PROBATE COURT OF BUTLER COUNTY, OHIOIN THE MATTER OF GUARDIANSHIP OFCase No.APPLICATION FOR APPOINTMENT OF GUARDIAN OF MINOR [R.C. 2111.03(C)]Applicant, a resident ofCounty, Ohio, hereby applies for the appointment of (himself)(herself) or some suitable person as guardian of the following minor and represents that the applicant is not an administrator, executor, or other fiduciary of an estate wherein the minor is interested.Name of MinorAgeDate of BirthResidence or Legal SettlementAttached is a list of the next of kin of the minor. (Form 15.0) A guardian is necessary because (R.C. 2111.06),THE TYPE OF GUARDIANSHIP APPLIED FOR IS Non-LimitedLimitedPerson and EstateEstate OnlyPerson OnlyIF THE APPLICATION IS FOR LIMITED GUARDIANSHIP, The length (time period) of the guardianship requested is: IndefiniteDefinite to.,The limited powers requested are:Applicant attaches affidavit pursuant to R.C. 3109.27.Applicant represents that grounds exist for the Court to exercise its jurisdiction. (Applies to guardianship of person only. R.C. 3109.22). The Applicant has (not) been charged with or convicted of a crime involving theft, physical violence, or sexual, alcohol or substance abuse except as follows (if applicable, state date and place of each charge or each conviction.)9/1/91FORM 16.0 -APPLICATION FOR APPOINTMENT OF GUARDIAN OF MINOR2001 © American LegalNet, Inc.The whole estate of said minor is estimated as follows:Personal property...........................................................................................$Real estate......................................................................................................$Annual rents...................................................................................................$Other annual income..................................................................... Total$Applicant offers the attached bond in the amount of$I hereby certify that all the information and statements contained in this application and attached exhibits are correct to the best of my knowledge and belief.Attorney for applicantApplicantTyped or printed nameTyped or printed nameStreetStreetCityStateZipCityZipStatePhone number (include area code)Phone number (include area code)Supreme Court Registration Number2001 © American LegalNet, Inc.
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