Fla. Prob. R. 5.902

(a) Petition.

In the Circuit Court of the

Judicial Circuit,

in and for

County, Florida

Probate Division

Case No.

In Re: Guardianship of

Respondent’s Name

PETITION FOR APPOINTMENT OF GUARDIAN

Petitioner, , files this petition pursuant to

section 744.1097, Florida Statutes, and alleges that:

1. The petitioner, proposed guardian.....(name)....., who is

years of age, whose residential address is

and post office address is. The relationship

of the petitioner to the respondent is.

2. Venue is proper in.....(county)....., pursuant to section

744.1097(2), Florida Statutes, (choose one):

( ) a. the incapacitated person resides in.....(county).....,

Florida;

( ) b. the incapacitated person is not a Florida resident but

owns property in.....(county)....., Florida; or

( ) c. a debtor of the incapacitated person resides in

.....(county)...., Florida and the incapacitated person is not a Florida resident

and does not own property in Florida.

3. The nature of the incapacity of the respondent:

4. The extent of the guardianship requested for the respondent:

( ) a. plenary; or

( ) b. limited.

5. The guardianship requested for the respondent is (choose one):

( ) a. of the person;

( ) b. of the property; or

( ) c. of the person and property.

6. The nature and value of the property subject to guardianship:

7. The names and addresses of the living next of kin of the

respondent are:

Name Address Relationship

8. Choose one:

( ) a. the petitioner proposes that.....(name)..... be

appointed as guardian and that.....(name)..... is qualified to serve;

( ) b. a willing and qualified guardian has not been located;

or

( ) c. the proposed guardian is a professional guardian and

has complied with the registration requirements of section 744.2002, Florida

Statutes.

9. The proposed guardian should be appointed because:

10. There are or are not alternatives to the

appointment of a guardian, such as trust agreements, powers of attorney,

designation of health care surrogate, or other advanced directive, known to

petitioner.

Under penalties of perjury, I declare that I have read the foregoing, and

the facts alleged are true, to the best of my knowledge and belief.

Signed.....(date)......

Signature:

Petitioner

Name:

Address:

Phone Number:

E-mail Address:

(b) Order.

In the Circuit Court of the

Judicial Circuit,

in and for

County, Florida

Probate Division

Case No.

In Re: Guardianship of

Respondent’s Name

ORDER FOR APPOINTMENT OF GUARDIAN

1. By order of this court on.....(date)....., the respondent

.....(name)..... was adjudicated incapacitated and is now a ward as defined in

section 744.102(22), Florida Statutes. The extent of the incapacity is

.....(plenary or limited)...... The ward retains the rights listed in section

744.3215(a), Florida Statutes.

2. No alternative to guardianship exists that sufficiently addresses

the respondent’s needs.

3. A.....(plenary or limited)..... guardianship of the:

( ) a. person;

( ) b. property; or

( ) c. person and property

is consistent with the respondent’s welfare and safety, is the least restrictive

alternative, and reserves to the respondent the right to make decisions in all

matters commensurate with the ward’s ability to do so.

4. .....(Name of guardian)..... is qualified to serve as.....(plenary or

limited)..... guardian of the:

( ) a. person;

( ) b. property; or

( ) c. person and property of the ward

5. ( ) a. .....(Name of guardian)..... is the standby guardian or

preneed guardian;

( ) b. there is no standby guardian or preneed guardian;

( ) c. there is a standby guardian or preneed guardian, but

such person is not qualified to serve pursuant to section 744.309, Florida

Statutes; or

( ) d. there is a standby guardian or preneed guardian, but

appointment of such person is contrary to the best interests of the ward

because:

6. Any additional facts that support the selection of guardian:

7. ( ) a. No advance directive exists;

( ) b. the following advance directive exists and is entitled

.....(name of advance directive)..... and is dated.....(date of advance

directive).....;

( ) c. the advance directive is being revoked or modified and

the surrogate under the advance directive entitled.....(name of advance

directive)..... and is dated.....(date of advance directive)..... was given notice of

this proceeding and any motion to revoke or modify the advance directive; or

( ) d. if the advance directive is being revoked or modified

the facts supporting the revocation or modification:

ORDERED and ADJUDGED as follows:

8. The court hereby appoints.....(name of guardian)..... as

the.....(plenary or limited)..... guardian of the:

( ) a. person;

( ) b. property; or

( ) c. person and property of the ward.

9. The guardian may exercise only those delegable rights that have

been removed from the ward and specifically delegated to the guardian, which

are:

( ) a. to contract;

( ) b. to sue and defend lawsuits;

( ) c. to apply for government benefits;

( ) d. to manage property or to make any gift or disposition

of property;

( ) e. to determine the ward’s residence;

( ) f. to consent to medical and mental health treatment;

and

( ) g. to make decisions about the ward’s social environment

or other social aspects of the ward’s life.

10. The guardian may not exercise the following rights, even if such

rights were removed from the ward:

a. to marry;

b. to vote;

c. to personally apply for government benefits;

d. to have a driver license;

e. to travel; and

f. to seek or retain employment.

11. The amount of the bond to be given by the guardian is:

12. The guardian:

( ) a. must; or

( ) b. is not required to

place all, or part, of the property of the ward in a restricted account in a

financial institution designated pursuant to section 69.031, Florida Statutes.

13. ( ) a. No known advance directive exists;

( ) b. the advance directive entitled.....(name of advance

directive)..... and is dated.....(date of advance directive)..... is being modified or

revoked as follows:

( ) i. the surrogate shall not continue to exercise any

authority over the ward with regard to health care decisions;

( ) ii. the surrogate shall continue to exercise

authority over the respondent with regard to health care decisions;

( ) iii. the surrogate shall exercise the following

authority over the ward with regard to:

; or

( ) iv. The guardian shall exercise the following

authority over the ward with regard to health care decisions:

14. The respondent.....(may or may not)..... have a license to carry a

firearm or possess a weapon or firearm.

ORDERED this.....(date)......

Judge