Oregon > Local County > Marion > Circuit Court > Probate > Guardianship
Guardians Report - Oregon
| Guardians Report Form. This is a Oregon form and can be used in Guardianship Probate Circuit Court Marion Local County . |
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IN THE CIRCUIT COURT FOR THE STATE OF OREGON FOR THE COUNTY OF MARION In the Matter of the Guardianship of ) ) ) Case No. (Enter name of protected person) ) GUARDIANS REPORT I am the guardian for the person named above, and I make the following report to thecourt as required by law: 1) My name is 2) My address and telephone number are: Phone: 3) The name, if applicable, and address of the place where the person now resides are: 4) The person is currently residing at the following type of facility or residence: 5) The person is currently engaged in the following programs and activities and receiving the following services (brief description): 6) I was paid for providing the following items of lodging, food or other services to the person: 7) The name of the person primarily responsible for the care of the person at the persons place of residence is: 8) The name and address of any hospital or other institution where the person is now admitted on a temporary or permanent basis are: 9) The persons physical condition is as follows: 10) The persos mn ental condition is as follows: 1 -- GUARDIANS REPORT guardrpt.wpd Rev. 1/24/01<<<<<<<<<********>>>>>>>>>>>>> 2 11) I made the following contacts with the person during the past year (brief description): 12) I made the following major decisions on behalf of the person during the past year (brief description): 13) I believe the guardianship should or should not continue because: 14) At the time of my last report, I held the following amount of money on behalf of the person: $ . Since my last report, I have received the following amount of money on behalf of the person: $ . I spent the following amount of money on behalf of the person: $ . I now hold the following amount of money on behalf of the person: $ . 15) A true copy of this report will be given to the person, any conservator for the person and any other person who has requested notice. 16) Since my last report: (A) I have been convicted of the following crimes (not including traffic infractions): (B) I have filed for or received protections from creditors under the Federal Bankruptcy Code (yes or no) . (C) I have had a professional or occupational license revoked or suspended (yes or no)_______________. (D) I have had my driver license revoked or suspended (yes or no) . 17) Since my last report, I have delegated the following powers over the protected person for the following periods of time (provide name of person powers delegated to): Dated this day of , 200 . Guardian STATE OF OREGON ) )ss County of Marion ) I, (guardians name), being first duly sworn,say that the above statements are true. (Guardians signature) SUBSCRIBED AND SWORN TO before me this day of , 200 . NOTARY PUBLIC FOR OREGON My commission expires: __________ 2 -- GUARDIANS REPORT guardrpt.wpd Rev. 1/24/01
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