Final Order Appointing Guardian Of Person Or Estate

Revised 6/2019 IN THE COURT OF COMMON PLEAS, CHESTER COUNTY, PENNSYLVANIA IN THE MATTER OF: , No. 15 AN ALLEGED INCAPACITATED PERSON FINAL ORDER APPOINTING GUARDIAN Person Estate AND NOW , this day of , , following a hearing held , pursuant to proper notice to the alleged incapacitated person (Respondent), who appeared in person at the hearing was represented at the hearing by , Esquire failed to appear because: , after giving full consideration to the factors set forth in Chapter 55 of the Probate, E state and Fiduciaries Code, 20 Pa. C.S. 2475501, et seq. , and in acc ordance with the following Findings of Fact : Findings of Fact Pursuant to PEF Code, 20 Pa. C.S. 2475512.1 1. make and communicate decision s is ; American LegalNet, Inc. www.FormsWorkFlow.com 2 2. The extent ke and communicate decisions is ; 3. Considering the availability of family, friends and other supports, and the existence of any advance directives, the Respondent is found to need the following g uardianship servic es: ; 4. Based on the ab ove factors, the Respondent is found to need a Guardian (s) as described below ; 5. The duration of such guardianship shall be , IT IS hereby ORDERED and DECREED as follows: I. Guardian of the Person is /are appointed as: A. Limited Guardian (s) with the following responsibilities: a. Provisions for care, maintenance and custody: . b. Pl ace where Respondent shall live : . c. Provisions for training, education, medical and psychological services, social and vocational opportunities, and the like: . d. Authority to execute consents or approvals on behalf of Respondent : B. Plenary Guardian (s) American LegalNet, Inc. www.FormsWorkFlow.com 3 Additional Powers (Specific proof an d findings of fact will be necessary to justify any of these additional powers. 20 Pa.C.S. 247 5521(d)) The Guardian (s) of the P erson shall have, in addition to the powers granted above, the following authority: To consent to (abortion) (sterilization) (ps ychosurgery) (electroconvulsive procedure) (removal of bodily organ/s) (other: ). To consent to performance of experimental procedures or participation in experiments (bio - medical) (behavioral) (other: ). T o prohibit marriage/To consent to divorce . Powers of Attorney Any general or limited powers of atto r n e y (other than a health care power of atto r ney) previou s ly executed by the Respondent are her e by revoked and vacated. If there is an existing health car e power of attorney which is not revoked below, the health care agent is advised, pursuant to 20 Pa.C.S. 2475460(a), that he or she is accountable to the Guardian (s) of the Person as well as the Respondent (the principal). The G uardian (s) of the P erson is hereby authorized to revoke the appointment of the health care agent. The court hereby revokes the health care power of attorney. The court authorizes the continuance of the health care power of attorney. HIPAA P er sonal R epresentative The Guardian (s) of the P erson shall be deemed to hav e authority to act on behalf of Respondent , as personal representative for the purposes of the Health Care Insurance Portability and Accountability Act of 1996 (HIPAA) , for the dur ation of the Guardianship. As the personal representative for HIP A A purposes, the Guardian (s) of the P erson shall be treated the same as American LegalNet, Inc. www.FormsWorkFlow.com 4 Res p ondent by any health care related person or entity, and shall have access to all protected health information of R espondent . II. Guardian of the Estate is/are appointed as A. Limited Guardian (s) with the following authority: a. rol: ; b. Other: . B. Plenary Guardian (s) Additional Guardian of the E state provisions The Guardian (s) of the Estate may petition the court for allowances to pay for other fees, costs, or expenses incurred in providing services hereunder. All banks and other financial institutions maintaining provide the Guardian (s) of the Estate with all requested account related information pertaining to all account assets held , including jointly held accounts . If requested by the Guardian (s) of the Estate, said banks and other financial institutions shall transfer to the Gua rdian (s) American LegalNet, Inc. www.FormsWorkFlow.com 5 Except as authorized below, the Guardian (s) of the Estate shall not use principal without first petition ing the court and obtaining approval therefore. The Guardian (s) of th e Estate is authorized to expend the principal from the as follows: To establish a burial fund or purchase pre - paid funeral expenses in the event the same do not currently exist. The Gu ardian (s) of the Estate shall take all actions necessary to obtain and/or maintain medical insurance for the Respondent, including under the Medical Assistance Program, if applicable. The Guardian (s) or the The Guardian (s) of the Estate shall file a copy of the Will of Respondent (if any) with the Chester County Clerk of the withi n three (3) months o date that is by . Furthermore, all financial institutions, including without limitation, banks, savings and loan s, credit un ion s , and brokerages, shall grant to the G uardi an (s) of [ Respondent ] estate access to any and all assets, records, and accounts maintained for the benefit of Respondent , and the G uardian (s) of Respondent d to transfer, retitle, withdraw, or to otherwise exercise dominion a n d control over any and all said assets, records, and a ccounts. The failure of any financial institution to honor this order may lead to contempt proceedings and the imposition of sanctions . American LegalNet, Inc. www.FormsWorkFlow.com 6 Bond The Guardian (s) of the Estate ( shall / shall not) post a bond with surety . If bond is required , it shall be p osted within ten (1 0 ) da ys from the date of this Order in the amount of $ . The cost of the bond may be paid from the Estate assets. Firearms In order to comply with 18 Pa.C.S. 2476105 (a) and (c)(4) of the Pennsylvania Uniform Firearms A ct, the Guardian (s) of the Estate shall inquire about the ownership and/or possession of any firearms by the incapacitated person and, within sixty ( 60 ) days of the Adjudication, shall to another eligible person An incapacitated person is not permitted to obtain a license to carry a firearm. Any existing license issued to the incapacitated person should be returned to the issui ng authority. III. Compensation of Guardian none $ monthly (Medical Assistance cases) $ hourly (if not Medical Assistance case ) other, per record: $ Bill ing for Compensation semi - annually other American LegalNet, Inc. www.FormsWorkFlow.com 7 Payment to the Guardian (s) for compensation must be preceded by the filing of a petition by the Guardian (s ) with the Chester C s approval of that petition. The petition must detail the time and type of services rendered by the Guardian (s) which justifies the requested payment . Compensation for the Guardian (s) mu st be taken from the income, not from his/her assets ( i.e not from investment account principal ) , unless court approval also has been obtained. IV. Review A Review Hearing in the above matter shall be held ; or . V. Reports The Guardian s (Person and Estate) shall file the following reports with the Clerk of the 1. An inventory by the G uardian(s) of the estate within 90 days of this decree; 2. An annual report by the G uardian(s) of the estate one year after appointment and annually thereafter; 3. An annual report by the G uardian(s) of the person one year after appointment and annually th ereafter; 4. A final report by the G uardian(s) of the person and the estate within 60 days of the death of the incapacitated person, an adjudication of capacity, a chang e of guardian, or the expiration of an order of limited duration; 5. A final report from the G uardian(s) of the person and the estate upon rece ipt of the American LegalNet, Inc. www.FormsWorkFlow.com 8 6. Notice of the filing of the above reports , using Form G - 07 , shall be given to the following: VI. Notice of Right to Appeal Read to Respondent in Court To be read to Respondent by: & an affidavit of service/verification filed within 10 days of this Order. [ R espondent ] is hereby no