Colorado > Statewide > Probate
Guardians Report Adult JDF 850 - Colorado
| Guardians Report Adult Form. This is a Colorado form and can be used in Probate Statewide . |
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District Court Denver Probate Court ________________________________ County, Colorado Court Address: __________________________________________ In the Interest of: _________________________________________________ Ward Attorney or Party Without Attorney (Name and Address): COURT USE ONLY Case Number: ________________ Phone Number:________________ E-mail:___________________ FAX Number:_________________ Atty. Reg. #:_______________ Division_______ Courtroom _______ GUARDIAN'S REPORT ADULT INITIAL REPORT/CARE PLAN ANNUAL REPORT Current Reporting Period From ________________To __________________ (MM/DD/YYYY) (MM/DD/YYYY) Instructions to Guardian: Colorado law requires that every guardian of an adult complete a Guardian's Report every year. When you complete this report, you must file the report with the Court and mail copies of the report to the Ward and all interested persons as identified in the Order Appointing Guardian. Complete the Certificate of Service at the end of this report to show the names and addresses of all the people to whom you mailed the report and the date on which you mailed it. I. SUMMARY OF REPORT A. Do you recommend that the guardianship continue? If No, explain: __________________________________________________________ ______________________________________________________________________ B. Have you had any criminal charges filed against you or convictions entered since the last report? If Yes, explain: _________________________________________________________ ______________________________________________________________________ C. Do you recommend any changes to the guardianship? If Yes, explain: ________________________________________________________ _____________________________________________________________________ D. Do you wish to remain guardian? If No, explain: __________________________________________________________ ______________________________________________________________________ E. Has the Ward's physical and medical condition (hospitalization/injuries) changed since the last report? If Yes, explain: ________________________________ _____________________________________________________________________ Yes No JDF 850 R4/09 GUARDIAN'S REPORT - ADULT Page 1 of 5 American LegalNet, Inc. www.FormsWorkFlow.com Yes No F. Has the Ward been hospitalized in the last year? If Yes, explain: _________________________________________________________ ______________________________________________________________________ G. Is there a need for further medical, social or psychological evaluations of the Ward? Please explain: _________________________________________________________ ______________________________________________________________________ H. Has the Ward's residence changed since the last report? Identify specifics in Section V. I. Does the Ward have sufficient financial resources? II. WARD'S INFORMATION Name: Address (Include name of facility): New Residence from last Report Age: City:___________________ State: _____ Zip Code: ________ Telephone Number: ____________________ Type of Residence: Private Nursing Home Assisted Living Home Other: ____________________ III. GUARDIAN'S INFORMATION Updated Information from last Report Guardian's Name: _____________________________ Email address: _____________________________ Address (Street and P.O. Box):______________________________________________________________ City: ____________________ State:_____ Zip Code: ________ Telephone Number: ___________________ Co-Guardian's Name: ______________________________ Email address: _________________________ Address (Street and P.O. Box):______________________________________________________________ City: __________________ State: _____ Zip Code: ________ Telephone Number: ____________________ IV. CURRENT CONDITION OF THE WARD Describe the Ward's mental, physical, and social condition and if any additional evaluations are needed. JDF 850 R4/09 GUARDIAN'S REPORT - ADULT Page 2 of 5 American LegalNet, Inc. www.FormsWorkFlow.com V. PLACEMENT AND CARE SUPERVISION A. If the Ward has moved since the last reporting period, identify the date of the move, address of residence, type of residence and reason for the change. Date Move of Name of Facility and Address Type of Residence Reason for Change B. Who currently supervises the Ward's care and treatment on a daily basis? Name: ___________________________________ Telephone Number: __________________________ VI. VISITATION OF WARD Colorado law requires that a guardian maintain sufficient contact with the Ward. A. How often do you visit the Ward? Daily Weekly Monthly Other: _______________________ B. How often do you contact the Ward or the Ward's care provider? Daily Weekly Monthly Other: C. When was the last time you saw the Ward in person? (date) D. How long are the visits and summarize your activities with and on behalf of the Ward? E. Does the Ward participate in decision-making? Yes No Briefly describe. VII. FINANCIAL MATTERS A. Are there sufficient financial resources to take care of the Ward? believe is the best way to handle this problem? Yes No If No, what do you B. Do you have possession or control of the Ward's assets, e.g. property, financial accounts? If Yes, describe: Yes No C. Do you have control of the Ward's Income? If Yes, describe: JDF 850 R4/09 GUARDIAN'S REPORT - ADULT Yes No Page 3 of 5 American LegalNet, Inc. www.FormsWorkFlow.com D. If applicable, identify the Representative Payee for Social Security and other income benefits. Name: ______________________________________Phone Number: ___________________________ E. Have any fees been paid to you in your role as guardian? If Yes, describe: Yes No F. Have any fees been paid to others for the care of the Ward or his/her property? If Yes, describe and identify name of person: Yes No Complete this section only if there is no Conservatorship and the Guardian has custody of funds. SUMMARY OF FINANCIAL ACTIVITY DURING REPORTING PERIOD Beginning balance of bank accounts (savings, checking, etc.) Plus money received (Social Security, SSI, pension, disability, interest, etc) from any source on behalf of the person Less total fees to care providers Less total monies paid to the Ward, e.g. personal needs Less total fees paid to guardian Less any other expenses, e.g. housing, insurance, maintenance $ +$ -$ -$ -$ -$ $ Ending balance of bank accounts You are required to maintain supporting documentation for all receipts and all disbursements under your
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