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Ind. Marion Cnty. Probate Forms

Index of Marion County Probate Forms, and the forms

activein force · 2026-10-02 – presentcompiled-edition

INDEX OF MARION COUNTY PROBATE FORMS

The forms listed below are referred to in the Local Rules of the Marion Superior Court, Probate

Division (“MSCPR”), and are numbered in correspondence with the pertinent Rule.

FORM NO.

Form 401.1-A Application for Appointment of Personal Representative

Form 401.1-B Application for Appointment of Guardian

Form 401.1 Petition to Appoint Personal Representative

Form 401.2 Proof of Lost Will and Affidavit

Form 402.2 Suggested Form of Attorney Fee Agreement

Form 402.4 Notice to Court and Order Setting Hearing

Form 409.4. Attorney’s Undertaking In Guardianships

Form 409.5 Acceptance of Restrictions on Guardianship Account

Form 412.0 Instructions to Guardians of the Person with Sample Annual Report

Form 412.1 Instructions to Guardians of Estate

Form 412.2 Instructions to Personal Representatives of Supervised Estate

Form 412.3 Instructions to Personal Representatives of Unsupervised Estate

Form 413.3 Physician’s Report

Form 413.4 Attorney’s Affidavit Regarding Notice

Form 418.6 (A) Attorney’s Undertaking in Minor’s Settlement

Form 418.6 (B) Acceptance of Restrictions on Minor’s Settlement Account

Form 421.1 Affidavit for Transfer of Assets without Administration

Marion County Probate Form 401.1-A Application for Appointment of Personal

Representative

STATE OF INDIANA ) IN THE MARION SUPERIOR COURT

) SS: PROBATE DIVISION

COUNTY OF MARION ) CAUSE NO: 49D08 ______________________

IN THE MATTER OF THE )

UNSUPERVISED / SUPERVISED ) [choose one]

ESTATE OF __________________ )

APPLICATION FOR APPOINTMENT OF PERSONAL REPRESENTATIVE

[If there are Co-Personal Representatives, then

complete one form for each personal representative]

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 ____ No ____

If you do not have a High School

Education, 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.

______________________________________________________________________

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.

AFFIRMATION OF PETITIONER:

As Petitioner requesting my appointment as Personal Representative 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 decedent's estate.

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 decedent.

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

Marion County Probate Form 401.1-B Application for Appointment of Guardian

STATE OF INDIANA ) IN THE MARION SUPERIOR COURT )

SS: PROBATE DIVISION

COUNTY OF MARION ) CAUSE NO: 49D08 ___________________

IN THE MATTER OF THE GUARDIANSHIP )

OF THE ________ 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 ____ No ____

If you do not have a High School Education,

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.

_____________________________________________________________________________

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.

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

Marion County Probate Form 401.1. Petition to Appoint Personal Representative

STATE OF INDIANA ) IN THE MARION SUPERIOR COURT

) SS: PROBATE DIVISION

COUNTY OF MARION ) CAUSE NO. 49D08_____________________________

IN THE MATTER OF THE )

UNSUPERVISED / SUPERVISED ) [choose one]

ESTATE OF __________________ )

PETITION TO APPOINT PERSONAL REPRESENTATIVE,

FOR PROBATE OF WILL, AND FOR ISSUANCE OF LETTERS

Comes now ________, the Petitioner, [delete or modify the next clause depending on

whether the Petitioner is appearing in person in Court or whether he or she is a non-resident

whose attorney is appearing alone]in person and by counsel / by counsel, and respectfully

request the Court to appoint h__ as Personal Representative of the Estate of _________,

deceased, and in support thereof, states the following:

1. _________ (“the Decedent”), a__ ___married ___male, age ____, having been

born on ______, died testate on ____________, while domiciled at ______________________

_______________________ in Marion County, Indiana.

2. On ________, Decedent properly executed h___ Last Will and Testament by

executing an acknowledgment of said will and verification of its execution by _________ and

______, witnesses thereto. The original of said Last Will is attached hereto or submitted

with this Petition.

3. The Petitioner herein, _________________, is a person qualified to serve as

Personal Representative of the Estate of the Decedent in that: In Item _____ of h___ Will, the

Decedent nominated ________________________ to serve as her personal representative and as

hereinafter set forth and in the accompanying Application, is otherwise suitable qualified to serve

as a fiduciary.

4. The Petitioner’s current residence address [if an individual] business address [if a

corporate fiduciary] is as follows: _________________________________________[

5. The Petitioner is at least eighteen (18) years old and is not incapacitated by mental

or physical health impairment, or infirmity, in any manner which would interfere with the ability

to serve as a fiduciary.

6. The name, office address, attorney number, telephone number, fax number and e-mail address of the attorney for the Petitioner are as follows:

7. [As required by I.C. §29-1-10-1, if the Petitioner is a nonresident individual or

corporate fiduciary, the petition must also include the following:

a. a statement that the Petitioner accepts the appointment as fiduciary;

b. a statement providing the name, address and telephone number of the

resident agent appointed by the Petitioner to accept service of process, notices, and other

documents in the fiduciary proceeding;

c. a statement that the Petitioner has agreed to submit personally to the

jurisdiction of the Court in any proceeding that relates to the estate of the decedent or

protected person.]

8. The name, residence address, and relationship to the Decedent of each person

entitled to receive a devise, bequest, or distributive share from the Decedent’s estate are as

follows: [insert list or table]

9. To the Petitioner’s best knowledge, the Decedent’s estate is believed to be solvent

and to consist of the following assets with the following approximate market value:

A. Real Property: $ ____________

B. Motor Vehicles: ____________

C. Household Goods: ____________

D.. Other Tangible Personal Property: ____________

E. Intangible Personal Property: ____________

10. That the names and addresses of Decedent's known creditors are as follows:

11. [Delete if not applicable] Item ____ of the Decedent’s Last Will specifically

authorizes the administration of h__ estate to be unsupervised.

12. [Alternative to ¶ 11] As shown by the attached signed consents, all persons who

are named beneficiaries in the Decedent’s Last Will consent to the Court opening the estate

under unsupervised administration; consent to _______________________________ being

appointed as personal representative of the estate; and consent that the Court should require no

bond, or a minimum bond, to secure h___ performance as personal representative.

WHEREFORE, the Petitioner prays the Court for an order appointing _____as Personal

Representative of the Estate of ______, decedent, directing Letters [Testamentary / of

Administration] be issued upon the taking of an oath, and that said Petitioner be authorized to

proceed with the unsupervised administration of the decedent's estate; that bond not be required

but if it is so required it be established in the minimum amount; and for all other relief which is

proper in the premises.

I ____________ hereby affirm under the penalties for perjury that the statements in this

Petition are true and correct.

_______________________________[signature]

__________[printed name], Petitioner

_________________________[attorney signature]

Printed name of Attorney and Atty. I.D. number

Law firm name [if any]

Attorney’s mailing address

Attorney’s telephone number

Attorney’s fax number and e-mail address

Marion County Probate Form 401.2.

STATE OF INDIANA ) IN THE MARION SUPERIOR COURT

) SS: PROBATE DIVISION

COUNTY OF MARION ) CAUSE NO. 49D08\

IN THE MATTER OF ):

THE ESTATE OF )

AFFIDAVIT REGARDING ORIGINAL WILL OFFERED FOR PROBATE

ELECTRONICALLY

The undersigned hereby alleges and represents as follows:

1. Affiant concurrently is filing a petition for probate of the Last Will and Testament of

the above named Decedent and for appointment as the Personal Representative of the

estate

2. Affiant possesses Decedent's original Last Will and Testament and the copy submitted

for probate herewith is a true and accurate copy of the Will.

3. Decedent gave no indication to Affiant or anyone else, to Affiant's knowledge, of any

intention to revoke this Will.

4. Affiant will retain or deposit with the attorney for the Personal Representative the

original of the electronically filed Will until the Decedent’s estate is closed and the

Personal Representative is released from liability. If the Will is offered only to Spread the

Will of Record Affiant will retain or deposit with their attorney the original of the

electronically filed Will until the expiration of the time for filing a will contest.

5. Upon the Court's request, or as otherwise required by statute the original Last Will and

Testament will be delivered to the Court.

Further Affiant sayeth not.

I affirm under penalties of perjury that the foregoing representations are true.

______________________

Affiant

Before me, a Notary Public in and for said County and State, personally appeared

__________________________ who acknowledged the execution of the foregoing

affidavit and who, having been duly sworn, stated that any representations therein

contained are true.

Witness my hand and Notarial Seal this ____ day of ______________, ____.

____________________________________

, Notary Public

Printed

County of Residence: My Commission Expires: _____________

Marion County Probate Form 401.3 Proof of Lost Will and Affidavit

STATE OF INDIANA ) IN THE MARION SUPERIOR COURT

) SS: PROBATE DIVISION

COUNTY OF MARION ) CAUSE NO. 49D08

IN THE MATTER OF: )

)

THE ESTATE OF ) CAUSE NO. 49D08 ____________________

PROOF OF LOST WILL AND AFFIDAVIT REGARDING

WHETHER ORIGINAL WILL DESTROYED WITH INTENT TO REVOKE

The undersigned hereby alleges and represents as follows:

1. Affiant is acquainted with the affairs of the above-entitled Decedent.

2. While Affiant has not located Decedent's original Last Will and Testament, Affiant

believes that the copy submitted for probate herewith is a true and accurate copy of

Decedent's said Will as executed.

3. Decedent gave no indication to Affiant or anyone else, to Affiant's knowledge of any

intention to revoke said Will.

4. Affiant believes that Decedent did not destroy said original Will with the intent to

revoke.

Further Affiant sayeth not.

I affirm under penalties of perjury that the foregoing representations are true.

________________________

Affiant

Before me, a Notary Public in and for said County and State, personally appeared

__________________________ who acknowledged the execution of the foregoing

affidavit and who, having been duly sworn, stated that any representations therein

contained are true.

Witness my hand and Notarial Seal this ____ day of ______________, ____.

____________________________________

,Notary Public

Printed

County of Residence: My Commission Expires: _____________

Marion County Probate Form 402.2. Suggested Form of Attorney Fee Agreement

The following suggested form of engagement letter does not necessarily address

all issues (regarding the scope of the attorney’s work, the attorney-client

relationship with the fiduciary, or the determination, billing and payment of the

attorney’s fee) that should be addressed with respect to a particular estate or

guardianship.

Date

Petitioner Co-Petitioner (if any)

Address Address

RE: Estate of ___________________________________________

Dear ______________:

I am pleased that you have chosen me and my law firm to represent your interests with

respect to the matters involving the estate of ___________ (deceased) (protected person). Under

the Indiana Rules of Professional Conduct, it is advisable that we confirm in writing the terms and

conditions under which this law firm will provide services to you so that both we and you can

concentrate on the provision of the services you require.

You have agreed to pay for the legal services provided by me at the rate of $______ an

hour. From time to time, it may be necessary to also utilize the services of other professional

members of the firm in order to properly provide appropriate representation for you. Our fees for

legal services will be billed on an hourly basis according to the billing rates charged by each

attorney or paralegal of our firm. These rates currently range from $________ per hour for

beginning associates to $________ per hour for more senior associates and to $________ per hour

for partners. Paralegal time is charged at $________ per hour. These billing rates are subject to

adjustment at the beginning of a calendar year.

In matters involving supervised probate estates and guardianship estates, the Court will

determine the amount of attorneys’ fees, expenses and fees to you and our firm that it will permit

the estate to pay as costs of administration. In the event the Court authorizes fees in an amount less

than you agree to in this agreement, you (agree) (do not agree) to personally pay the difference.

Almost always, the fees and expenses we collect are in the amount authorized by the Court but

given unforeseen circumstances that may apply to this case, I cannot make that commitment at the

outset.

Our fees are not contingent in any way upon the outcome of your case, but will reflect the

uniqueness, complexity and the difficulty of obtaining the resolution of the matters at issue. Due

to the many variables which affect the time needed to provide the services you have requested, I

am unable to provide you with an estimate of your total fees.

I have requested advancement against attorney fees and expenses of _________ ($ ). In

the event of a supervised estate or guardianship, this advancement and all future advancements, if

any, may not be paid from the assets of the estate without order of the Court. That amount will be

placed into my trust account for your credit towards payment of the future fees and expenses of

this law firm. You agree to keep that amount current in my trust account so that I will always have

money in the trust account to pay on your behalf the attorney fees and expenses as they are

incurred.

The following are firm billing policies which you should know. We will provide you with

invoices on a monthly basis. The invoices will describe our services and itemize our expenses in

accordance with our standard firm policies. These invoices reflect attorney services rendered

during the month, the incurrence of litigation expenses and the current balance of your amount in

our trust account. If the statement reflects an amount due you are expected to pay the amount upon

receipt of the bill and replenish the retainer as set forth above. The bill for services rendered

represents our time devoted to your case and our expenditures made on your behalf during the

preceding month. Therefore, the services and costs may have been rendered up to thirty days or

more prior to your receipt of the bill. Expenses which you agree to pay include such items as:

________________________________________________________________

_____________________________________________________________________________.

If we anticipate that certain major expenses will be incurred, we may request that you pay these

expenses directly in advance of when they are incurred.

Payment of each invoice is due upon receipt. Subject to any limitations imposed by the

Indiana Rules of Professional Conduct, our firm will be entitled to cease work on any aspect of

this representation if any invoices are not paid within thirty (30) days after the invoice is mailed.

If any attorney fees or expenses remain unpaid by the time the bills are prepared for the following

month, we reserve the right to assess a one percent late fee on all unpaid balances. If we are

required to resort to collection proceedings to recover any amounts from you, we will also be

entitled to recover all costs incurred concerning such collection proceedings including reasonable

attorneys’ fees incurred either by us or separate counsel.

You shall have the right at any time to terminate our services and representation upon

written notice to the firm. Such termination shall not, however, relieve you of the obligation to

pay for all services rendered and costs or expenses incurred on your behalf prior to the date of such

termination. As permitted by law, we reserve the right to retain your files until all invoices have

been paid in full.

We reserve the right to ask the Court’s permission to withdraw from your representation

if, among other things, you fail to honor the terms of this engagement letter, you fail to cooperate

or follow our advice on a material matter, or any fact or circumstances would, in our view, render

our continuing representation unlawful or unethical. If we elect to withdraw from your

representation, you agree to take all steps necessary to free us of any obligation to perform further,

including the execution of any documents reasonably necessary to complete our withdrawal, and

we will be entitled to be paid for all services rendered and costs and expenses incurred on your

behalf through the date of withdrawal.

During the course of our representation of you, I encourage you to call to discuss any

questions or concerns that you may have. I have found that communication is the best means

available for avoiding misunderstanding or undue anxiety regarding a pending case. You will find

that I may not always be available to speak with you over the telephone. Commitments to other

clients, regularly scheduled court appearances, depositions and other responsibilities both within

and outside my office sometimes precludes my availability to speak with a client when such calls

are received. I have given you all of my telephone numbers and want you to feel free to try to

reach me after normal business hours.

By signing this letter, you agree with the terms of this engagement letter. I have enclosed

an additional original of this letter for your signature. Please sign in the appropriate space and

return it to me in the enclosed self-addressed, stamped envelope.

Again, I welcome the opportunity to represent you in this case. Please keep a copy of this

letter for your files.

Sincerely,

LAW FIRM

Attorney

The undersigned acknowledges that she and he have read this letter and agree to all of the terms

set forth herein.

_________________ ________________________________

Date Name

_________________ ________________________________

Date Name

Marion County Probate Form 402.4 Notice to Court and Order Setting Hearing

STATE OF INDIANA ) IN THE MARION SUPERIOR COURT

) SS: PROBATE DIVISION

COUNTY OF MARION ) CAUSE NO. 49D08_____________________________

IN THE MATTER OF: )

)

THE ESTATE/GUARDIANSHIP OF )

)

_____________________ )

NOTICE OF POSSIBLE NON-COMPLIANCE

Comes now ___________________, attorney for __________________ [fiduciary]

heretofore appointed as [guardian / personal representative] on _________________by the Court

to serve in such capacity, and, pursuant to MCPR 402.4, hereby notifies the Court that __he is

concerned that said fiduciary is not timely performing or improperly performing h___ fiduciary

duties to the [protected person or creditors and beneficiaries of the estate].

Wherefore, the Court is requested to set the matter for hearing and require the fiduciary to

personally appear and account to the Court for all actions taken or not taken by the fiduciary.

Respectfully submitted,

LAW FIRM

Attorneys for the Fiduciary

__________________________________

Attorney, #_________

Attorney Contact Information

CERTIFICATE OF SERVICE

The undersigned hereby certifies that a copy of the foregoing was served upon the

following by first class, United States mail, postage prepaid, this _____day of _______, 2_____:

Fiduciary

Address

Beneficiary

Address

Creditor

Address

__________________________________________

Attorney

STATE OF INDIANA ) IN THE MARION SUPERIOR COURT

) SS: PROBATE DIVISION

COUNTY OF MARION ) CAUSE NO. 49D08_____________________________

IN THE MATTER OF: )

)

THE ESTATE/GUARDIANSHIP OF )

)

_____________________ )

ORDER TO APPEAR FOR COMPLIANCE HEARING

This matter came before the Court on a Notice of Possible Non-Compliance filed by the

attorney for the personal representative/guardian heretofore appointed to serve by the Court in

this cause.

AND THE COURT being duly advised in the premises, hereby issues an Order that the

personal representative/guardian __________________________________ and their counsel

______________________________________ shall appear in this Court on the ______ day of

_______________________, 20____, at _______ o’clock ____.m. to report to the Court on the

actions of the personal representative/guardian in this matter.

The Clerk is hereby directed to mail a copy of this Order to the personal

representative/guardian, their attorney, the protected person and all heirs/beneficiaries and

creditors.

ALL OF WHICH IS ORDERED this ______ day of _______________, 20_____.

__________________________________________

David Certo, Judge, Marion Superior Court

Probate Division

SERVE PERSONAL REPRESENTATIVE/GUARDIAN AT:

_________________________________

SERVE ATTONEY FOR PERSONAL REPRESENTATIVE/GUARDIAN AT:

_________________________________

SERVE PROTECTED PERSON/HEIR/BENEFICIARY AT:

_________________________________

SERVE CREDITOR AT:

_________________________________

Marion County Probate Form 409.4. Attorney’s Undertaking in Guardianship

STATE OF INDIANA ) IN THE MARION SUPERIOR COURT

) SS: PROBATE DIVISION

COUNTY OF MARION ) CAUSE NO. 49D08_____________________________

IN THE MATTER OF: )

)

THE GUARDIANSHIP OF )

)

_____________________ )

DATE OF BIRTH_____________

ATTORNEY’S UNDERTAKING AND OBLIGATION IN GUARDIANSHIP

I, the undersigned guardian, having been appointed by the Probate Court of Marion

County on this date, hereby authorize attorney, _______________________________, to deposit

all of the next guardianship assets, in the amount of $ ______________________, in a bank

account or brokerage account in my name as guardian with the restriction that withdrawal of

principal or income may be made ONLY on written order of this Court.

Date: ________________ _____________________________________

Guardian

_____________________________________

Co-Guardian

I, the undersigned, as an officer of this Court, hereby assume and undertake personal

responsibility to the above-named incapacitated person and to the Court to make the restricted

deposit designated above and to deliver a copy of the Depository Institution’s Acceptance Of

Restrictions On Guardianship Account in accordance with Marion County Probate Form

413.8 (A) evidencing such restricted deposit to the Court within thirty (30) days from date or to

refund all of said funds to the Court forthwith upon demand.

Date:_________________ ________________________________

Attorney

Marion County Probate Form 409.5. Acceptance of Restrictions on Guardianship Account

STATE OF INDIANA ) IN THE MARION SUPERIOR COURT

) SS: PROBATE DIVISION

COUNTY OF MARION ) CAUSE No. 49D08_____________________________

IN THE MATTER OF: )

THE ESTATE/GUARDIANSHIP OF )

_____________________ )

DEPOSITORY INSTITUTION’S ACCEPTANCE OF RESTRICTIONS

ON GUARDIANSHIP ACCOUNT

The undersigned hereby certifies that he or she is an authorized officer or employee of a

financial institution or brokerage firm (“Undersigned Institution”) whose name appears below

and further certifies that the following account has been opened:

Type of account: _______________________________________________________________

Account number: ______________________________________________________________

Amount deposited: ____________________________________________________________

Account opened in name of: ______________________________________________________

Authorized signer on account: ____________________________________________________

The Undersigned Institution further certifies and agrees that:

1. The terms of such account include a restriction that withdrawal of principal or

interest may be made only on written order of the Marion Superior Court, Probate

Division and that the Undersigned Institution agrees to comply with said restriction and to retain

a copy of the court’s order restricting the account.

2. No funds shall be released by the Undersigned Institution unless a certified order

is tendered to the Undersigned Institution, bearing the signature of the Judge of the Court and the

seal of the Marion Superior Court 8, Probate Division.

3. If the Undersigned Institution is uncertain as to whether funds should be released,

it shall telephone the Probate Court at (317) 327-5063 with its request for instructions.

4. If a fiduciary attempts to withdraw funds without a certified court order, the

Undersigned Institution shall promptly notify the Court in writing as to the fiduciary’s attempt to

withdraw funds without a certified court order.

Date:__________________ ____________________________________

(Name of Financial Institution)

_______________________________

(Signature)

_______________________________

(Printed)

Marion County Probate Form 412.0. Instructions to Guardian of the Person with

Sample Annual Report

MARION SUPERIOR COURT – PROBATE DIVISION

GUARDIANSHIP OF _____________________________________________________

CAUSE NUMBER_____________________________

COURT’S INSTRUCTIONS TO GUARDIAN OF THE PERSON

Please read carefully before you date and sign. One copy of this form must be filed

with the Court before your appointment as guardian is confirmed by the Court. Keep a

copy for your records.

You have been appointed as the guardian of an individual who is unable to care for his or

her own personal affairs. It is important that you fully realize your duties and responsibilities.

Listed below are some of your duties.

You should be represented at all times by an attorney of record. Your attorney is

required to notify the Court if you are not properly performing your duties to the protected

person. By signing these Instructions you agree that the filing of that notice does not violate the

attorney-client privilege. If the Court receives such notice it will set the matter for hearing and

require you to personally appear and account to the Court for all actions taken or not taken by

you as guardian.

The Instructions which follow are to be considered by you as Orders of the Court which

require you to perform as directed. The Court appreciates your efforts on behalf of the protected

person.

David Certo,

Judge, Marion Superior Court

Probate Division

As Guardian of the person, you have the following duties and authority:

1. You must be or become sufficiently acquainted with the protected person and maintain

sufficient contact with the protected person to know his or her capabilities, disabilities,

limitations, needs, opportunities, and physical and mental health.

2. You are responsible to make sure the protected person has an adequate place to live that

is appropriate for the protected person’s needs. You can decide where the protected

person will live. You must obtain approval of the Court before you move the protected

person to another residence or health facility that is more than fifty miles away.

3. You are responsible to make sure that the protected person receives needed and

appropriate medical care. You can consent to medical or other professional care and

treatment for the protected person’s health and welfare. You can consent to the protected

person’s admission to a health care facility.

4. You shall, to the extent possible, encourage and promote the self-reliance and

independence of the protected person.

5. You can, to the extent that the protected person is able, delegate to the protected person

certain responsibilities for decisions affecting the protected person’s well-being.

6. You or your attorney must notify the Court if your address changes.

7. You must file a report with the Court at least every two years. The report must state the

present residence of the protected person and a statement of the protected person’s

current condition and general welfare. A sample report form is attached. Failure to file

the report may result in your removal as guardian.

I authorize my attorney to notify the Court in the event that he or she has reason to

believe that I am not timely performing or am improperly performing my duties to the

protected person even if such information would be otherwise confidential.

I acknowledge that I have carefully and completely read the above instructions and

received a copy for my records. I agree to properly carry out my duties.

Dated this _________day of _________________________________, 20 _____.

_______________________________ ___________________________________

Signature, Guardian Signature, Guardian

_______________________________ ___________________________________

Print, Guardian Print, Guardian

I acknowledge that I have carefully and completely discussed the above instructions

with my client before this form was signed and believe that he or she is fully aware of and

capable of performing the duties required of a guardian of the estate.

_______________________________ ___________________________________

Signature, Attorney Signature, Attorney

_______________________________ ___________________________________

Print, Attorney Print, Attorney

MARION SUPERIOR COURT – PROBATE DIVISION

GUARDIANSHIP OF _____________________________________________________

CAUSE NUMBER_____________________________

REPORT OF GUARDIAN OF PERSON

The undersigned, _____________________________, as guardian of the person of

______________________________ [name of protected person], respectfully reports:

1. List the protected person’s current address: _______________________________

2. What type of residence is this? [House, apartment, nursing home, etc.] ___________

3. What is the protected person’s current condition and health? ___________________

_________________________________________________________________

4. When did you, the Guardian, last personally see the protected person? ____________

____________________________________________________

5. Does the guardianship of the person of the protected person need to remain in effect?

____________ If not, why not? ___________________________________________

I affirm, under the penalties of perjury, that the above statements are true.

Dated: _________________________ ___________________________________

Signature of Guardian

___________________________________

Printed Name of Guardian

___________________________________

Guardian’s Address

___________________________________

Guardian’s Telephone Number

Marion County Probate Form 412.1. Instructions to Guardian of Estate

MARION SUPERIOR COURT – PROBATE DIVISION

GUARDIANSHIP OF _____________________________________________________

CAUSE NUMBER_____________________________

COURT’S INSTRUCTIONS TO GUARDIAN OF ESTATE

Please read carefully before you date and sign. One copy of this form must be filed

with the Court before your appointment as guardian is confirmed by the Court. Keep one

copy for your records.

Introduction:

You have been appointed as the guardian of an individual who is unable to care for his or

her own financial affairs. It is important that you fully realize your duties and responsibilities.

Listed below are some of your duties, but not all of them.

You must be represented at all times by an attorney of record. Your attorney is required to

reasonably supervise and guide your actions as guardian unless and until that attorney is permitted

by order of the Court to withdraw from representing you.

Your attorney is required to notify the Court in the event that you are not timely

performing or improperly performing your fiduciary duties to the protected person, and by

signing these Instructions you agree that the filing of that notice does not violate the attorney-client privilege. If the Court receives such notice, it will set the matter for hearing and will

require you to personally appear and account to the Court for all actions taken or not taken by

you as guardian. You are required to notify the Court in writing in the event that your attorney is

not timely performing or improperly performing his or her duties to reasonably supervise and

guide your actions as guardian. Upon receipt of the notice, the Court will set the matter for

hearing and require you and your attorney to personally appear and account to the Court for all

actions taken or not taken by the attorney.

The Instructions which follow are to be considered by you as Orders of the Court which

require you to perform as directed. Although your attorney will file all papers with the Court, the

ultimate responsibility to see that all accounts and other documents are accurately prepared and

filed, rests with you and you can be found personally liable should you not properly perform.

The Court appreciates your efforts on behalf of the protected person.

David Certo,

Judge, Marion Superior Court

Probate Division

As Guardian you are required to:

1. Locate, collect and maintain all property owned by the protected person. Keep motor

vehicles and real estate insured and protected.

2. Have your attorney file with the Court, within ninety (90) days after your appointment,

a verified inventory and appraisal of all the property belonging to the protected person,

with values as of the date you were appointed. You must provide a copy of the

inventory to the protected person (if over fourteen (14) years of age) and to certain

other persons as set out in Indiana Code §29-3-9-5.

3. Have your attorney file with the Court a verified current account of all the income and

expenditures of the guardianship every two (2) years after your appointment, consisting

of three schedules. The first schedule must include all assets listed on the inventory or

on the last current account along with any additions or adjustments to the inventory.

The second schedule must be an itemized list of expenditures, supported by attached

cancelled checks or facsimiles of paid checks as evidence of payment. The third

schedule must be a recapitulation indicating the remaining property after subtracting

expenditures.

4. Pay bond premiums as they become due.

5. File and pay taxes on the protected person’s income and assets.

6. Have your attorney file a final accounting with the Court upon the termination of the

guardianship, whether due to the death of the protected person, or for any other reason.

7. Keep all of the assets of the protected person separate from your own. Guardianship

funds should never be co-mingled with personal funds. Unauthorized use of the

guardianship funds will result in personal liability.

8. Open a guardianship checking account in your name “as guardian of (the protected

person)” This account shall be used for all payments or disbursements on behalf of the

protected person. The account should be in the protected person’s Social Security

number, not yours. It cannot be a joint account. Make sure that the financial institution

you are utilizing will provide you with cancelled checks or images of paid checks and

evidence of payments made from the account..

9. Real estate, automobiles and other accounts and investments should be held in the name

of the protected person.

10. All investment accounts and other bank account holdings should be retitled as follows:

“John Smith Guardianship, Mary Jones Guardian.”

11. Obtain approval from the Court to use guardianship assets, other than for normal bills.

12. Do not self-deal. Do not buy anything from or sell anything to the protected person. Do

not borrow anything from the protected person.

13. If applicable, timely qualify the protected person for Medicaid or other public

assistance.

14. It is the duty of the guardian to protect and preserve the protected person’s property, to

account for the use of the property faithfully, and to perform all the duties required by

law of a guardian.

15. The guardian has the same duties and responsibilities concerning the protected person

whether or not the protected person is a relative of the guardian.

16. NEVER pay attorney fees or compensation to yourself from assets of the guardianship

without first obtaining the advance written approval of the Court.

17. If any questions arise during the guardianship, immediately consult with your attorney.

I authorize my attorney to notify the Court in the event that he or she has reason to

believe that I am not timely performing or improperly performing my fiduciary duties to the

protected person even if such information would be otherwise confidential.

I acknowledge that I have carefully and completely read the above instructions and

received a copy for my records. I agree to properly carry out my duties.

Dated this _________day of _________________________________, 20 _____.

_______________________________ ___________________________________

Signature, Guardian Signature, Guardian

_______________________________ ___________________________________

Print, Guardian Print, Guardian

I acknowledge that I have carefully and completely discussed the above instructions

with my client before this form was signed and believe that he or she is fully aware of and

capable of performing the duties required of a guardian of the estate.

_______________________________ ___________________________________

Signature, Attorney Signature, Attorney

_______________________________ ___________________________________

Print, Attorney Print, Attorney

Marion County Probate Form 412.2. Instructions to Personal Representative of Supervised Estate

MARION SUPERIOR COURT – PROBATE DIVISION

SUPERVISED ESTATE OF _____________________________________________________

CAUSE NUMBER_____________________________

COURT’S INSTRUCTIONS TO PERSONAL REPRESENTATIVE

OF SUPERVISED ESTATE

Please read carefully before you date and sign. One copy of this form must be filed with the

Court before your appointment as personal representative is confirmed by the Court. Keep one copy

for your records.

Introduction:

You have been appointed as the personal representative of the estate of a deceased person. By your

appointment, the Court has placed in you the highest trust that you will perform your duties in the best

interests of all beneficiaries and creditors of the estate. It is important that you fully realize your duties and

responsibilities. Listed below are some, but not all of them.

You must be represented at all times by an attorney of record. Your attorney is required to

reasonably supervise and guide your actions as personal representative unless and until that attorney is

permitted by order of the Court to withdraw from representing you.

Your attorney is required to notify the Court in the event that you are not timely performing or

improperly performing your fiduciary duties to the beneficiaries and creditors of the estate and by signing

these Instructions, you agree that the filing of that notice does not violate the attorney-client privilege. If

the Court receives such notice, it will set the matter for hearing and require you to personally appear and

account to the Court for all actions taken or not taken by you as personal representative. You are required

to notify the Court in writing in the event that your attorney is not timely performing or improperly

performing his or her duties to reasonably supervise and guide your actions as personal representative.

Upon receipt of the notice, the Court will set the matter for hearing and require you and your attorney to

personally appear and account to the Court for all actions taken or not taken by the attorney.

The Instructions which follow are to be considered by you as Orders of the Court which require you

to perform as directed. Although your attorney will file all papers with the Court, you, as personal

representative, are ultimately responsible to see that the estate is properly and promptly administered, and

you are personally liable for incorrect distributions, payments, or acts, as well as any unpaid taxes or costs

of administration. The Court appreciates your efforts on behalf of the estate.

David Certo

Judge, Marion Superior Court

Probate Division

As Personal Representative, you are required to:

1. Locate, collect and maintain all property owned by the decedent.

2. Keep motor vehicles and real estate insured and protected.

3. Immediately fill out a change of address at the post office to have the decedent’s mail

forwarded to you.

4. No later than two (2) months after your appointment, have your attorney file in this Court

an inventory describing all property belonging to the estate, with date of death values, and forthwith serve

a copy of the inventory on all known heirs, beneficiaries or distributees of the estate.

5. Estate Checking Account.

A. Open a separate checking account in your name “as personal representative for the estate of

(the decedent).” Obtain a federal tax I.D. number for the checking account. Do not use your Social

Security number or decedent’s Social Security number.

B. DO NOT put any of your funds or anyone else’s funds in this account.

C. Always pay for estate expenses by checks from this account. Do not pay any expenses with

cash.

D. Make sure that the bank is willing to return cancelled checks or electronic versions of the

checks to you.

E. Keep records of all deposits including the identity of the person or entity paying the money

into the estate.

6. Determine all debts that the decedent owed. Look through decedent’s tax returns and other

papers. Talk to anyone who knew decedent’s business. Consult your attorney as to payment of debts, costs

of administration, bond premiums, and funeral bills. Some debts may be unenforceable. Some may have

priority over others.

7. Have your attorney provide written notice of the administration of the estate to all known

creditors of the estate.

8. If the decedent owned a business or was involved in contracts which were not yet fully

performed, have your attorney obtain directions from the Court as to those matters.

9. DO NOT MAKE any distribution of personal property or real estate to an heir or devisee

without prior Court order.

10. NEVER borrow estate property or put it to your own personal use.

11. Prepare and file income tax returns for the tax year in which the decedent died and any

returns for prior years if needed. Timely prepare and file any estate, inheritance or fiduciary tax returns and

pay taxes as they come due.

12. Accounting. Indiana law requires the estate to be closed within one (1) year of your

appointment as personal representative. Before the estate can be closed, you must file with the Court a final

accounting of your actions as personal representative.

A. Have your attorney file your final accounting, consisting of three (3) schedules, after the

administration of the estate has been completed.

B. The first schedule must include all assets listed on the inventory, any income and additional

assets obtained during administration, and any adjustments to the inventory.

C. The second schedule must be an itemized list of expenditures. Documentation for each

expense shall include: (a) the payee; (b) check number or other identifying number on the instrument;

the payee, a description of the reason for the disbursement sufficient to substantiate the reason for the

disbursement as part of the administration of the estate. Cancelled checks or facsimile copies of paid

checks for each expenditure must be attached as evidence of payment.

D. The third schedule must be a recapitulation indicating the remaining estate property after

subtracting expenditures. A proposed distribution must be furnished to all interested parties, including

heirs.

13. After the Court approves your final account, make distribution to the proper people and file

a supplemental report with the Court, attaching receipts.

14. Notify the Court and your attorney of any change in your address or telephone number.

15. NEVER pay yourself or your attorney any fees from assets of the estate without a prior

Court Order, unless your attorney confirms to you that the law or local court rules allow you to reimburse

yourself from estate assets for necessary expenses that you previously paid with your personal funds.

16. Keep a record of the time you spend working on the estate. You are entitled to a reasonable

fee, unless you waive a fee. Time records will help the Court determine your fee.

17. Always contact your attorney for advice if you are unsure as to any act as personal

representative. Have your attorney counsel you in relation to the estate and explain anything that you do

not fully understand.

18. Do not sell an estate asset without prior Court Order unless the Will, in very specific terms,

authorizes sale without court order. Consult your attorney about this.

I authorize my attorney to notify the Court in the event that he or she has reason to believe

that I am not timely performing or improperly performing my fiduciary duties to the beneficiaries

and creditors of the estate even if such information would be otherwise confidential.

I acknowledge that I have carefully and completely read the above instructions and received

a copy for my records. I agree to properly carry out my duties.

Dated this _________day of _________________________________, 20 _____.

_______________________________ ___________________________________

Signature, Personal Representative Signature, Personal Representative

_______________________________ ___________________________________

Print, Personal Representative Print, Personal Representative

I acknowledge that I have carefully and completely discussed the above instructions with my

client before this form was signed and believe that he or she is fully aware of and capable of

performing the duties required of a personal representative of a supervised estate.

_______________________________ ___________________________________

Signature, Attorney Signature, Attorney

_______________________________ ___________________________________

Print, Attorney Print, Attorney

Marion County Probate Form 412.3. Instructions to Personal Representative of

Unsupervised Estate

MARION SUPERIOR COURT – PROBATE DIVISION

SUPERVISED ESTATE OF _____________________________________________________

CAUSE NUMBER_____________________________

COURT’S INSTRUCTIONS TO PERSONAL REPRESENTATIVE

OF UNSUPERVISED ESTATE

Please read carefully before you date and sign. One copy of this form must be filed

with the Court before your appointment as personal representative is confirmed by the

Court. Keep one copy for your records.

Introduction:

You have been appointed as the personal representative of the estate of a deceased person.

By your appointment, the Court has placed in you the highest trust that you will perform your

duties in the best interests of all beneficiaries and creditors of the estate. It is important that you

fully realize your duties and responsibilities. Listed below are some, but not all of them.

You must be represented at all times by an attorney of record approved to so act by written

order of the Court. Your attorney is required to reasonably supervise and guide your actions as

personal representative unless and until that attorney is permitted by order of the Court to withdraw

from representing you.

Your attorney is required to notify the Court in the event that you are not timely

performing or improperly performing your fiduciary duties to the beneficiaries and creditors of

the estate and by signing these Instructions you agree that the filing of that notice does not

violate the attorney-client privilege. If the Court receives such notice it will set the matter for

hearing and require you to personally appear and account to the Court for all actions taken or not

taken by you as personal representative. You are required to notify the Court in writing in the

event that your attorney is not timely performing or improperly performing their duties to

reasonably supervise and guide your actions as personal representative. Upon receipt of the

notice, the Court will set the matter for hearing and require you and your attorney to personally

appear and account to the Court for all actions taken or not taken by the attorney.

The Instructions which follow are to be considered by you as Orders of the Court which

require you to perform as directed. Although your attorney will file all papers with the Court, you,

as personal representative, are ultimately responsible to see that the estate is properly and promptly

administered, and you are personally liable for incorrect distributions, payments, or acts, as well

as any unpaid taxes or costs of administration.

The Court appreciates your efforts on behalf of the estate.

David Certo

Judge, Marion Superior Court

Probate Division

As personal representative, you are required to:

1. Locate, collect and maintain all property owned by the decedent.

2. Keep motor vehicles and real estate insured and protected.

3. Immediately fill out a change of address at the post office to have the decedent’s

mail forwarded to you.

4. Within two (2) months of your appointment you must either:

A. file with the Court an inventory conforming with the requirements of I.C. 29-1-7.5-

3.2 (b) and forthwith serve a copy of the inventory on all known heirs, beneficiaries or

distributees of the estate, or,

B. file with the Court a verified certification that an inventory conforming with the

requirements of I.C. 29-1-7.5-3.2 has been prepared, that it is available to be furnished to

distributees on request and that notice of preparation of the inventory and its availability has

been forthwith served on all known heirs, beneficiaries or distributees.

5. Estate Checking Account.

A. Open a separate checking account in your name “as personal representative for the

estate of (the decedent).” Obtain a federal tax I.D. number for the checking account. Do not

use your Social Security number or decedent’s Social Security number.

B. DO NOT put any of your funds or anyone else’s funds in this account.

C. Always pay for estate expenses by checks from this account. DO NOT pay any

expenses with cash..

D. Make sure that the bank is willing to return cancelled checks or electronic copies

or digital images of the paid checks to you.

E. Keep records of all deposits, including the identity of each person or entity paying

the money into the estate.

6. Determine all debts that the decedent owed. Look through decedent’s tax returns

and other papers. Talk to anyone who knew decedent’s business. Consult your attorney as to

payment of debts, costs of administration, bond premiums, and funeral bills. Some debts may be

unenforceable. Some may have priority over others.

7. Have your attorney provide written notice of the administration of the estate to all

known creditors of the estate.

8. NEVER borrow estate property or put it to your own personal use.

9. DO NOT distribute any estate assets until assets (including personal property) are

appraised, and consult with your attorney prior to making any distribution.

10. Prepare and file income tax returns for the tax year in which the decedent died and

any returns for prior years if needed. Timely prepare and file any estate, inheritance or fiduciary

tax returns and pay taxes as they come due.

11. After you fully complete the estate administration, you must file a closing

statement with the Court verifying that all proper claims, expenses and taxes have been paid, that

all assets have been properly distributed, and that a copy of the closing statement has been sent to

all distributes, fully accounting for all assets, expenses and distributions made to the heirs.

12. Notify the Court and your attorney of any change in your address or telephone

number.

13. Keep a record of the time you spend working on the estate. You are entitled to a

reasonable fee, unless you waive a fee. Time records will help the Court determine your fee.

14. Always contact your attorney for advice if you are unsure as to any act as personal

representative. Have your attorney counsel you in relation to the estate and explain anything that

you do not fully understand.

I authorize my attorney to notify the Court in the event that he or she has reason to

believe that I am not timely performing or improperly performing my fiduciary duties to the

beneficiaries and creditors of the estate even if such information would be otherwise

confidential.