FORM SUMMARY Name of Form Statement Requesting Removal of Rights and Transfer of Additional Powers to Guardian GN-3644 Form Number Statutory Reference: Benchbook Reference: Purpose of Form: §54.63, Wisconsin Statutes Statement Requesting Removal of Rights and Transfer of Additional Powers to Guardian. Person that submits statement. Original to Court, copies to interested parties. Who Completes It: Distribution of Form: Accompanying Forms: New Form/Modification: Modifications: New Form. Developed to comply with 2005 Wis. Acts 264, 387 and 388. About this Form: This form is the product of the Wisconsin Records Management Committee, a committee of the Director of State Court's Office and a mandate of the Wisconsin Judicial Conference. If you have additional information that does not change the meaning of the form, attach it on a separate page. The form itself shall not be altered. Date: 01/26/07 Page 1 American LegalNet, Inc. www.FormsWorkflow.com For Official Use STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF Statement Requesting Removal of Rights and Transfer of Additional Powers to Guardian Case No. Date of Birth I am: guardian. another interested person. I request the removal of rights from the ward and transfer to the guardian of powers in addition to those specified in the order of appointment of the guardian, based on an expansion of the ward's incapacity. The specific rights requested to be removed from the ward and powers requested to be transferred to the guardian and relevant support See attached for this request are as follows: Signature of Person Making Statement Name Printed or Typed Address Name of Attorney Address _____________________________________________ Date Telephone Number Bar Number GN-3644, 01/07 Statement Requesting Removal of Rights and Transfer of Additional Powers to Guardian §54.63, Wisconsin Statutes American LegalNet, Inc. www.FormsWorkflow.com This form shall not be modified. It may be supplemented with additional material.