Form Prb Gi Gdr PDF Details

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QuestionAnswer
Form NameForm Prb Gi Gdr
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesI-G, PROBATE, ashtabula probate court, evaluated

Form Preview Example

PRB-GI-GDR (REV. 8/10)

PROBATE COURT OF ASHTABULA COUNTY, OHIO

IN THE MATTER OF THE GUARDIANSHIP OF

Case No.

 

Docket

 

Page

GUARDIAN’S REPORT

[R.C. 2111.49]

NOTE: If allotted space is inadequate to respond, write “See Exhibit” in the space and add appropriate exhibit letter sequence, then attach exhibit containing information requested for that space.

1. This is the (check one)

1st

2nd

3rd

4th

 

5th

6th

or

 

, Guardian Report.

2. Ward’s present address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City:

 

 

 

 

 

 

 

 

 

 

State:

 

 

 

 

Zip

 

 

Telephone: (

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Ward’s living arrangements at the above address are best described as:

 

 

 

 

 

 

 

a.

His or her own apartment or home (includes assisted living facilities)

 

 

 

 

b.

Private home or apartment of:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1)

 

the ward’s guardian

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(2)

 

a relative of the ward, whose name is

 

 

 

 

 

 

 

 

 

 

 

and relationship is

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(3) A non-relative whose name is

 

 

 

 

 

 

 

 

 

 

 

 

c.

 

A foster, group or boarding home

 

 

 

 

 

 

 

 

 

 

 

d.

 

A nursing home

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e.

 

A medical facility or state institution

 

 

 

 

 

 

 

 

 

 

 

f.

 

Other (describe)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

g. If c, d, e, or f is checked complete the following:

(1)The name of the home, facility, or institution

(2)The name of an individual at the home, facility, or institution who has knowledge and is authorized to give information to the Court about the ward

 

 

Name

 

 

 

 

 

Telephone (

 

)

 

 

4. The ward will be at the address given in Item 2:

 

 

 

 

 

 

 

a. Indefinitely

 

 

 

 

 

 

 

 

 

 

 

 

b. Temporarily - the new address and telephone number is:

 

 

 

 

 

 

 

(1)Unknown - I will provide this information when known

 

 

 

 

 

 

 

(2)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

State

 

 

 

 

 

 

 

 

 

Zip

 

Telephone (

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17.7 GUARDIAN’S REPORT

 

 

 

 

 

 

 

Page 1 of 2

5.Guardian’s contact with the ward

a.Approximate number of times the guardian had contact with the ward during the period covered by this report:

b.The nature of those contacts (phone, personal, or other):

c.Date the ward was last seen by the guardian:

6.Have you observed any major change in the ward’s physical or mental condition during the period covered by this

report?

Yes

No

If “yes” is checked, briefly describe the changes

7. The care given to the ward is

Adequate

Not Adequate

If “Not Adequate” is checked, explain

8. The guardianship should be

Continued

Not Continued

If “Not Continued” is checked, explain

9. During the period covered by this report, the ward

has

has not

been

seen by a physician. If the ward has been seen, the last date was

 

and for the purpose of

 

 

 

 

 

 

 

 

 

Attached is a statement by a licensed physician, a licensed clinical psychologist, a licensed social worker, or a mental retardation team, that has evaluated or examined the ward within three months prior to the date of this report regarding the need for continuing the guardianship. [R.C. 2111.49(A)(1)(i)] (Form 17.1)

If an attorney has been consulted on this report:

Date

____________________________________________

Attorney’s Signature

(Type or Print Attorney’s Name)

(Street)

(City, State, Zip Code)

______________________________________

Guardian’s Signature

(Type or Print Guardian’s Name)

(Street)

(City, State, Zip Code)

Telephone Number

Sup. Ct. Regis. No.

(Telephone Number - Include Area Code)

(Knowingly giving false information on a Probate document is a criminal offense.)

[R.C. 2921.13(A)(11)]

Page 2 of 2

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Be mindful when filling out this pdf. Ensure that every single field is filled in properly.

1. You will want to fill out the retardation correctly, therefore take care while working with the sections including these particular blank fields:

Writing segment 1 in Sup

2. Once your current task is complete, take the next step – fill out all of these fields - the wards guardian, a relative of the ward whose name, and relationship is, A nonrelative whose name is, A foster group or boarding home, A nursing home, A medical facility or state, Other describe, If c d e or f is checked complete, The name of the home facility or, The name of an individual at the, Name, Telephone, The ward will be at the address, and a Indefinitely with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Telephone, Name, and The name of the home facility or of Sup

3. Completing City, Zip, State, Telephone, GUARDIANS REPORT, and Page of is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

A way to fill out Sup part 3

4. The following section needs your involvement in the subsequent parts: a Approximate number of times the, report, b The nature of those contacts, c Date the ward was last seen by, Have you observed any major, report, Yes, If yes is checked briefly describe, The care given to the ward is, Adequate, Not Adequate, If Not Adequate is checked explain, The guardianship should be, Continued, and Not Continued. Remember to provide all requested information to go forward.

Part no. 4 in completing Sup

It is possible to make a mistake while filling in your The guardianship should be, and so you'll want to look again prior to deciding to submit it.

5. To finish your document, the last section has several additional fields. Filling out Attached is a statement by a, If an attorney has been consulted, Date, Attorneys Signature, Guardians Signature, Type or Print Attorneys Name, Type or Print Guardians Name, Street, Street, City State Zip Code, City State Zip Code, Telephone Number, Sup Ct Regis No, and Telephone Number Include Area Code should conclude everything and you're going to be done quickly!

Stage number 5 in completing Sup

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