When a loved one becomes incapacitated and unable to make decisions for themselves, it often falls upon family members or appointed guardians to step into their shoes, making crucial decisions on their behalf. In Henry County, Georgia, this weighty responsibility is formalized through the Probate Personal Status form, a comprehensive document that ensures the incapacitated adult's needs are met and their wellbeing is continuously monitored. This form, submitted to the Probate Court of Henry County, covers a broad spectrum of the adult ward’s life, from their living conditions and address to the specifics of their caregiving, reflecting the period of guardianship. Guardians are required to provide a detailed account of the ward’s living situation, whether it be in their own home, a nursing home, or another residence, and specify their financial oversight in the form of a Financial Reporting section, which clarifies whether they also serve as conservators. Moreover, the form demands information about the support, care, education, health, and welfare of the adult ward, ensuring a holistic view of their status. Completing and submitting this form is not just about legal compliance; it's a testament to the guardians' commitment to the dignity, health, and welfare of their ward, necessitating accuracy, honesty, and thoroughness to honor this crucial role.
| Question | Answer |
|---|---|
| Form Name | Probate Personal Status Form |
| Form Length | 3 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 45 sec |
| Other names | probate court county personal status, probate personal status, status breportb template, breportb probate court |
IN THE PROBATE COURT OF HENRY COUNTY
STATE OF GEORGIA
RE: |
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__________________________________ |
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FILE NO.: _______________________ |
Printed Name of Incapacitated Adult Ward |
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DUE DATE: _____________________ |
__________________________________ |
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Printed Name of Guardian(s) |
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PRESENT AGE: ____________________ |
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DATE OF BIRTH: ___________________ |
ADULT PERSONAL STATUS REPORT
The following is a true and complete reporting concerning the above incapacitated adult covering the period from _____________________________, 20___ to _____________________________ , 20___.
1.Describe the adult ward’s living conditions:
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________
2.The adult ward’s current address is: ________________________________________________
__________________________________________________________________________ and he/she has resided at this address since: _____________________________________________
3.Describe the adult ward’s living situation (check one):
□Personal Care Home
□Ward’s own home
□Nursing Home
□Guardian’s Home
□A home other than the Guardian’s home and their relationship to adult ward______________
□Other _______________________________________________________________________
4.Date you last observed your adult ward: ______________________________________________
5.How often are you able to visit your adult ward?________________________________________
6.How long are your average visits? ___________________________________________________
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Adult Personal Status Report, July 2014
__________________________________ |
FILE NO.: ______________________ |
Printed Name of Incapacitated Adult Ward
FINANCIAL REPORTING (check all that apply)
□I/We also serve as Conservator (s) for the adult ward. If so, my/our accounting for the current year is:
□Filed simultaneously with this report.
□Was filed earlier on this date: __________________________________________________
□Not due yet, but will be filed on this date: ________________________________________
□Has not been filed yet because: ________________________________________________
OR
□I/We do not serve as Conservator for the adult ward
□I/We have not received funds for the support, care, education, health and welfare of the adult ward.
□I/We have received support: Please list a description of the amount(s) and expenditures of all such funds received during the reporting period:
____________________________________________________________________________
VERIFICATION
The answers to the foregoing questions and the information provided with regard to the adult ward are true and correct to the best of my knowledge and belief and are hereby made under oath.
__________________________________ |
_______________________________________ |
Guardian/Conservator Signature |
Guardian/Conservator Signature |
_____________________________________ |
___________________________________________ |
Printed Name of Guardian/Conservator |
Printed Name of Guardian/Conservator |
Sworn to and subscribed before me |
Sworn to and subscribed before me |
This_____ day of ______________, 20_____. |
This _____ day of ___________________, 20_____. |
______________________________________ |
___________________________________________ |
Notary Public/Probate Court Clerk |
Notary Public / Probate Court Clerk |
My commission expires:__________________ |
My commission expires:_______________________ |
IF YOU FIND THAT YOU NEED TO SELL THE ADULT WARD’S REAL PROPERTY, VEHICLES, STOCKS AND/OR PERISHABLE PROPERTY, PLEASE CONTACT THE PROBATE COURT, OR YOUR ATTORNEY, FOR INFORMATION REGARDING THE REQUIRED PROCEDURE.
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Adult Personal Status Report, July 2014
CONFIRMATION OF COMPLIANCE WITH FILING REQUIREMENT
Based on the foregoing Personal Status Report for Adult Ward, said report is hereby accepted for filing in the Probate Court of Henry County.
This ____ day of ______________________20___.
_______________________________________________
CLERK / DEPUTY CLERK, Henry County Probate Court
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Adult Personal Status Report, July 2014