Person: ________________________________________ NOMINEE: The name, address, telephone number and date of birth of the proposed Guardian and the relationship of the Alleged Incapacitated Person are as follows: is is not an existing or pending Guardianship action for the person and/or the estate of the Alleged Incapacitated Person. If there is an existing or pending Guardianship, set forth the following: 1. State Where Guardianship/Limited Guardianship Pending or Established: _______________________________________________________________________________ 2. Name of Guardian/Limited Guardian: _______________________________________________ 3. Date of Appointment: ___________________________________________________________ 4. Type of Guardianship: ___________________________________________________________ PETITION FOR GUARDIANSHIP Page 3 of 6 REV 02/08 American LegalNet, Inc. www.FormsWorkFlow.com RESIDENCE OF PERSON TO BE ASSISTED: 1 The name, address, and telephone number of the person or facility having the care and placement of 2 3 4 3. Telephone: 5 6 7 8 9 10 11 12 13 4. Describe any alternative arrangements previously made by the Alleged Incapacitated Person, 14 15 16 17 18 19 20 21 ________________________________________________________________________________ 22 23 24 25 ________________________________________________________________________________. 3. The duration of guardianship should be as follows: ________________________________________________________________________________ ________________________________________________________________________________. AREAS OF ASSISTANCE: 1. The nature and degree of the alleged incapacity: _____________________________________
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