PETITION FOR GUARDIANSHIP OF AN ADULT AG-2

Transcription

1 Second Judicial District Court of the State of Nevada, Washoe County PETITION FOR GUARDIANSHIP OF AN ADULT AG- The District Court Filing Office is located on the first floor at: Court Street Reno, NV 901

2 Do Not Copy Or File This Page PETITION FOR GUARDIANSHIP OF AN ADULT PACKET AG- INSTRUCTIONS FOR COMPLETING FORMS CAREFULLY READ ALL INSTRUCTIONS BEFORE STARTING TO FILL OUT ANY OF THE FORMS. Use black or blue ink only. Neatly print or type the information requested. Do not use correction fluid/tape on the forms. This packet contains the following forms: 1. Petition for Guardianship of An Adult. Index of Exhibits and Exhibit Cover Pages. Physician s Certificate with Needs Assessment (to be filled out by Physician). Preliminary Plan of Care. Preliminary Cost of Care. Required Identification Sheet. efile User Agreement. Citation to Appear and Show Cause 9. Proof of Service 10. Acknowledgement of Duties and Responsibilities of a Guardian of the Person 11. Acknowledgment of Duties and Responsibilities of a Guardian of the Estate 1. Letters of Guardianship 1. Definitions of Terms The forms are set up for two petitioners. If there is only one person petitioning for guardianship, please print n/a wherever the form asks for information about the second petitioner. The penalty for willfully making a false statement under penalty of perjury is a minimum of 1 year, and a maximum of years in prison, in addition to a fine of not more than $, N.R.S REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

3 Do Not Copy Or File This Page INSTRUCTIONS: STEP 1 Complete the Petition as Shown: You must attach a copy of the Physician s Certificate as Exhibit 1, the Plan of Care as Exhibit, and the Cost of Care as Exhibit. Explain in your Petition how any attached documents support your Petition. If you have other documents that support your Petition for Guardianship, attach copies of the documents to your Petition as exhibits (see INSTRUCTIONS: STEP ). 1) Print your name, address, telephone number, and . ) Check the box for the correct type of guardianship. Print the name and date of birth of the Proposed Protected Person, (formerly known as the Ward). You will be assigned a Case No. when you file the Petition with the Court. ) Check the box(es) for the correct type of guardianship (see Definitions). ) Complete pages 1-1, following the instructions on each page. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

4 1 Code: 0 Name: Address: Telephone: Self-Represented Litigant IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF WASHOE In the Matter of the Guardianship of The Person only The Estate only The Person and the Estate (Print Name of Proposed Protected Person) DOB:, Proposed Protected Person. /, Case No. Dept. No. PETITION FOR: GENERAL GUARDIANSHIP -OR- SPECIAL GUARDIANSHIP WITH LIMITED AUTHORITY OF THE PERSON -OR- ESTATE -OR- PERSON AND ESTATE Preliminary Information Provide the information requested in each question below. If more room is needed, attach additional sheets. 1. Circumstances: Why does the Proposed Protected Person need a guardianship? REV 09/01 JDB 1 AG PETITION

5 1. Alternatives to Guardianship: Why are less restrictive means such as: a Trust; Power of Attorney; Supported Decision Making Agreement; Representative Payee Designation; or something else not being used? a. Is there a Durable Power of Attorney for Health Care: YES -OR- NO. If yes: Who is designated as primary agent? Who was nominated as a guardian? What specific authority in the power of attorney should remain with the primary agent? b. Is there a Durable Power of Attorney for Financial Matters: YES -OR- NO. If yes: Who is designated as primary agent? Who was nominated as a guardian? What specific authority in the power of attorney should remain with the primary agent? c. Does the proposed protected person have any other document stating who they would prefer to have as guardian: YES -OR- NO. If yes: Who is the preferred guardian? REV 09/01 JDB AG PETITION

6 1. Guardianship Necessity: What do the Proposed Guardian(s) hope to be able to do as a guardian that he/she/they cannot do now?. Opposition to Guardianship: Who, including the Proposed Protected Person, might oppose this request for guardianship and why? Authority Requested: Specifically, what authority, if any, are you requesting to manage the Proposed Protected Person s estate? For example: investments, loans, business transactions, contracts, sale or lease of property, etc. a. b. c. d.. Your suitability as a guardian: Why should you and any other Proposed Guardian be the Guardian(s)?. Is this Petition being filed as the result of an investigation of a report of abuse, neglect, exploitation, isolation or abandonment of the Proposed Protected Person? YES -OR- NO If yes, what is the name of the agency that investigated? REV 09/01 JDB AG PETITION

7 1. Are you requesting guardianship for the purpose of initiating litigation? YES -OR- NO 9. Other Information: What other information would you like the Court to know? Proposed Protected Person s Preferences: What do you think the Proposed Protected Person s preferences are regarding the following areas: a. Who would be appointed guardian? b. Where would the Proposed Protected Person live? c. Who would live with the Proposed Protected Person? d. Would the Proposed Protected Person operate a motor vehicle? YES -OR- NO e. What personal support services would the Proposed Protected Person prefer? f. Where would the Proposed Protected Person receive medical services and from whom? Additional Requests Place an X in a box to select the options below. You may select more than one box. 11. The following additional requests are included in this Petition if checked: a. Authority to Deal with Personal Property: Permission to sell, donate, distribute, dispose of, and/or abandon or distribute to family members, personal property deemed necessary and proper to maintain the integrity of the Proposed Protected Person s estate so long as REV 09/01 JDB AG PETITION

8 1 such property is not named or included in any estate planning document. b. Guardian s Fees and Costs: The Court consider for approval at the permanent hearing the proposed guardian s fees as shown: c. Request for Court-Directed Mediation: The Court is requested to direct that any parties contesting this Petition enter into mediation prior to a hearing on the Petition. d. Request Regarding Guardian s Bond: In considering the amount of bond to be required of the Proposed Guardian(s), or whether access to the Proposed Protected Person s accounts should be Blocked in lieu of requiring a bond, please state your relationship to the Proposed Protected Person: MARRIAGE, FOR YEARS -OR- RELATIVE, (How are you related? Brother, sister, parent, aunt, etc.) -OR- NO BOND SHOULD BE REQUIRED FOR THE FOLLOWING REASON: 1. First Proposed Guardian s Information: a. Name (Number of) Statutory Requirements to Appoint a Guardian Under Provide the information requested. If more room is needed, attach additional sheets. REV 09/01 JDB AG PETITION

9 Date of birth Nevada Resident: YES -OR- NO Address Phone ( ) Relationship to Proposed Protected Person b. Proposed Guardian IS NOT -OR- IS receiving compensation as guardian to more than one protected person who is not related by blood or marriage. c. Has the Proposed Guardian been convicted of a felony? YES -OR- NO d. Has the Proposed Guardian been suspended or disbarred from any organization involving investments, securities or property? YES -OR- NO e. Has the Proposed Guardian been found by clear and convincing evidence to have committed abuse, neglect, or exploitation of a child, spouse, parent or other adult? YES -OR- NO f. Is the Proposed Guardian a party to a civil or criminal proceeding? 1 YES -OR- NO g. Has the Proposed Guardian filed bankruptcy in the last seven () years? YES -OR- NO 1. Second Proposed Guardian s Information (write n/a in the blanks if there is only one): a. Name Date of birth Nevada Resident: YES -OR- NO Address Phone ( ) Relationship to Proposed Protected Person b. Proposed Guardian IS NOT -OR- IS receiving compensation as guardian to more than one protected person who is not related by blood or marriage. REV 09/01 JDB AG PETITION

10 c. Has the Proposed Guardian been convicted of a felony? YES -OR- NO d. Has the Proposed Guardian been suspended or disbarred from any organization involving investments, securities or property? YES -OR- NO e. Has the Proposed Guardian been found by clear and convincing evidence to have committed abuse, neglect, or exploitation of a child, spouse, parent or other adult? YES -OR- NO f. Is the Proposed Guardian a party to a civil or criminal proceeding? YES -OR- NO h. Has the Proposed Guardian filed bankruptcy in the last seven () years? YES -OR- NO 1. Proposed Protected Person s Information: Name: Aliases: Date of birth: Current Residence Address: Caregiver: Nevada Resident since when (include date)? Age: 1 Is the Proposed Protected Person a Veteran? YES -OR- NO Is the Proposed Protected Person receiving Medicaid? YES -OR- NO If no, is the Proposed Protected Person eligible for Medicaid? YES -OR- NO 1. The Proposed Protected Person s Relatives. To the extent known by the Proposed Guardian(s), the names and addresses of the surviving relatives of the Proposed Protected Person who are within the second degree of consanguinity are as follows: // REV 09/01 JDB AG PETITION

11 a. Parents: DECEASED -OR- NAMED BELOW -OR- UNKNOWN: i. Name: Address: ii. Name: Address: b. Spouse: DECEASED -OR- NONE -OR- NAMED BELOW -OR- UNKNOWN: i. Name: Address: Married years. c. Surviving siblings: NONE -OR- NAMED BELOW -OR- UNKNOWN: i. Name: Address: ii. Name: Address: iii. Name: Address: iv. Name: Address: d. Surviving children: NONE -OR- NAMED BELOW -OR- UNKNOWN: i. Name: Address: ii. Name: Address: REV 09/01 JDB AG PETITION

12 iii. Name: Address: iv. Name: Address: e. Surviving grandparents: NONE -OR- NAMED BELOW -OR- UNKNOWN: i. Name: Address: ii. Name: Address: iii. Name: Address: iv. Name: Address: f. Grandchildren over age 1: NONE -OR- NAMED BELOW -OR- UNKNOWN: i. Name: Address: ii. Name: Address: iii. Name: Address: iv. Name: Address: REV 09/01 JDB 9 AG PETITION

13 Physician s Certificate: Attached as Exhibit #1 is a Physician s Certificate prepared by Dr. on (date). 1. Plan of Care: Attached as Exhibit # is a Preliminary Plan of Care. 1. Cost of Care: Attached as Exhibit # is a Preliminary Cost of Care. 19. Guardianship of the Estate Supporting Information: If a guardianship of the estate is sought by Proposed Guardian(s), the following supporting information about the Proposed Protected Person s presently known income and assets shall be provided: a. Income. Proposed Guardian(s) believe that the Proposed Protected Person receives monthly income in the following amounts: i. Social Security/SSI.. $ ii. Veteran s Monthly Benefit.. $ iii. Pension:... $ iv. Other: $ TOTAL MONTHLY INCOME. $ b. Representative Payee. Are there benefits payable for the Proposed Protected Person that are paid to a Representative Payee? YES -OR- NO -OR- UNKNOWN If yes, who is the Representative Payee? c. Assets. Proposed Guardian(s) believe that the Proposed Protected Person owns (or has a community interest in) the following assets (print only the last four digits of bank account numbers): i. Checking Acct #. $ ii. Saving(s) Acct #. $ iii. Trust:... $ iv. Other:... $ v. IDENTIFIABLE ASSETS (Home, Car, etc.). $ REV 09/01 JDB 10 AG PETITION

14 d. Is the proposed protected person the beneficiary of a Trust? YES -OR- NO -OR- I DON T KNOW Summary Administration If Summary Administration should apply, place an X in a box to select the option below. 0. Summary Administration: The Proposed Protected Person s assets are anticipated to be less than ten thousand dollars ($10,000.00). It is believed to be in the Proposed Protected Person s best interests that the Court order this case to be treated as a Summary Administration and dispense with annual accountings and the final account at the termination of the guardianship. WHEREFORE, Proposed Guardian(s) request that the Court enter its Order as follows: 1. If Co-Guardians are appointed, that they be authorized to act unilaterally and independently of each other with respect to making decisions;. The Proposed Guardian(s) be appointed as the GENERAL GUARDIANS -OR- SPECIAL GUARDIANS of the PERSON -OR- ESTATE -OR- PERSON AND ESTATE of the Proposed Protected Person;. Letters of Guardianship be issued to the Proposed Guardian(s) upon the taking of the oath of office as required by law;. That the Proposed Preliminary Plan of Care and Preliminary Cost of Care be approved;. The Proposed Guardian(s) be granted the authority requested to act as needed to provide for the Proposed Protected Person;. The Court grant the relief requested in this Petition;. That Citations for the hearing pursuant to NRS 19.0 be issued;. If requested, the Proposed Guardian(s) be approved for payment of guardian s fees and costs as set forth herein; REV 09/01 JDB 11 AG PETITION

15 The Court determine whether or not the Proposed Protected Person is a person described in 1 U.S.C. 9(g)() as an individual who is prohibited from possessing firearms, ammunition, or explosives, and if so, enter a finding of same, and authorize the Guardian(s) to secure any firearms, ammunition, or explosives possessed by the Proposed Protected Person; 10. The Court determine whether or not the Proposed Protected Person has the requisite understanding, to vote or otherwise participate in the election process; 11. For any additional Orders that the Court determines are appropriate and necessary in this case. This document does not contain the personal information of any person as defined by NRS 0A.00. I/We declare, under penalty of perjury under the law of the State of Nevada, that I/we have read the foregoing document and am/are competent to testify of its contents of my/our own knowledge and the contents are true of my/our own knowledge except for those matters stated therein on information and belief, and, as to those matters, I/we believe them to be true. Date: First Proposed Guardian s Signature: Date: Print Your Name: Second Proposed Guardian s Signature: Print Your Name: REV 09/01 JDB 1 AG PETITION

16 Do Not Copy Or File This Page INSTRUCTIONS: STEP 1) Write the exhibit number, number of pages (not including the Exhibit Cover Page), and a description for each exhibit. This is completed for the first three required exhibits. Complete the Index of Exhibits and Exhibit Cover Sheet(s) as Shown: If more space is needed, attach additional sheets. ) Attach the Index of Exhibits to the document after the last page of the document, before any exhibits. ) For each exhibit, create an Exhibit Cover Page. ) Write the exhibit number on the Exhibit Cover Page. Additional pages are available online, at the Self Help Center, Law Library, or Filing Office. ) Attach the correct Exhibit Cover Page to the front of each exhibit. ) Upload your exhibits in the order listed on the Index of Exhibits. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

17 INDEX OF EXHIBITS Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description

18 EXHIBIT EXHIBIT EXHIBIT

19 EXHIBIT EXHIBIT EXHIBIT

20 EXHIBIT EXHIBIT EXHIBIT

21 Do Not Copy Or File This Page INSTRUCTIONS: STEP Complete the Physician s Certificate with Needs Assessment: The Physician s Certificate must be filled out by a qualified person (listed on form). Attach the completed Certificate as Exhibit 1. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

22 PHYSICIAN S CERTIFICATE WITH NEEDS ASSESSMENT (Please answer all questions) I,, am qualified in the following way to complete this form: Full Name Yes No I am a physician licensed to practice in the State of Nevada. Yes No I am a physician who is employed by the Department of Veterans Affairs. Yes No I am a person who is otherwise qualified to execute the certificate. My qualifications are as follows: SECTION I I examined, an adult, on. Patient s Full Name Date of Exam This patient s diagnosis and condition is: In addition to examining the patient, I reviewed the following documents: Revised //010. Page 1

23 I certify that this adult patient is unable to respond (check all that apply): To a substantial and immediate risk of physical harm. To an immediate need for medical attention. To a substantial and immediate risk of financial loss. Describe immediate risk or need: Does the patient present a danger to himself/herself? Does the patient present a danger to others? Why or why not? Yes No Yes No Has the patient been subjected to abuse, neglect, or exploitation? If yes, explain: Yes No Attached hereto is (check all that apply): A copy of my report of the above exam which includes my findings, opinion and diagnosis regarding the patient and his/her mental condition and/or capacity. A copy of the patient s chart notes which support and/or detail my findings, opinion and diagnosis regarding the patient and his/her mental condition and/or capacity. A letter, signed by me, detailing my findings, opinion and diagnosis regarding the patient and his/her mental condition and/or capacity. Revised //010. Page

24 SECTION II Does the patient need a guardian? Why? Yes No Is the patient capable of living independently with or without assistance? Why or why not? Yes No SECTION III The patient s level of needed supervision is as follows: Locked Facility hour supervision Independent living with some supervision No supervision No supervision when taking medication My opinion as to the patient s everyday functions is as follows: Independent Needs Support Needs Substantial Assistance Needs Total Care CARE OF SELF (Activities of Daily Living (ADLs) and related activities) Maintain adequate hygiene, including bathing, dressing, toileting, dental Prepare meals and eat for adequate nutrition Identify abuse or neglect and protect self from harm Revised //010. Page

25 Independent Needs Support Needs Substantial Assistance Needs Total Care FINANCIAL Manage and use checks, deposit, withdraw, dispose, invest monetary assets Enter into a contract, financial commitment, or lease arrangement Employ persons to advise or assist him/her Resist exploitation, coercion, undue influence Independent Needs Support Needs Substantial Assistance Needs Total Care MEDICAL Give/Withhold medical consent Admit self to health facility Make or change an advance directive Manage medications Contact help if ill or in medical emergency Independent Needs Support Needs Substantial Assistance Needs Total Care HOME AND COMMUNITY LIFE Choose./Establish abode Maintain reasonably safe and clean shelter Drive or use public transportation Make and communicate choices about roommates Avoid environmental dangers such as stove, poisons, and obtain emergency help Revised //010. Page

26 SECTION IV Would the patient s attendance at a hearing be detrimental to him/her? If yes, why? Yes No Would attendance at the hearing be detrimental to the physical health of the patient? Yes No If yes, why? Is the patient able to appear at a hearing? Yes No If no, why not? Would the patient comprehend the reason for a hearing? Would the patient contribute to a hearing? Yes No Yes No If you conclude the patient cannot attend the hearing, please do the following: Inform the patient that the petitioner is requesting that the court appoint a guardian for him/her. Ask the patient for a response to the guardianship petition. Inform the patient of his/her right to counsel and ask whether the patient wishes to be represented by counsel in the guardianship proceeding. Ask the preferences of the patient for the appointment of a particular person as the guardian. I certify that the patient has been advised of his/her right to counsel and asked whether he/she wishes to be represented in the guardianship proceeding. (Please initial). Revised //010. Page

27 What was the patient s response to the guardianship petition? Does the patient want to be represented by counsel in the guardianship proceeding? Yes No Does the patient have any preferences for the appointment of a particular person as guardian? Yes No If yes, what preferences? Are there any conditions that you believe may have limited the responses by the patient? Yes No If yes, what conditions? I declare under penalty of perjury that the foregoing is true and correct. Date: Signature: Address: Revised //010. Page

28 Do Not Copy Or File This Page INSTRUCTIONS: STEP Complete the Preliminary Plan of Care and Preliminary Cost of Care as Shown: Fill out both the Preliminary Plan of Care and Preliminary Cost of Care to the best of your ability. If you do not know the answer to a question, write unknown. Attach the completed Preliminary Plan of Care as Exhibit and the completed Preliminary Cost of Care as Exhibit. 1) Complete each form. Write unknown if you do not know an answer. ) Attach to your Petition as Exhibits (see INSTRUCTIONS: STEP ). REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

29 PRELIMINARY PLAN OF CARE A. Residential Placement: 1. Residential Placement: at Since: Private Residence Assisted Living Group Home Skilled Nursing Facility, locked? YES -OR- NO. Could the Proposed Protected Person reside in a less-restrictive environment? YES -OR- NO Please explain:. Do they wish to reside in a different place/environment? YES -OR- NO. Caregivers: (Name, age, relationship to Proposed Protected Person) (Name, age, relationship to Proposed Protected Person) (Name, age, relationship to Proposed Protected Person) B. Medical, Mental and Person Care Plan: 1. Physical Health: Excellent -OR- Average -OR- Below Average Conditions: Assistive Devices:. Mental Health: Excellent -OR- Average -OR- Below Average Conditions: Rev. 11/01 ER

30 . Challenges/concerns: Safety: Care giving: Abuse/exploitation: Unmet needs:. Medical/mental/personal care goals: C. Social and Personal Services: 1. Current/desired social activities:. Current/desired personal services:. Social and personal service care goals: Rev. 11/01 ER

31 PRELIMINARY COST OF CARE BUDGET 1. Total Monthly Income (from all sources): $. Monthly Expenses: Residence: $ Utilities: $ Food: $ Medications/Doctors: $ Transportation: $ Care Services: $ Guardian s Fees: $ Personal/Incidentals: $ Taxes: $ Insurance: $ Other/Misc.: $ Total Monthly Cost of Care: $. Monthly Surplus (+) / Shortfall (-): $. Annual Surplus (+) / Shortfall (-) [monthly x 1]: $. Liquid resources available: $. Other resources available: $. What resources would be used when liquid resources run out?. Number of months of care-coverage available: Rev. 11/01 ER

32 Do Not Copy Or File This Page INSTRUCTIONS: STEP Complete the Required Identification Sheet as Shown: For the Proposed Protected Person and each Proposed Guardian, you must attach a copy of one of the following documents: Social Security Card, taxpayer identification card, valid driver s license, valid identification card, or valid passport. If you cannot obtain a copy of identification for the Proposed Protected Person and/or Proposed Guardian, complete as much information as possible. 1) Check the box for the type of guardianship. Print the name and date of birth of the Proposed Protected Person. You will be assigned a Case No. when you file the Petition with the Court. ) Complete the remaining information as requested, following the instructions on the page. Simply attach a copy of each identification to the form. You do not need to use an Index of Exhibits or Exhibit Cover Page. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

33 1 IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF WASHOE 9 In the Matter of the Guardianship of The Person only The Estate only The Person and the Estate, (Print Name of Protected Person) DOB:, Case No. Dept. No REV 10/01 JDB/MN A Protected Person. / REQUIRED IDENTIFICATION SHEET You must attach a valid copy of ONE of the following forms of identification for each of the Guardian(s) and the Protected Person. I. Check the correct box for the identification filed. Guardian: Social Security Card Taxpayer Identification Card Passport Driver s License ID Card Second Social Security Card Taxpayer Identification Card Guardian: Passport Driver s License ID Card Protected Social Security Card Taxpayer Identification Card Person: Passport Driver s License ID Card Copy Birth Certificate II. Check the correct box for the information requested. Placement of Protected Person: Group Home Out of State Secured Facility Family/Friends Guardian(s) Independently Host Family Other: Supportive Adult Residence Skilled Nursing Home Type of Guardianship you have: Location of Guardian(s): 1 Nevada Other State (Name of State): Who is or are the Proposed Guardian(s): Person Person/Estate Estate Special Male Female Parent Spouse Public Other Relative Other: Private: License Number: Gender of Protected Person: This document DOES OR DOES NOT contain the personal information of a person as required by NRS Required Identification Sheet Adult

34 Do Not Copy Or File This Page INSTRUCTIONS: STEP EFlex Account and EFile User Agreement: To file your documents, you will need to sign up for an eflex account. You must have an address to sign up for eflex. To sign up, fill out and return to the Filing Office at Court Street, Reno, Nevada or a signed copy of the efile Standard User Agreement, and sign up online for an account at There is no fee to sign up for a Standard eflex account. Fill in as much information as possible. Sign and date at the bottom of the page. If you need further assistance signing up for an account, please visit the Filing Office or Law Library at Court Street, Room 101, Reno, Nevada, or the Self Help Center at 1 S. Sierra Street, Reno, Nevada. We can assist you with all steps related to electronic filing. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

35 SECOND JUDICIAL DISTRICT COURT WASHOE COUNTY STATE OF NEVADA EFILE USER AGREEMENT (Standard) This serves as your efile User Agreement with the Second Judicial District Court for the purpose of registering an account to permit efiling of court case documents using the eflex Electronic Filing System ( eflex account ). Currently, this account will be subject to a $0.00 fee per transaction. By registering for an eflex account I agree and consent to the following: I will submit court filings electronically through eflex on court cases for which I am an active party or attorney of record, or an officer of the Court filing documents in my official capacity. As a registered eflex account holder, I cannot deactivate my address without filing a Written Notice of Intent to change my address with the District Court. This Written Notice of Intent must include my name, bar number and a list of all pending court matters. Also included must be an acknowledgment that all parties and attorneys of record on those pending matters have been notified of my new address. I understand that it is my responsibility to keep my address updated on my eflex account profile. I understand that once my eflex account is inactivated, I will no longer be able to electronically efile or view any documents using my account nor will I receive eflex electronic service. Furthermore, I will no longer have access to court records through my eflex account. Electronic signatures (e.g. /s/) are permissible on electronically filed documents submitted from the e-filer s E-Flex account. (See Nevada Electronic Filing and Conversion Rules, Rule 11). I will accept eflex electronic notices sent to my on file with eflex as valid and effective service for all efiled documents replacing the need for paper service. Electronic service of documents is limited to those documents permitted to be served by mail, express mail, overnight delivery, or facsimile transmission. A complaint, petition or other document that must be served with a summons, and summons or a subpoena cannot be served electronically. I agree to the terms of the license agreement as stated by Tybera on the court s eflex website under terms of use and privacy policy when registering for an eflex account and pressing the submit button. I understand that addresses supplied by the registered user via the username/password accessed through eflex Account supersede the court s case management system for the purpose of determining valid and effective service of efiled documents. I understand that it is my responsibility to keep my address updated on my eflex account profile. I agree to file the proper motion to withdraw/notice of change/substitution of counsel/notice of termination of employment (whatever applies) into each of my cases whenever I depart from an agency, office, or law firm, or cease to represent a party in any case, or cease to be an eflex user within 10 days of any such change. If known, I will designate the new attorney and/or e-filer contact on each case. Further, I will separately notify the Clerk of Court of any employment change which will globally affect all or a majority of my cases. Revised February 1, 01

36 I Acknowledge receipt, understanding and agree to follow the Nevada Electronic Filing and Conversion Rules (EFCR). I understand if a party submits a proposed Order and the Order is efiled by the Court, ONLY eflex account holders will be served by the Court. I understand all other parties must be served by the party who submitted the proposed Order by other means. I understand as a registered eflex account holder, I will only have access to documents in court cases for which I am an active party or attorney of record. In the event that I inadvertently obtain access to unauthorized information on any case, I will immediately notify the Court Administrator/Clerk of Court, presiding judicial officer and all active attorneys on that specific case. I will take every precaution to shield myself and all members of my firm from viewing, downloading or disseminating any unauthorized information. I will delete and destroy immediately any unauthorized information that I inadvertently obtain. I understand any violation of the terms of this agreement may result in sanctions imposed by the Court. Attorney or Person Name: If an attorney, Bar ID: Law Firm: If not an attorney, DOB: Interpreter needed: Yes or No Language: If not an attorney, Case number(s): eflex Address: 1 st Alternate eflex Address: nd Alternate eflex Address: Mailing Address: City: State: Zip Code: Phone Number: Fax Number: Designated eflex contact person: I hereby certify that I have read the above information and agree to abide by the requirements and terms as stated in this agreement. Date: Signature of Attorney/Person Agency Signatory: To become a registered eflex account holder, you must request an account online at and click on the Request an Account button. Next, print out this form, complete and sign it and deliver the ink-signed copy to the Second Judicial District Court Filing Office, Court Street, Reno, NV 901. Upon completion of your account request AND receipt of the signed efile User Agreement, your electronic request for a user account will be approved. You will be notified by and be able to login with your user name and requested password within three () working days. Revised February 1, 01

37 Do Not Copy Or File This Page INSTRUCTIONS: STEP Filing the Documents You will need to upload the original document to eflex. EFlex is available online, in the Filing Office, the Law Library, or the Self Help Center. Scanners are available at the Law Library, Filing Office, and Self Help Center. Copy machines are available at the Law Library. There is a per page charge for copying. A comprehensive eflex user guide is available from the sign in screen for eflex at If you need help efiling, contact the Filing Office, Law Library, or Self-Help Center. 1. Sign up for efiling at washoecourts.com.. efile the original Petition. Once the documents have been filed, you will be assigned a Case Number. Print the Case Number on the appropriate lines throughout your paperwork.. efile the Required Identification Sheet.. Print out a file stamped copy of the Petition. Please make sure to keep the original copies of all the documents you file for your personal records. The Judge may request to see the original, certified copies of documents at your hearing. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

38 Do Not Copy Or File This Page INSTRUCTIONS: STEP Complete the Citation to Appear and Show Cause as Shown You must provide a copy of the Petition and Citation to Appear and Show Cause to the following people: Proposed Protected Person, his or her attorney, any surviving family within the second degree of consanguinity to include parents of the Proposed Protected Person, siblings of the Proposed Protected Person (age 1 or older), grandparents of the Proposed Protected Person, children of the Proposed Protected Person (age 1 or older), grandchildren of the Proposed Protected Person (age 1 or older), the Director of the Human Service Agency if the Proposed Protected Person has received or is receiving benefits from Medicaid, and the Department of Veteran Affairs if the Proposed Protected Person is receiving benefits from the VA, or anyone else who is listed under NRS The Proposed Protected Person must be personally served with the Petition and citation at least 10 business days prior to the hearing. 1) Check the box for the type of guardianship. Print the name and date of birth of the Proposed Protected Person and Case No. just as they appear on all other documents in the case. ) Print the names of each person who must be notified of the guardianship hearing STOP HERE and continue to the next step REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

39 1 Code: IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA In the Matter of the Guardianship of The Person only The Estate only The Person and the Estate (Print Name of Proposed Protected Person) DOB:, Proposed Protected Person. / TO: IN AND FOR THE COUNTY OF WASHOE (Name of Second Proposed Guardian, if any), Case No. Dept. No. CITATION TO APPEAR AND SHOW CAUSE and any person having the care, custody, and control of the Proposed Protected Person: YOU ARE HEREBY CITED and required to appear before a Judge of this Court in Department of the Second Judicial District Court located at One South Sierra Street, Reno, Nevada, OR Department of the Second Judicial District Court located at Court Street, Reno, Nevada, on, at the hour of, then and there to show cause why and (Name of Proposed Guardian) should not be appointed to act as guardian(s) of the Proposed Protected Person. REV 10/01 JDB 1 AG CITATION TO APPEAR AND SHOW CAUSE

40 YOU ARE HERBY NOTIFIED that the above named Proposed Protected Person shall appear at the hearing, and may consent or oppose the Petition, and will be represented by an attorney who shall be appointed by the Court if the Proposed Protected Person has not already retained counsel. YOU ARE NOTIFIED that the Proposed Protected Person may be adjudged incapacitated or of limited capacity, and a guardian may be appointed. YOU ARE FURTHER NOTIFIED that (Name of Second Proposed Guardian, if any) (Month, day and year Petition was filed) (Name of Proposed Guardian) and, if appointed as guardian(s) of OR THE PERSON OR THE ESTATE OR THE PERSON AND THE ESTATE SPECIAL GUARDIAN(S), may have full management, care, and control of the Proposed Protected Person. The Proposed Protected Person s rights may be affected as specified in the PETITION FOR: GENERAL GUARDIANSHIP OR SPECIAL GUARDIANSHIP WITH LIMITED AUTHORITY OF THE ESTATE OR PERSON AND ESTATE PERSON OR THIS CITATION is based upon the verified Petition filed by the above-named Proposed Guardian(s) on and is issued pursuant to the Order of this Court. This document does not contain the personal information of any person as defined by NRS 0A.00. Dated this day of, 0. JACQUELINE L. BRYANT CLERK OF THE COURT By: Deputy Clerk REV 10/01 JDB AG CITATION TO APPEAR AND SHOW CAUSE

41 Do Not Copy Or File This Page INSTRUCTIONS: STEP 9 Setting the Hearing Take one copy of the Petition, and the Citation to Appear and Show Cause to the third floor of the Courthouse at 1 South Sierra Street on Tuesday, Wednesday, or Thursday between the hours of 9:00 a.m. and 1:00 p.m. and request to set a guardianship hearing. A clerk or judicial assistant will come out to further assist you with setting the hearing and completing the Citation to Appear and Show Cause. A file stamped copy of the Citation to Appear and Show Cause will be returned to you. INSTRUCTIONS: STEP 10 Making Copies of the Petition and Citation to Appear and Show Cause You will need one copy of the Petition and one copy of the Citation to Appear and Show Cause for each person listed on the front of the Citation (see INSTRUCTIONS: STEP ). You must include any attachments. Keep the original documents for yourself. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

42 Do Not Copy Or File This Page INSTRUCTIONS: STEP 11 Serving the Documents Serve everyone listed on the front of the Citation with one copy of the Petition and one copy of the Citation to Appear and Show Cause. Service may be made by certified mail, with a return receipt requested at least 0 calendar days before the hearing, or personal service at least 10 judicial days before the date set for the hearing. PERSONAL SERVICE CANNOT BE COMPLETED BY YOU. The Proposed Protected Person must be personally served. If you serve by certified mail, keep the white slips and green return cards to attach to your Proof of Service (see INSTRUCTIONS: STEP 1 and INSTRUCTIONS: STEP 1). If you serve by personal service, service may be completed by: The Civil Division of the Sheriff s Office in the County in which the person you are serving resides or works; or A responsible adult over the age of 1 years (such as a friend or relative); or A private process service. Proof of personal service must be completed by the person who served and filed in this case. Service by Publication You must make a serious attempt to locate everyone listed on the front of the Citation. If none of the persons, (excluding the Director of the Department of Health and Human Services, the Department of Veteran s Affairs, and the minor child(ren)), entitled to notice of a hearing can be served after *due diligence, you may need to file an Ex Parte Motion for Publication. *Due Diligence is a serious attempt to find the person in the State of Nevada. A serious attempt includes, but is not limited to: checking with last known address or place of employment, contacting them at their last known address or phone number, contacting family or friends that may be able to provide you with an address or serve them for you, conduct an online search on internet databases such as White Pages or Google people locator, contacting them via social media such as Facebook or Twitter, or a real property search from the Washoe County Assessor s Office. If you request the Court s permission to provide notice via publication, you must list all of your attempts to find each person in your request. Just by saying you do not know where the person is and have not heard from them IS NOT ENOUGH for a court order to publish in the newspaper. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

43 Do Not Copy Or File This Page INSTRUCTIONS: STEP 1 Complete the Proof of Service as Shown: Page 1 of : 1) Print your name, address, telephone number, and . ) Check the box for the type of guardianship. Print the name and date of birth of the Proposed Protected Person, and the case number. ) Print the name of the person who served the documents. ) The person who serves the documents must complete the remainder of the Proof of Service, following the instructions on the Proof of Service. Page of : If you serve more than people, additional pages may be attached and are available at the Self Help Center or online at ) The person who serves the documents must sign and date page of the Proof of Service. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

44 1 Code: 0 Name: Address: Telephone: Self-Represented Litigant IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA In the Matter of the Guardianship of The Person only The Estate only The Person and the Estate (Print Name of Proposed Protected Person) IN AND FOR THE COUNTY OF WASHOE, Case No DOB:, Proposed Protected Person. / Dept. No PROOF OF SERVICE I,, state as follows: (Print name of person making service) 1. I am eighteen years of age or older. Check the appropriate box, and fill in all requested information. If more space is needed, you may attach additional pages to this document. If you served by certified mail, return receipt requested, attach a copy of the certification receipts to this document.. I served a true and correct copy of the documents entitled PETITION FOR: GENERAL GUARDIANSHIP OR SPECIAL GUARDIANSHIP WITH LIMITED AUTHORITY and CITATION TO APPEAR AND SHOW CAUSE in the following way: REV 10/01 JDB 1 AG PROOF OF SERVICE

45 Name of Person Served: Date of Service: Name of Person Served: Date of Service: Name of Person Served: Date of Service: Name of Person Served: Date of Service: Address (Street, City, State, Zip Code): Certified mail, return receipt requested OR Personal Service Address (Street, City, State, Zip Code): Certified mail, return receipt requested OR Personal Service Address (Street, City, State, Zip Code): Certified mail, return receipt requested OR Personal Service Address (Street, City, State, Zip Code): Certified mail, return receipt requested OR Personal Service This document does not contain the personal information of any person as defined by NRS 0A.00. I declare, under penalty of perjury under the law of the State of Nevada, that I have read the foregoing document and am competent to testify of its contents of my own knowledge and the contents are true of my own knowledge except for those matters stated therein on information and belief, and, as to those matters, I believe them to be true. Date: Your Signature: Print Your Name: REV 10/01 JDB AG PROOF OF SERVICE

46 Do Not Copy Or File This Page INSTRUCTIONS: STEP 1 Filing and Mailing the Proof of Service If you served some or all parties by certified mail, return receipt requested: As soon as you receive the green cards from the post office, attach the original green cards and the original post office receipt slips (white slips) to a plain piece of paper and make a copy. Attach the copy as an exhibit to the Proof of Service (see INSTRUCTIONS: STEP ). Keep your original and bring it to the hearing. If the certified letter is returned unclaimed, make a copy of the envelope and attach the copy as an exhibit to the Proof of Service. Keep the envelope and bring it to the hearing. You will need to file the Proof of Service and any exhibits through eflex, before the hearing. A copy of the filed Proof of Service and any attachments must be served by mail or by personal service on the other party. It can be served by regular mail. It does not have to be mailed certified mail, return receipt requested. **You are now ready for your hearing. Please review and fill out the remainder of the packet and bring it with you to the hearing. INSTRUCTIONS: STEP 1 The Hearing Arrive approximately 1 minutes prior to your scheduled time for the hearing. Go to the third floor and check in with the clerk at the front counter. The Proposed Protected Person must be with you for the hearing, unless you have a signed, recent document from a health care provider stating that attendance will cause extreme harm to the Proposed Protected Person or others. When your case is called, enter the courtroom and take a seat at the table on your right. The Judge will have questions for you. If the guardianship is granted, the Judge will issue an Order Appointing Guardian. You will be provided a copy of the order. After you have received a Court Order granting guardianship, complete the Guardian s Acknowledgment(s) and Letters of Guardianship if not already done so. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

47 Do Not Copy Or File This Page INSTRUCTIONS: STEP 1 Complete the Guardian s Acknowledgment of Duties and Responsibilities for the Person, Estate, or Person and Estate as Shown: Once an Order Appointing Guardian(s) has been entered, the Guardian(s) must complete the Acknowledgment of Duties and Responsibilities. You will find two separate acknowledgments attached. Only one is shown below. If a guardianship of the person and estate is granted, fill out both acknowledgments. If not, fill out the one for the person or the estate depending on the type of guardianship. If co-guardians are appointed, each must fill out their own form. Additional copies of the forms are available at no cost at the Self Help Center, Law Library, or Filing Office. 1) Print your name, address, telephone number, and . ) Check the box for the type of guardianship. Print the name and date of birth of the Protected Person, and the case number ) Initial on each line indicating that you agree and understand each duty and responsibility. Complete the remaining pages. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS

48 Code: 10 Name: Address: Telephone: Self-Represented Litigant IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA In the Matter of the Guardianship of The Person only The Estate only The Person and the Estate, (Print Name of Protected Person) DOB:, A Protected Person. / IN AND FOR THE COUNTY OF WASHOE Case No. Dept. No. GUARDIAN S ACKNOWLEDGMENT OF DUTIES AND RESPONSIBILITIES OF THE PERSON I hereby declare that I understand there are certain duties and responsibilities required of me in the administration of the above guardianship. By initialing each item below, I understand my guardianship duties and responsibilities include, but are not limited to the following: A. Duties and Functions I hereby acknowledge and understand that the duties and functions of a Guardian are as follows: To always act in the best interest of the Protected Person. To supply the Protected Person with proper care, including food, shelter, clothing, and all incidental necessities: appropriate residence, support, and education, including training for a profession, if applicable. To provide the Protected Person with medical, surgical, dental, psychiatric, REV 10/01 MN; JB 1 Guardian s Acknowledgment of Duties (Person)

49 psychological, hygienic, or other care and treatment as needed. To notify all interested parties, the Court, the trustee, and named executor or appointed personal representative of the estate of the Protected Person within 0 days after the death of the Protected Person. B. Court Authority 1. I hereby acknowledge and understand that court authority must be obtained prior to: Moving or placing the Protected Person in a residence outside of the State of Nevada. Moving or placing the Protected Person in a secured residential long-term care facility unless the Court specifically granted the authority when the guardian was appointed or the placement is pursuant to a written recommendation by a licensed physician, a licensed social worker, or employee of a county or state office for protective services. Restricting communication, visitation, or interactions between a Protected Person and a relative or person of affection. I hereby acknowledge and understand that court authority must be obtained prior to: Engaging the Protected Person in experimental medical, biomedical, or behavioral treatment. Engaging the Protected Person in any medical practice to sterilize them. C. Notices and Reports I hereby acknowledge and understand that in addition to the performance of the duties outlined above, the following will be required of me: Within days of being appointed as guardian, a copy of the Order Appointing Guardian must be served on the Protected Person. Within 10 days after the Court has filed the Order Appointing Guardian, a Notice of REV 10/01 MN; JB Guardian s Acknowledgment of Duties (Person)

50 Entry of Order Appointing Guardian must be filed and mailed to all individuals entitled to notice. Annually, within 0 days of the anniversary of the appointment of guardianship, an Annual Report of Guardian must be filed to update the Court on the health and wellbeing of the Protected Person. Within 10 days of moving the Protected Person to a secured residential long-term care facility, an Annual Report of Guardian must be filed. At any time the Court orders, an Annual Report of Guardian must be filed. Within 0 days of filing an Annual Report of Guardian, a copy of the report must be given to the guardian of the estate, if any have been appointed. 10 days prior to changing the Protected Person s residence within Nevada, notice of the intended relocation must be provided to all persons entitled to notice. D. Miscellaneous I hereby acknowledge and understand the following: It is my responsibility to accurately keep all records and file all reports with the Court regarding the well-being of the Protected Person. It is my responsibility to maintain all records and documents for the guardianship of the Protected Person for years after the Court terminates the guardianship. It is my responsibility to inform the Court if I am no longer qualified to serve as a guardian, and the Court will determine whether or not I can continue the guardianship. The following can disqualify me from keeping my guardianship: 1. If I am convicted of a gross misdemeanor or felony in any state.. If I file or receive protection as an individual or as a principle of any entity under the federal bankruptcy laws. REV 10/01 MN; JB Guardian s Acknowledgment of Duties (Person)

51 If I have my driver s license suspended, revoked, or cancelled for nonpayment of child support.. If I am suspended for misconduct or disbarred from the practice of law, the practice of accounting, or any other profession which involves or may involve the management or sale of money, investments, securities or real property, or requires licensure in any state.. If I have a judgment entered against me for misappropriated funds or assets from any person or entity in any state. I shall, as a guardian, take possession of the following unless a guardian of the estate is granted and the guardian of the estate has taken possession of them: The originals of any contracts executed by the Protected Person, Power of Attorney executed by the Protected Person, Estate planning documents prepared by the Protected Person (including but not limited to the last will and testament, durable power of attorney), and revocable trusts, revocable or irrevocable trusts the Protected Person is beneficiary to, and any written evidence of present or future vested interest in any real or intangible property. I should seek the advice and assistance of an attorney if I need legal advice, or if I do not fully understand my duties and responsibilities, to ensure that I remain in full compliance with the laws of the State of Nevada. I have read and reviewed the Guardian s Acknowledgment of Duties and Responsibilities and I understand the terms and conditions under which the Guardianship is to be managed. I agree to comply with the rules and duties of a guardian as set forth in the laws of the State of Nevada. I fully understand that failure to comply with the Guardianship statues, or with any REV 10/01 MN; JB Guardian s Acknowledgment of Duties (Person)

52 1 Order made by the Court, may result in my removal as Guardian and that I may be subject to such penalties as the Court may impose. I declare under penalty of perjury that I have read and understand my duties and responsibilities as outlined in the foregoing Guardian s Acknowledgment of Duties and Responsibilities. This document does not contain the personal information of any person as defined by NRS 0A Date Signature Print Name REV 10/01 MN; JB Guardian s Acknowledgment of Duties (Person)

53 1 Code: 10 Name: Address: Telephone: Self-Represented Litigant IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF WASHOE In the Matter of the Guardianship of The Person only The Estate only The Person and the Estate, (Print Name of Protected Person) DOB:, A Protected Person. / Case No. Dept. No GUARDIAN S ACKNOWLEDGMENT OF DUTIES AND RESPONSIBILITIES OF A GUARDIAN OF THE ESTATE I hereby declare that I understand there are certain duties and responsibilities required of me in the administration of the above guardianship. By initialing each item below I understand my guardianship duties and responsibilities include, but are not limited to the following: A. Duties and Functions I hereby acknowledge and understand that the duties and functions of a guardian are as follows: To protect, preserve, and manage the income, assets, and estate of the Protected Person REV 10/01 MN; JB and utilize the income, assets, and estate of the Protected Person solely for the benefit of the Protected Person. 1 GUARDIAN S ACKNOWLEDGMENT OF DUTIES (ESTATE)

54 To protect, preserve, manage, and dispose of the estate of the Protected Person according to law and for the best interests of the Protected Person. To apply the estate of the Protected Person for the proper care, maintenance, education, and support of the Protected Person, and any person to whom the Protected Person has a legal obligation to support. To have due regard for other income or property available to support the Protected Person and any person to whom the Protected Person has a legal obligation to support. To have such other authority and perform such other duties as are provided by law. To maintain the Protected Person s assets in the name of the Protected Person or the guardianship. To notify all interested parties, the Court, the trustee, and named executor or appointed personal representative of the estate of the Protected Person within 0 days after the death of the Protected Person. B. Investing and Managing Protected Person s Estate I hereby acknowledge and understand that the following rules govern the manner in which the Protected Person s separate property shall be managed and invested: Except in circumstances where I am the spouse of the Protected Person, I may not utilize any guardianship funds for my personal benefit or commingle guardianship funds with my own funds. I may, without prior approval of the Court, invest the Protected Person s property in any (1) bank credit union, or savings and loan institution in the State of Nevada to the extent that the deposits are insured by the Federal Deposit Insurance Corporation, National Credit Union Share Insurance Fund, or a private insurer; () interest bearing obligations of or fully guaranteed by the United States, the United States Postal Service, or Federal REV 10/01 MN; JB GUARDIAN S ACKNOWLEDGMENT OF DUTIES (ESTATE)

55 National Mortgage Association; () interest bearing general obligations of this state or any county, city, or school district in the State of Nevada; () or any money market mutual funds which are invested only in those instruments described in this paragraph. C. Court Authority I hereby acknowledge and understand that court authority must be obtained prior to: Investing property of the Protected Person. Continuing the business of the Protected Person. Borrowing money for the Protected Person. Entering into contracts for the Protected Person or complete the performance of contracts of the Protected Person. Making gifts from the Protected Person s estate or making expenditures for the Protected Person s relatives. Selling, leasing, or placing in a trust, any property of the Protected Person. Exchanging or partitioning the Protected Person s property. Releasing the power of the Protected Person as trustee, personal representative or custodian for a minor or guardian. Exercising or releasing the power of the Protected Person as a donee of a power of appointment. Exercising the right of the Protected Person to take under or against a will. Transferring to a trust created by the Protected Person, any property unintentionally omitted from the trust. Submitting a trust to the jurisdiction of the Court if the Protected Person is a beneficiary of the income of the trust, or the trust was created by the Court. Paying any claim by the Department of Health and Human Services to recover benefits REV 10/01 MN; JB GUARDIAN S ACKNOWLEDGMENT OF DUTIES (ESTATE)

56 for Medicaid correctly paid to or on the behalf of the Protected Person. Transferring money in a Protected Person s account to the Nevada Higher Education Prepaid Tuition Trust Fund created in accordance with NRS B.10. To take any other action which the guardian deems would be in the best interests of the Protected Person, without having prior consent from this Court. D. Selling Property of the Protected Person 1. I hereby acknowledge and understand that all sales of real property of the Protected Person must: Only occur after the Court grants authority for the sale. Be confirmed by the Court prior to finalizing the sale with the prospective buyer.. I hereby acknowledge and understand that I must provide written notice of my intent to sell personal property of the Protected Person that has a total value of less than $10, UNLESS: The property is a threat to public health or safety. The property is contaminated, and salvage is impractical. The handling or storage of property might endanger public health or safety.. I hereby acknowledge and understand that if I intend to sell personal property of the Protected Person that has a total value above $10, I must: Publish notice of intended sale. Provide written notice to the individuals entitled to notice, including the Protected Person and his or her family members.. I hereby acknowledge and understand that I am responsible for the actual value of all personal property of the Protected Person sold unless: I make a report to the Court within 90 days of the sale. REV 10/01 MN; JB GUARDIAN S ACKNOWLEDGMENT OF DUTIES (ESTATE)

57 I hereby acknowledge and understand that I may sell any security of the Protected Person if: I petition the Court for confirmation of the sale. The Court confirms the sale.. I hereby acknowledge and understand that: I shall record all certified copies of any court order authorizing the sale, mortgage, lease, surrender, or conveyance of real property in the county recorder s office in which any portion of the land is located. I am to carry out effectively any transactions affecting the Protected Person s property as authorized by NRS 19. The Court may authorize me to execute any promissory note, mortgage, deed of trust, deed, lease, security agreement, or other legal document or instrument which is reasonably necessary to carry out such transaction. E. Notices and Reports I hereby acknowledge and understand that in addition to the performance of the duties outlined above, the following will be required of me: Within days of being appointed guardian, a copy of the Order Appointing Guardian must be served to the Protected Person. Within 0 days of being appointed guardian of the estate, an Inventory, Appraisal, and Report of Value must be filed with the Court for all known property of the Protected Person. Within 0 days of discovering property not mentioned in the initial inventory, an amended inventory must be filed with the Court. Within 0 days of being appointed guardian of the estate a certified copy of the Letters of Guardianship must be recorded in the county recorder s office of any county where the Protected Person possesses real property. REV 10/01 MN; JB GUARDIAN S ACKNOWLEDGMENT OF DUTIES (ESTATE)

58 Annually, within 0 days of the anniversary of the appointment of guardianship, an Annual Account of Guardianship must be filed to update the Court on the status of the Protected Person s Estate, and served on all interested parties. At any time the Court orders, an Inventory, Appraisal, and Report of Value and/or an Accounting of Guardianship must be filed. F. Miscellaneous I hereby acknowledge and understand the following: It is my responsibility to accurately keep all records and file all reports with the Court regarding the finances of the Protected Person. It is my responsibility to maintain all records and documents for the guardianship of the Protected Person s estate for years after the Court terminates the guardianship. It is my responsibility to inform the Court if I am no longer qualified to serve as a Guardian, and the Court will determine whether or not I can continue the guardianship. The following can disqualify me from keeping my guardianship: 1. If I am convicted of a gross misdemeanor or felony in any state.. If I file or receive protection as an individual or as a principle of any entity under the federal bankruptcy laws.. If I have my driver s license suspended, revoked, or cancelled for nonpayment of child support.. If I am suspended for misconduct or disbarred from the practice of law, the practice of accounting, or any other profession which involves or may involve the management or sale of money, investments, securities or real property, or requires licensure in any state. REV 10/01 MN; JB GUARDIAN S ACKNOWLEDGMENT OF DUTIES (ESTATE)

59 If I have a judgement entered against me for misappropriated funds or assets from any person or entity in any state. I may petition the Court for advice, instructions, and approval in any matter concerning the following: 1. The administration of the Protected Person s estate;. The priority of paying claims;. The propriety of making any proposed disbursement of funds;. Elections for or on behalf of the Protected Person to take under the will of a deceased spouse;. Exercising for or on behalf of the Protected Person: a. Any option or other rights under any policy of insurance or annuity; and b. The right to take under a will, trust or other devise;. The propriety of exercising any right exercisable by owners of property; and. Matters of a similar nature. I shall, as a guardian of the estate, take possession of: 1. All property of substantial value of the Protected Person;. All rents, income, issues and profits from the property;. The title to all property of the Protected Person;. The originals of any contracts executed by the Protected Person, Power of Attorney executed by the Protected Person, estate planning documents prepared by the Protected Person (including but not limited to the last will and testament, durable power of attorney), and revocable trusts, revocable or irrevocable trusts the Protected Person is beneficiary to, and any written evidence of present or future vested interest in any real or intangible property. REV 10/01 MN; JB GUARDIAN S ACKNOWLEDGMENT OF DUTIES (ESTATE)

60 I shall collect all debts due to the Protected Person. I shall represent the Protected Person in legal proceedings. I may pay claims against the Protected Person or Protected Person s estate with the Protected Person s estate. I should seek the advice and assistance of an attorney if I need legal advice, or if I do not fully understand my duties and responsibilities, to ensure that I remain in full compliance with the laws of the State of Nevada. I certify that I have read and reviewed the Guardian s Acknowledgment of Duties and Responsibilities and I understand the terms and conditions under which the guardianship is to be managed. I agree to comply with the rules and duties of a guardian as set forth in the laws of the State of Nevada. I fully understand that failure to comply with the guardianship statues, or with any Order made by the Court, may result in my removal as guardian and that I may be subject to such penalties as the Court may impose. I declare under penalty of perjury that I have read and understand my duties and responsibilities as outlined in the foregoing Guardian s Acknowledgment of Duties and Responsibilities. This document does not contain the personal information of any person as defined by NRS 0A.00. Date Signature Print Name REV 10/01 MN; JB GUARDIAN S ACKNOWLEDGMENT OF DUTIES (ESTATE)

61 Do Not Copy Or File This Page INSTRUCTIONS: STEP 1 Page 1 of : Complete the Letters of Guardianship as Shown: 1) Check the box for the type of guardianship. Print the name and date of birth of the Protected Person, and the case number. ) Print the name(s) of the guardian(s). Leave the rest of page 1 blank. Page of : ) Fill in the requested information for the guardian. ) Fill in the requested information for the second guardian, if any. Leave the rest of the document blank. You will sign when you take the Oath. REV 10/01 JDB; ER AG VISUAL INSTRUCTIONS