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IN RE THE GUARDIANSHIP OF APPEARANCE BY UNREPRESENTED (Indiana Legal Help)

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Page 1 of 1 Approved by the Coalition for Court Access
CCA-GF-0520-4001
www.indianalegalhelp.org
STATE OF INDIANA IN THE _____________________________COURT
COUNTY OF CAUSE NO: _______________________________
IN RE THE GUARDIANSHIP OF
____________________________
APPEARANCE BY UNREPRESENTED
1. My name is _________________________________ and in this case I am not represented
by a lawyer.
2. My contact information for receiving legal service of documents and case information as
required by Court Rules is:
Address:
Email address:
☐ I will accept service at the above email address.
Phone: _______________________ Fax:
OR, if in a related case, you have used the Attorney General confidential address, you may
check the box below:
☐ Attorney General confidential address
3. This is a GU case type as defined in Administrative Rule 8(B)(3).
4. There are other cases related to this case: (If yes, please indicate below)
☐ Yes ☐ No
Caption and case number of related cases:
Caption: Case No.:
Caption: Case No.:
Additional information as required by local rule:
Signature
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this document on ________________________ by
☐ e-service using the e-filing system
☐ first-class U.S. mail, postage prepaid
☐ hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
______________________________
Signature
___________
Page 1 of 3 Approved by the Coalition for Court Access
CCA-GU-0520-4002
www.indianalegalhlep.org
STATE OF INDIANA IN THE ___________________________ COURT
COUNTY OF ___________________ CAUSE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
________________________
Minor Child
VERIFIED PETITION FOR APPOINTMENT OF GUARDIAN(S) OF THE PERSON OF MINOR
Come now the Petitioner(s) ________________________________________________, and
respectfully petitions the Court to appoint Petitioner(s) as guardian(s) of
______________________________________, a minor child. In support of this request, Petitioner(s)
would show the Court as follows:
1. __________________________________ was born on _____________________, is
_______ years old and is incapacitated due to minority and resides at the following address:
_____________________________________________________________________________________.
2. Petitioner(s) reside at
_____________________________________________________________________________________
_____________________________________________________________________________________.
3. The child has been in the physical custody and care of Petitioner(s) since
___________________________, because:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________.
4. Petitioner(s) is/are the child’s ________________________. Petitioner(s) has/have been
supporting and caring for the child in the following ways:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
5. A Child In Need Of Services (CHINS) petition
☐ has been filed regarding this child and is ☐ open ☐ closed
☐ has not been filed regarding this child.
6. A program of informal adjustment
☐ has been filed regarding this child and is ☐ open ☐ closed
☐ has not been filed regarding this child.
___________
Page 2 of 3 Approved by the Coalition for Court Access
CCA-GU-0520-4002
www.indianalegalhlep.org
7. Petitioner(s):
☐ are aware of another guardian appointed for or acting as the custodian of the minor child
and their name is _______________________________________________________ and
address is: _______________________________________________________________.
☐ are not aware of another guardian appointed for or acting as the custodian of the minor
child.
8. A protective order:
☐ has been issued for the minor.
☐ has not been issued for the minor.
9. The child has the following real or personal property. The lines below should include a
description and approximate value of the property. Property includes any compensation, pension,
insurance or allowance to which the minor child may be entitled:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
10. As far as Petitioner(s) know or can reasonably discover, the names and addresses of the
persons most closely related by blood or marriage to the minor child are:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
11. The appointment of a guardian is sought for the following reasons:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
12. If appointed as guardian(s) of the child, Petitioner(s) can provide the following for the
child:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Page 3 of 3 Approved by the Coalition for Court Access
CCA-GU-0520-4002
www.indianalegalhlep.org
13. The filing fee for this proceeding:
☐ has been paid. ☐ has not been paid. ☐ has been waived.
14. Petitioner(s) request that no bond be required of Petitioner(s) since the minor child has no
asset(s).
15. ☐ Petitioner(s) have been appointed guardian(s) of another person in this state.
☐ Petitioner(s) have not been appointed guardian(s) of another person in this state.
16. Less restrictive alternatives are not sufficient to meet the needs of the child because
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________.
Wherefore, Petitioner(s) respectfully requests to be appointed guardian(s) of
______________________________________________ after notice and a hearing.
The undersigned affirms under penalties for perjury that the foregoing representations and
statements are true.
______________________________ ______________________________
Signature Signature
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this document on ________________________ by
☐ e-service using the e-filing system
☐ first-class U.S. mail, postage prepaid
☐ hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
I hereby certify that I sent a copy of this document on ________________________ by
☐ e-service using the e-filing system
☐ first-class U.S. mail, postage prepaid
☐ hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
______________________________ ______________________________
Signature Signature
Page 1 of 2 Approved by the Coalition for Court Access
CCA-GU-0520-4003
www.indianalegalhelp.org
CONFIDENTIAL DOCUMENT *TREAT AS IF FILED ON GREEN PAPER*
Guardianship Registry Information Sheet-Trial Rule 3.1 (A)(10)
(☐ Individual ☐ Estate ☐ Estate and Individual)
Choose One* (☐ Minor ☐ Adult) Choose One*(☐ Temporary ☐ Permanent)
Related Cases (List any cases in which the Protected Person is a party, e.g., CHINS)
___________________________ ___________________________ __________________________
Petitioner Relationship to Protected Person* ______________________________
Last:*__
____________________ Suffix:_____ First:*____________________ Middle:_____________
DOB:_______________ Gender:*_____ Race:*___________________________ Hispanic?: ______
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:*_______________________________________________________________________
Attorney Name:____________________ Bar Number:___________ App. Filed Date: _______________
Protected Person Estimated Value $___________
Last:*__
____________________ Suffix:_____ First:*____________________ Middle:_____________
DOB:*______________ Gender:*_____ Race:*___________________________ Hispanic?: ______
Eye Color:__________ Hair Color:__________ Height:__________ Weight:__________ lbs
Scars, Marks, and Tattoos: _______________________________________________________________
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
Attorney Name:____________________ Bar Number:___________ App. Filed Date: _______________
Guardian Ad Litem Full Name:____________________________________________________________
Interpreter required? ______ Language: ___________
Guardian ☐ Check if same as petitioner ☐ Certified (Only check if Federal or State Certified)
Last:*__
____________________ Suffix:_____ First:*____________________ Middle:_____________
DOB:_______________ Gender:*_____ Race:*___________________________ Hispanic?: ______
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:*_______________________________________________________________________
Attorney Name:____________________ Bar Number:___________ App. Filed Date: _______________
Guardian Institution
Name:*__
____________________________________________________________________________
Address:*_____________________________________________________________________________
Phone:_________________ Fax:_________________ Agent Name:_____________________________
Close Relative (Entitled to Notice) Relationship to Protected Person ________________________
Last:*______________________ Suffix:_____ First:*____________________ Middle:_____________
Gender:*_____ Race:*___________ Hispanic?: _______
Mailing Address:*______________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
X
X
____
_______________
____
_______________
____
__________
_______________
____
_______________
____
Page 2 of 2 Approved by the Coalition for Court Access
CCA-GU-0520-4003
www.indianalegalhelp.org
CONFIDENTIAL DOCUMENT *TREAT AS IF FILED ON GREEN PAPER*
Guardianship Registry Information Sheet- Trial Rule 3.1 (A)(10)
(Additional)
Petitioner Relationship to Protected Person ________________________
Last
:*______________________ Suffix:_____ First:*____________________ Middle:_____________
DOB:_______________ Gender:*_____ Race:*___________________________ Hispanic?: ______
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
Attorney Name:____________________ Bar Number:___________ App. Filed Date: _______________
Guardian ☐ Check if same as petitioner ☐ Certified (Only check if Federal or State Certified)
Last
:*______________________ Suffix:_____ First:*____________________ Middle:_____________
DOB:_______________ Gender:*_____ Race:*___________________________ Hispanic?: ______
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
Attorney Name:____________________ Bar Number:___________ App. Filed Date: _______________
Close Relative (Entitled to Notice) Relationship to Protected Person ________________________
Last:*______________________ Suffix:_____ First:*____________________ Middle:_____________
Gender:*_____ Race:*___________ Hispanic?: _______
Mailing Address:*______________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
Interested Party
Last:*______________________ Suffix:_____ First:*____________________ Middle:_____________
Gender:*_____ Race:*___________ Hispanic?: _______
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
Interested Party
Last:*______________________ Suffix:_____ First:*____________________ Middle:_____________
Gender:*_____ Race:*___________ Hispanic?: ______
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
_____
_______________
____
_______________
____
_______________
____
_______________
____
_______________
____
Page 1 of 1 Approved by the Coalition for Court Access
CCA-GU-0520-4004
www.indianalegalhelp.org
Form ACR (Access to Court Records)
STATE OF INDIANA IN THE ___________________________ COURT
COUNTY OF ___________________ CAUSE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
_____________________________
Minor Child
Notice of Exclusion of Confidential Information from Public Access
(FILED WITH TRIAL COURT CLERK)
Contemporaneous with the filing of this notice, _______________________________ has filed
confidential information under the Indiana Rules on Access to Court
Records._______________________________________, provides this notice that the confidential
information is to remain excluded from public access in accordance with the authority listed below:
Name or description of document
ACR grounds for exclusion
Guardianship Registry Information Sheet
Access to Court Records Rule 5(b)(2)
________________________________
Signature
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this document on ________________________ by
☐ e-service using the e-filing system
☐ first-class U.S. mail, postage prepaid
☐ hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
I hereby certify that I sent a copy of this document on ________________________ by
☐ e-service using the e-filing system
☐ first-class U.S. mail, postage prepaid
☐ hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
______________________________ ______________________________
Signature Signature
___________
Page 1 of 1 Approved by the Coalition for Court Access
CCA-GU-0520-4005
www.indianalegalhelp.org
STATE OF INDIANA IN THE ___________________________ COURT
COUNTY OF ___________________ CAUSE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
________________________
Minor Child
PARENT AND OTHER INTERESTED PERSON’S WAIVER OF NOTICE AND
CONSENT TO THE APPOINTMENT OF GUARDIAN(S) OF THE PERSON OF
MINOR CHILD
I _____________________________________________, being duly sworn upon my
oath, state that I am an adult, and my date of birth is _________________________. I am
the _____________________________ of the following child(ren):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
I am familiar with the Verified Petition For Appointment Of Guardians Of The Person
Of A Minor and hereby consent to the appointment of Petitioner,
______________________________________________________________________________
as guardian of the above named child(ren). I expressly waive service of summons and
notice on this Petition.
I affirm under the penalties of perjury that the foregoing representations are true.
__________________________________ ____________________________________
Date Signature
____________________________________
Printed Name
STATE OF INDIANA
COUNTY OF__________________
Before me, ___________________________a notary public in and for
__________________________County, State of Indiana, personally appeared
___________________________________, and he/she having been first duly sworn upon his/her
oath, says that the facts all alleged in the foregoing instrument are true.
Date _____________________________ ____________________________________
Notary Public
My Commission Expires: ___________________________
___________
Page 1 of 1 Approved by the Coalition for Court Access
CCA-GU-0520-4006
www.indianalegalhelp.org
STATE OF INDIANA IN THE ___________________________ COURT
COUNTY OF ___________________ CAUSE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
________________________
Minor Child
ORDER SETTING HEARING ON PETITION FOR APPOINTMENT OF GUARDIAN
Comes now, ___________________________________________________________,
and files a Verified Petition for Appointment of Guardian of the Person of
_____________________________________________________________________________.
The Court schedules the Verified Petition for hearing on:
____________________________________________________________________________at
__________________________________________.
Date: ____________________________ ____________________________________
Judicial Officer
Distribution:
______________________________ ______________________________
______________________________ ______________________________
______________________________ ______________________________
______________________________ ______________________________
______________________________ ______________________________
___________
Page 1 of 1 Approved by the Coalition for Court Access
CCA-GU-0520-4007
www.indianalegalhelp.org
STATE OF INDIANA IN THE ___________________________ COURT
COUNTY OF ___________________ CAUSE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
________________________
Minor Child
ORDER APPOINTING GUARDIAN FOR MINOR
The Court now finds as follows:
1. The individual for whom the Guardian is sought is a minor child.
2. The appointment of a Guardian is necessary to provide care and supervision of the
Minor Child’s physical person.
IT IS THEREFORE ORDERED as follows:
1. ____________________________________________ is adjudicated a Minor
Child.
2. ____________________________________________ is appointed Guardian.
3. No bond is required except on further Order.
4. The court has received the Oath of Guardianship and the Clerk shall issue Letters
of Guardianship.
SO ORDERED ________________________________________________________________
__________________________________________
Judicial Officer
Distribution:
______________________________ ______________________________
______________________________ ______________________________
______________________________ ______________________________
______________________________ ______________________________
______________________________ ______________________________
___________
Page 1 of 1 Approved by the Coalition for Court Access
CCA-GU-0520-4008
www.indianalegalhelp.org
STATE OF INDIANA IN THE ___________________________ COURT
COUNTY OF ___________________ CAUSE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
________________________
Minor Child
OATH OF GUARDIAN
I/We ___________________________________________________________________
swear and affirm that I/we will faithfully discharge my/our duties as guardian(s) of
______________________________________________________________________________
according to law.
___________________________________ ___________________________________
__________________________,Guardian __________________________,Guardian
Address: Address:
___________________________________ ___________________________________
___________________________________ ___________________________________
___________________________________ ___________________________________
Date of birth: _______________________ Date of birth: _______________________
STATE OF INDIANA
COUNTY OF__________________
Before me, ___________________________a notary public in and for
_________________________County, State of Indiana, personally appeared
___________________________________, and he/she having been first duly sworn upon
his/her oath, says that the facts all alleged in the foregoing instrument are true.
Date _____________________________ ____________________________________
Notary Public
My Commission Expires: ___________________________
___________
Page 1 of 1 Approved by the Coalition for Court Access
CCA-GU-0520-4009
www.indianalegalhelp.org
LETTERS OF GUARDIANSHIP OF THE PERSON
CAUSE NUMBER ______________________________________________
STATE OF INDIANA, _____________________ COUNTY, ___________________________
This is to CERTIFY that the Judge of the ______________________________________,
_____________________________ County, Indiana, has this day granted to
________________________, Guardian
The authority to administer to as Guardian, the guardianship of:
________________________, Protected Person
A guardian of the person is authorized to exercise those powers set out in Indiana Code
29-3-8-2(a), Subsections (2), (3) and (4) only.
A guardian of the estate is authorized to exercise those powers set out in Indiana Code
29-3-8-4, Subsections 1-8 only.
A guardian has no authority to do any act not specifically authorized herein except with
the prior written permission of the court.
Further limitations on the guardian’s authority are as follows:
Said guardianship shall extend until terminated as provided by law, and the said guardian,
______________________________________, having duly qualified as such, is authorized to
take upon themselves the performance of their duties of the trusts of this Guardianship according
to law.
Witness my hand and seal of the Court, as ___________________, Indiana.
This __________________________________________________________________.
__________________________________________
Clerk, ____________________ County
__________________________ Court
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IN RE THE GUARDIANSHIP OF APPEARANCE BY UNREPRESENTED (Indiana Legal Help)

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Completed 31 December 2021

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