COURT COUNTY OFPROBATE COURT OF LUCAS COUNTY, OHIO JACK R. PUFFENBERGER, JUDGE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.IN THE MATTER OF THE GUARDIANSHIP OF CASE NO.: JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)INVESTIGATOR'S REPORT ON GUARDIANSHIP (R.C. 2111.041)GENERAL INFORMATION {TO BE COMPLETED BY COUNSEL/APPLICANT}. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Prospective ward's age Residence Relationship to applicant If guardianship is limited, include specific duties requested: Grounds for application (R.C. 2111.01(D)) Documentation submitted and date of evaluation 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 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 roomINVESTIGATOR'S REPORT {TO BE COMPLETED BY PROBATE COURT INVESTIGATOR}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.Service of notice made in hospital, nursing facility, or community based care facility: Name of Facility Address of Facility Administrator or representative served Prospective ward's understanding of the concept of guardianship: Good Fair Poor Unable to Determine Prospective ward's attitude to the concept of guardianship was: Consenting Opposed Unable to Determine Specific requests of prospective ward concerning enumerated rights: Others present during contact: , one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:«HE28/9Z- PAGE 1 OF FORM 17.8 INVESTIGATOR'S REPORTMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OFDescribe the extent to which the prospective ward's rights were communicated and the method and language used. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)MENTAL AND PHYSICAL CONDITION OF PROSPECTIVE WARDObserved or reported evidence of mental and/or physical impairments affecting prospective ward's ability to properly care for himself. a) mental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOb) physical GREETINGS: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 ofRECOMMENDATIONSo'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 roomIs there a necessity for guardianship? Yes No Describe: Is there evidence that a less restrictive alternative is needed? Yes No Describe: Necessity for appointment of: Attorney Independent Expert Evaluator Special urgency needs (describe) 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., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. Address DateInvestigatorTelephone No.: Facsimile No.: E-Mail Address: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.PAGE 2 OF FORM 17.8 INVESTIGATOR'S REPORTMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com
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