Fillable IN RE THE GUARDIANSHIP OF APPLICATION FOR APPOINTMENT (Indiana Legal Help)

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IN RE THE GUARDIANSHIP OF APPLICATION FOR APPOINTMENT (Indiana Legal Help)

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STATE OF INDIANA IN THE _____________________________COURT
COUNTY OF CAUSE NO: _______________________________
IN RE THE GUARDIANSHIP OF
____________________________
APPLICATION FOR APPOINTMENT OF GUARDIAN
[If there are Co-Guardians, then complete one form for each Co-Guardian]
CONTACT INFORMATION:
Name of Petitioner:
Address of Petitioner:
[Including street number,
city, zip]
Home Phone Number:
Cell Phone Number:
E-Mail:
EDUCATIONAL BACKGROUND:
Do you have a High School Education? Yes
If you do not have a High School Education,
No
do you have a GDI? Yes No
Do you have a college education? Yes No
If so, please list college, number of years attended, and the year you obtained a degree, and the
type of degree you obtained.
Do you have a post graduate or professional degree Yes No
If so, please identify educational institution, the year you obtained that degree, and the degree
you obtained.
Page 1 of 3 Approved by the Coalition for Court Access
CCA-GU-0420-4011
www.indianalegalhelp.org
_______________
EMPLOYMENT:
Name of Employer:
Address of Employer:
Length of Employment:
If you are not currently employed, please state whether you are retired, or a homemaker, or a
surviving spouse or surviving partner of the deceased person, and please describe your most
occupation or work experience before your retirement or before you stopped working outside
your home.
FINANCIAL EXPERTISE:
Please list all prior experience in financial management, including investments and checkbook
management:
FELONY CONVICTIONS:
Do you have any prior felony convictions Yes No
If so, list date of conviction and type of felony.
AFFIRMATIONS OF PETITIONER:
As Petitioner requesting my appointment as Guardian of the Estate of
, I hereby state as follows:
1. That I have a attained 18 years of age and I am not incapacitated in any manner that
would interfere with my administration of the estate (property) of the minor or incapacitated
adult.
2. That my attorney is , with
offices located at
.
That my attorney's Phone Number is:
That my attorney's Fax Number is:
That my attorney's E-Mail address is:
3. That I have provided my attorney with my Social Security Number and the date of my
birth.
4. That I accept my appointment as fiduciary.
5. That I agree to submit personally to the Jurisdiction of this Court in any proceeding
that relates to the estate of the minor or incapacitated adult.
Page 1 of 3 Approved by the Coalition for Court Access
CCA-GU-0420-4011
www.indianalegalhelp.org
AFFIRMATION AND VERIFICATION:
I affirm under the Penalties of perjury that the foregoing information is true and correct. That as
a condition of my appointment as fiduciary in this matter, I hereby waive the privilege associated
with this information and authorize my attorney to disclose this information to the Court, upon
Court order, in the event of my failure to render an account as required by law or other
determination of a breach of my fiduciary duty.
Dated: This day of , 20 .
Signature of Petitioner
Page 3 of 3
Approved by the Coalition for Court Access
CCA-GU-0420-4011
www.indianalegalhelp.org
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IN RE THE GUARDIANSHIP OF APPLICATION FOR APPOINTMENT (Indiana Legal Help)

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Completed 31 December 2021

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