FORM FOR USE IN PETITION FOR APPOINTMENT OF GUARDIAN ADVOCATE OF THE PERSON UNDER FLORIDA PROBATE RULE 5.649
In the Circuit Court of the
__________________Judicial
Circuit,
in and for ________________
County, Florida
Probate Division
Case No.____________________
In Re: Guardianship Advocacy of
_______________________________
Respondent's Name
Person with Developmental Disability
_______________________________
PETITION FOR APPOINTMENT OF GUARDIAN ADVOCATE OF THE PERSON
Petitioner,_______________________________, files this petition under section 393.12, Florida Statutes, and Florida Probate Rule 5.649 and alleges that:
( ) i. intellectual disability;
( ) ii cerebral palsy;
( ) iii. autism;
( ) iv. spina bifida;
( ) v. Down syndrome;
( ) vi. Phelan-McDermid syndrome; or
( ) vii. Prader-Willi syndrome,
which manifested before the age of 18.
_______________________________
( ) a. to apply for government benefits;
( ) b. to determine residency;
( ) c. to consent to medical and mental health treatment;
( ) d. to make decisions about social environment/social aspects of life;
( ) e. to make decisions regarding education; and
( ) f. to bring an independent action for support.
Name | Address | Relationship |
_____________ | _____________ | _____________ |
_____________ | _____________ | _____________ |
_______________________________
_______________________________
______________________________________________________________
______________________________________________________________
_______________________________
_______________________________
The relationship and previous association of the proposed co-guardian advocate to the respondent is _________________. The proposed co-guardian advocate should be appointed because:________________
_______________________________
_______________________________
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:______________________
Proposed Guardian Advocate
Name:______________________
Address:______________________
______________________________
Phone Number:______________________
E-mail Address:______________________
Signature:______________________
Proposed Co-Guardian Advocate
Name:______________________
Address:______________________
________________
Phone Number:______________________
E-mail Address:______________________
FORM FOR NOTICE OF FILING OF A PETITION FOR APPOINTMENT OF GUARDIAN ADVOCATE OF THE PERSON UNDER SECTION 393.12(4), FLORIDA STATUTES, AND NOTICE OF HEARING
In the Circuit Court of the
__________________Judicial
Circuit,
in and for_______________
County, Florida
Probate Division
Case No._______________
In Re: Guardian Advocacy of
______________________
Respondent's Name
Person with Developmental Disability
______________________
NOTICE OF FILING OF A PETITION FOR APPOINTMENT OF GUARDIAN ADVOCATE AND NOTICE OF HEARING
TO: .....(Respondent)....., .....(attorney for respondent)....., .....(next of kin)....., .....(healthcare surrogate)....., and .....(agent under durable power of attorney).....
YOU ARE NOTIFIED that a petition for appointment of guardian advocate of the person has been filed. A copy of the petition for appointment of guardian advocate of the person is attached to this notice. There will be a hearing on the petition as follows:
You are to appear before the Honorable ...................., Judge, at.....(time) ....., on .....(date)....., at the county courthouse of .................... County, in ...................., Florida for the hearing of this petition.
The reason for this hearing is to inquire into the capacity of the respondent, the person with a developmental disability, to exercise the rights enumerated in the petition. (See § 744.102(12)(b), Fla. Stat.)
The respondent has the right to be represented by counsel of the respondent's own choice and the court has initially appointed the following attorney to represent the respondent:
Attorney for the respondent: .....(name)....., .....(address)....., .....(phone)....., .....(e-mail)......
Respondent has the right to substitute an attorney of the respondent's own choice in place of the attorney appointed by the court.
Signed .....(date)......
Signature:______________ | Signature:________________ |
Proposed Guardian Advocate Name:______________ | Proposed Co-Guardian Advocate (if any) Name:______________ |
Address:______________ ______________ | Address:______________ ______________ |
Phone Number:______________ | Phone Number:______________ |
E-mail Address:______________ | E-mail Address:______________ |
CERTIFICATE OF SERVICE
I CERTIFY that a copy of the foregoing notice of filing petition to appoint guardian advocate and notice of hearing and a copy of the petition for appointment of guardian advocate of the person was served on all persons indicated above, including on the attorney for the respondent, on .....(date)......
Signature:________________ | Signature:________________ |
Proposed Guardian Advocate Name:________________ | Proposed Co-Guardian Advocate (if any) Name:________________ |
Address:________________ | Address:________________ |
Phone Number:________________ | Phone Number:________________ |
E-mail Address:________________ | E-mail Address:________________ |
If you are a person with a disability who needs any accommodation in order to participate in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact [identify applicable court personnel by name, address, and telephone number] at least 7 days before your scheduled court appearance, or immediately upon receiving this notification if the time before the scheduled appearance is less than 7 days; if you are hearing or voice impaired, call 711.
In the Circuit Court of the
______________Judicial
Circuit,
in and for ___________
County, Florida
Probate Division
Case No.______________________
In Re: Guardianship of
_____________________________
Respondent's Name
Person with Developmental Disability
_____________________________
ORDER APPOINTING GUARDIAN ADVOCATE
On consideration of the petition for the appointment of guardian advocate of the person, the court finds that .....(respondent's name).....has a developmental disability of a nature that requires the appointment of guardian advocate of the person based on the following findings of fact and conclusions of law:
_____________________________
_________________________________
_________________________________
_________________________________
( ) a. to apply for government benefits;
( ) b. to determine residency;
( ) c. to consent to medical and mental health treatment;
( ) d. to make decisions about social environment/social aspects of life;
( ) e. to make decisions regarding education; and
( ) f. to bring an independent action for support.
ORDERED AND ADJUDGED:
ORDERED this .....(date)......
_____________
Judge
Fl. Prob. R. 5.905