COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.PROBATE COURT OF LUCAS COUNTY, OHIO JACK R. PUFFENBERGER, JUDGECalendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)IN THE MATTER OF THE GUARDIANSHIP OF CASE NO. SUPPLEMENTAL GUARDIANSHIP/CONSERVATOR INFORMATION (Attach to all new and successor guardianship or conservator applications). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .GENERAL CASE INFORMATIONTHE PEOPLE OF THE STATE OF NEW YORK TO(Check one box on each line for items 1 through 7) 1.This is a( ) guardianship( ) conservatorship2.This application is a( ) new case( ) successorGREETINGS:3.The subject is a( ) minor( ) incompetent( ) conservatorWE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable4.The fiduciary powers are( ) limited( ) unlimited,5.The application is for a( ) person( ) estate( ) person and estatelocated at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room6.Is this case related to any cause pending in any judicial system? Yes NoIf Yes, describe in detail Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. 7.A court reporter and official record is waived for the appointment hearing waived not waived(This waiver may be retracted in writing by counsel or guardian at or before the appointment hearing. However, if necessary, the Court may continue the hearing to schedule a reporter.), one of the Justices of theCourt in Witness, Honorableday of, 20 County,INFORMATION CONCERNING THE PROSPECTIVE GUARDIAN/CONSERVATOR(Attorney must sign above and type name below)Full name and AKA: Home Address: Attorney(s) forRelationship to Ward/Conservatee: Social Security Number: Occupation: «HE26.B¥- «HE26.B¥- «HE26.B¥- «HE26.B¥-Office and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:REV 4/8/02PAGE 1 OF FORM 15-A SUPPLEMENTAL GUARDIANSHIP/CONSERVATORSHIP INFORMATIONMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comTelephone No. (Home): (Work): Applicant (is/is not) an administrator, executor, or fiduciary of the estate wherein the proposed ward/conservatee is interest. INFORMATION CONCERNING THE PROPOSED WARD/CONSERVATEE: Full Name and AKA: Age: Date of Birth: Male: Female: Social Security NumberCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.Legal Settlement or Residence is: in County, Ohio. Length of residence is: . If the proposed ward/conservatee is living at an address different from the residence shown above , the address is .Name of person, other than the proposed ward/conservatee who may be contacted at the address where proposed ward/conservatee is living: Name Telephone List any problems that proposed ward/conservatee may have in communicating: List any agencies, either private or public, who have knowledge of the proposed ward/conservatee, and may be aware of assistance in determining the need for guardianship/conservatorship: INFORMATION CONCERNING NEED FOR GUARDIANSHIP: Describe briefly the basis for application: I hereby petition the Court to be appointed guardian/conservator of foregoing proposed ward/conservatee and certify that all the information and statements contained in this application and attached exhibits are correct to the best of my knowledge and belief.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County of, on the, at or adjourned date, to testify and give evidence as a witness in this action on the part of the, 20noon, and at any recessed in roomo'clock in the day ofYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of theCourt in Witness, Honorable, 20 County,day ofSignature of Attorney of Record(Attorney must sign above and type name below)ID#Signature of Prospective Guardian/Conservator Signature of Proposed Conservatee (Conservatorship only) I, , Attorney-at-law, hereby certify, that the within instrument was prepared and/or examined by me, and that the same, in my opinion, is correct and proper.Attorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:REV 4/8/02PAGE 2 OF FORM 15-A SUPPLEMENTAL GUARDIANSHIP/CONSERVATORSHIP INFORMATIONAmerican LegalNet, Inc. www.USCourtForms.com
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