Nevada > Statewide > District Court > Guardianship
Report Of The Guardian Of The Adult Person AA - Nevada
| Report Of The Guardian Of The Adult Person Form. This is a Nevada form and can be used in Guardianship District Court Statewide . |
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Code: (Your name) __________________________ (Address) __________________________ __________________________ (Telephone) __________________________ In Proper Person IN THE _____ JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF ____________ In the Matter of the Guardianship of the person the estate the person and the estate, ) ) ) ) ) of: ) ) ____________________________ ) ) an Adult. ) ________________________________________ ) STATE OF NEVADA COUNTY OF _________________ ) ) ) CASE NO. _____________________ DEPT NO. ______________________ REPORT OF THE GUARDIAN OF THE ADULT PERSON _________________________ through _______________________ BEGINNING DATE ENDING DATE I, (name of guardian) __________________________ am the Guardian of the Person of (name of ward) ___________________________. My annual report is as follows: I. General Information for the Ward and Guardian(s) Ward's date of birth: _____________________ Ward's address: _________________________________________________________________ Adult Report of Guardian 1 of 5 ©2006 Nevada Supreme Court Revised December 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Ward's phone number: ______________________ Ward's current physician (address and phone number) ___________________________________ _______________________________________________________________________________ Name(s) and addresses of guardian(s) ________________________________________________ Guardian(s) relationship to ward: ____________________________________________________ Number of times guardian(s) visited the ward in the last year: ____________ The ward (check one) does/ does not continue to need a guardian. (Explain) _____________ _______________________________________________________________________________ _______________________________________________________________________________ II. Physical and Mental Condition of the Ward (A) The ward currently lives in a (check one) private home/ boarding home/ nursing home/ other (explain) ________________________________________________________ (B) The ward's facility provides for the ward's daily living and recreational needs by (describe) ______________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ (C) The ward (check one) does not attend daily or regular weekly outings, training or work because: ______________________________________________________________________________. attends daily or regular weekly outings, training or work as follows: Adult Report of Guardian 2 of 5 ©2006 Nevada Supreme Court Revised December 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 _______________________________________________________________________________ _______________________________________________________________________________ (D) The activities described in (C), above (check one) do/ do not meet the ward's needs. (Explain, if necessary) ______________________________________________________ _______________________________________________________________________________ (E) The ward has had the following medical care during the last year: __________________ ______________________________________________________________________________ ______________________________________________________________________________ (F) The ward was last seen by a physician on (date) _________________________ (G) The ward's current physical health is Good/ Fair/ Poor (please describe) ______________________________________________________________________________ ______________________________________________________________________________ (H) There (check one) have/ have not been any substantial changes in the ward's mental abilities or health in the last year. (If there have been substantial changes, explain.) ______________________________________________________________________________ ______________________________________________________________________________ III. Miscellaneous Information (A) (Check one) The ward does not have any assets or property and does not have annual income more than $5,000. The ward does have assets or property or an annual income more than $5,000. (name) ___________________________ is responsible for these assets. (Note: you may need to Adult Report of Guardian 3 of 5 ©2006 Nevada Supreme Court Revised December 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 file an accounting. See accounting instructions and form in a separate packet and NRS 159.177NRS 159.181 and NRS 159.076.) (B) (Check one) The ward does not receive any county services. The ward receives the following county services: _____________________________________________________________________________ _____________________________________________________________________________ (C) (Check one) The ward does not receive any other services. The ward receives the following non-county services: _____________________________________________________________________________ _____________________________________________________________________________ (D) I would like the court to know the following: (briefly state anything else that you would like the court to know, or write "N/A") _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Adult Report of Guardian 4 of 5 ©2006 Nevada Supreme Court Revised December 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 SIGNED and SWORN to before me by (name of guardian) ___________________________ on the _____ day of ____________________, _____. _________________________________ NOTARY PUBLIC OR _________________________________ DEPUTY CLERK OR I DECLARE UNDER PENALTY OF PERJURY THAT TH
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