Nevada > County > Washoe > District Court > Family
Annual Report Of Guardian On Condition Of Minor 1125 - Nevada
| Annual Report Of Guardian On Condition Of Minor Form. This is a Nevada form and can be used in Family District Court Washoe County . |
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1 Code: 1125 2 3 4 5 6 IN THE FAMILY DIVISION 7 OF THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA 8 IN AND FOR THE COUNTY OF WASHOE 9 10 In the Matter of 11 ___________________________, Case No. ______________ A Minor. Dept. No. ______________ 12 ____________________________/ 13 14 15 ANNUAL REPORT OF GUARDIAN ON CONDITION OF MINOR 1. I, ________________________________, am the Guardian of the above-name minor 16 (Name of Guardian) 17 and my annual report is as follows: 18 2. The present age of the Minor is ___________________________________. 19 3. Living arrangement: 20 a. The current address of the Minor is:_______________________________________ b. The Minors residence is: 21 ( ) own home/apt. ( ) nursing home ( ) Guardians home/apt. ( ) group home 22 ( ) hospital or medical facility ( ) relatives home _________________________ (relationship) 23 c. The Minor has been in the present residence since ____________________________ 24 (date) If moved within the past year, state change(s) and reason(s) for change__________ 25 __________________________________________________________________ 26 __________________________________________________________________ 27 d. I rate the Minors living arrangement as: 28 ( ) excellent ( ) average ( ) below average -1- <<<<<<<<<********>>>>>>>>>>>>> 2 1 Explain____________________________________________________________ 2 __________________________________________________________________ 3 e. I believe the Minor is: 4 ( ) content with the living situation ( ) unhappy with the living situation 5 ( ) I recommend a more suitable living arrangement for the Minor as follows: 6 __________________________________________________________________ 7 __________________________________________________________________ 8 4. Physical health: 9 a. The Minors current physical condition is: 10 ( ) excellent ( ) good ( ) fair ( ) poor 11 b. During the past year, the Minors physical condition has: 12 ( ) remained about the same ( ) improved explain ______________________ 13 _________________________________________________________________ 14 ( ) worsened explain _____________________________________________ 15 _________________________________________________________________ 16 c. List below the names and address of the Minors treating physician(s) and dentist, 17 giving the date and purpose of the last visit: 18 Date Dr.s Name and Address Ailment/Treatment 19 ________________________________________________________________________ 20 ________________________________________________________________________ 21 ________________________________________________________________________ 22 ________________________________________________________________________ 23 ________________________________________________________________________ 24 ________________________________________________________________________ 25 ________________________________________________________________________ 26 ________________________________________________________________________ 27 ________________________________________________________________________ 28 ________________________________________________________________________ -2- <<<<<<<<<********>>>>>>>>>>>>> 3 1 5. Mental Health: 2 a. The minors current mental condition is: 3 ( ) excellent ( ) good ( ) fair ( ) poor 4 b. During the past year, the minors mental condition has 5 ( ) remained about the same ( ) improved explain _______________________ 6 ___________________________________________________________________ 7 ( ) worsened explain _______________________________________________ 8 ___________________________________________________________________ 9 c. During the past year, treatment or evaluation by a psychiatrist, psychologist, or 10 social worker ( ) was ( ) was not provided. 11 6. Social activities/services: 12 a. The minors current social condition is: 13 ( ) excellent ( ) good ( ) fair ( ) poor 14 b. During the past year, the minors social condition has: 15 ( ) remained about the same ( ) improved explain ________________________ 16 ___________________________________________________________________ 17 c. During the past year, the minor has participated in the following activites: 18 ( ) recreational _____________________________________________________ 19 ( ) educational _____________________________________________________ 20 ( ) social _________________________________________________________ 21 ( ) occupational ____________________________________________________ 22 ( ) no activities available 23 ( ) the minor refused to participate in any activites 24 ( ) the minor was unable to participate in any activities 25 7. I believe the minor has the following unmet needs _____________________________ 26 __________________________________________________________________ 27 __________________________________________________________________ 28 __________________________________________________________________ -3- <<<<<<<<<********>>>>>>>>>>>>> 4 1 8. The Guardianship ( ) should ( ) should not be continued because: 2 __________________________________________________________________ 3 __________________________________________________________________ 4 9. I ( ) do ( ) do not have possession or control of the minors estate. If yes, my 5 accounting is attached. 6 ________________ ____________________________________ Date S ignature 7 ____________________________________ 8 A ddress 9 ____________________________________ 10 City, State and Zip 11 ____________________________________ 12 Phone 13 Under penalties of perjury, the undersigned declares that he is the Guardian named in 14 the foregoing Account of Guardian and knows the contents thereof; that the document is 15 true of his own knowledge except as those mrs stated upon informatte ation and belief, and 16 that as to such matters, he believes it to be true. 17 ___________________________________ G uardian 18 19 20 21 22 SUBSCRIBED and SWORN to before me 23 this _________ date of _______________, _______. 24 25 __________________________________________ NOTARY PUBLIC 26 27 28 NOTICE: A hearing is required for approval of this accounting. See NRS 159.115 -4-
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