Guardians Final Report For Protected Person {Rule 7.11 Form 5}

Rule 7.11 -- Form 2: Initial/Annual/Final Report of Guardian If filing electronically, you must provide any protected information in full on form 6, according to Division VI of Chapter 16 of the Iowa Court Rules. If filing in paper, you may use form 6 to provide any protected information in full. In the Iowa District Court for In the Matter of the Guardianship of: Probate no. Check one Full name: first, middle, last If the Ward is a minor, use initials only County Initial Annual Final Report of Guardian Ward. The undersigned duly appointed and qualified Guardian states as follows: 1. 2. This Report is for the period from: Month / Day / Year to Month / Day / Year The current mental and physical condition of the Ward is: Check this box if you have attached a sheet with additional information. 3. The present living arrangement of the Ward, including a description of each residence where the Ward has resided and with whom during the reporting period is: Check this box if you have attached a sheet with additional information. 4. The following is a summary of the medical, educational, vocational, and other professional services provided for the Ward: Check this box if you have attached a sheet with additional information. 5. The following is a description of the Guardian's visits with and activities on behalf of the Ward: Check this box if you have attached a sheet with additional information. May 2014 Rule 7.11 -- Form 2 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Rule 7.11 -- Form 2: Initial/Annual/Final Report of Guardian, continued 6. 7. 8. The Ward's year of birth is: On Initial Report only The Ward is: single. married. No divorced. Is the Ward a minor? Yes If the Ward is a minor, names and addresses of parents: Name of parent Street address City State ZIP code Name of parent Street address City State ZIP code 9. Guardianship is recommended to be: continued. terminated. If termination is recommended, give reason(s). A hearing may be required on the matter of termination. Check this box if you have attached a sheet with additional information. 10. Other information the court requested that is useful in the opinion of the Guardian: Check this box if you have attached a sheet with additional information. 11. Have final court costs been paid? 12. Oath and Signature I, Print Guardian's name Yes No , have read this Report, and I certify under penalty of perjury and pursuant to the laws of the State of Iowa that the information I have provided in this Report is true and correct. , 20 Month Day Year Guardian's signature* Mailing address ( ). Phone number City State ZIP code Email address Additional email address, if applicable * Whether filing electronically or in paper, you must handwrite your signature on this form. If you are filing electronically, scan the form after signing it and then file electronically. Note: Bank statements, checks, receipts, stubs, and other items evidencing receipt of funds and payment must be available to the court on demand. May 2014 Rule 7.11 -- Form 2 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com