IN THE TENTH JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF CHURCHILL

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Case No. Dept. No. I The undersigned hereby affirms this document Does not contain a social security number. IN THE TENTH JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF CHURCHILL In the Matter of the Guardianship of the: Estate and Estate, A Minor A Protected Person GUARDIAN S ACKNOWLEDGEMENT OF DUTIES AND RESPONSIBILITIES UNDER NRS TEMPORARY GUARDIANSHIP GENERAL GUARDIANSHIP Estate Estate Summary Admin. and Estate and Estate SPECIAL GUARDIANSHIP NOTICES/SAFEGUARDS Blocked Account Required Estate Summary Admin. Bond Required and Estate I, (your name), Guardian, 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: (You must read and initial all items on this form to acknowledge that you understand your duties and responsibilities): Page 1 of Guardian s Acknowledgement of Duties and Responsibilities

I. Required duties and functions [ALL GUARDIANS] Filing an Order Appointing Guardian within ten () days of the undersigned s appointment as guardian; [Best Interest of Ward] Filing a Notice of Entry of Order Appointing Guardian within two () days of the filing of the Order Appointing Guardian; [Best Interest of Ward] Filing of General Letters of Guardianship within fourteen () days of the filing of the Order Appointing Guardian; [Best Interest of Ward] Seeking the advice and assistance of an attorney if the Guardian needs legal advice or does not understand his/her duties and responsibilities to ensure he/she remains in full compliance with the laws of the State of Nevada; [NRS.; NRS.0] Filing a petition, setting a hearing and noticing all persons entitled to notice if the qualifications of the Guardian change after appointment as Guardian; i.e.: [NRS.] The Guardian plans to move or has moved out of state; [.0()(b)()] The Guardian has been judicially determined to have committed abuse, neglect or exploitation of a child, spouse, parent or other person; [NRS.0()(c)] The Guardian has been convicted of a felony; [NRS.0(i); NRS.0()(e)] The Guardian has been suspended for misconduct or disbarred from the practice of law, the practice of accounting or any other profession which involves the management or sale of money, investments, securities or real property and requires licensure in Nevada or any other state; [NRS.0()] The Guardian has filed for bankruptcy within the past seven () years or is in the process of filing for bankruptcy, or has filed bankruptcy; [NRS.0(t)] Notifying the Court and certain other persons within thirty (0) days of the death of a Ward; [NRS.0(c)(1)(v)] Notifying the Court prior to exercising or releasing power of the Ward as done of a power of appointment; [NRS.1(1)(i)] Page of Guardian s Acknowledgement of Duties and Responsibilities

Notifying the Court prior to releasing the power of the Ward as trustee, personal representative, or custodian for a minor or guardian; [NRS.1(1)(h)] Notifying the Court prior to exercising the right of the Ward to take under or against a will; [NRS.1(1)(j)] Responding to inquiries of the Adult Guardianship Compliance Administrator; [NRS.0] II. Guardian of the Person [GUARDIAN(S) OVER PERSON OR OVER PERSON AND ESTATE] To file an annual Report of the Guardian every year to bring the Court up to date on the health and well-being of the Ward. The Report must be filed within one (1) year and sixty (0) days of the anniversary of the Guardian s appointment as guardian of the person of the Ward; [NRS.01] To supply the Ward with proper care, including food, shelter, clothing, and necessities; maintenance; support; and education, including training for a profession if applicable; [NRS.0(1)(a)] To supply the Ward with surgical, dental, psychiatric, psychological, hygienic, or other care and treatment as needed; [NRS.0(1)(b)] To obtain Court authority prior to authorizing major medical or dental treatment; [NRS.00] To obtain Court authority prior to authorizing the placement of a Ward in a secured residential long-term care facility; [NRS.0()] To obtain Court authority prior to removing the Ward from the State of Nevada; [NRS.0()] To obtain Court authority prior to authorizing the change of state of residence of or domicile of a Ward; [NRS.0()] III. Guardian of the Estate [GUARDIAN(S) OVER THE ESTATE ONLY OR OVER THE PERSON AND THE ESTATE] To place assets into a blocked account, if required by the Court Order Granting Guardianship, and obtain and file proof of the blocked account; [NRS.0()] To obtain a bond, if required by the Court Order Granting Guardianship, in the amount set by the Court Order and file notice of bond; [NRS.0] Page of Guardian s Acknowledgement of Duties and Responsibilities

To file an inventory and appraisement setting forth the description and valuation of the income and assets that comprise the Ward s estate within sixty (0) days of the undersigned s appointment of Guardian of the Estate of the Ward. [NRS.0(1)] The appraisal or valuation must be done by a disinterested appraiser, certified public accountant, or expert in valuation, unless, the value of an asset can be determined with reasonable certainty; [NRS.0(1)] The Guardian may be able to file a verified record of value; [NRS.0()(a)] The Guardian may use a statement of the assessed value of real property as determined by the County Assessor for purposes, except that if the real property is to be sold, the Guardian must file an appraisal. [NRS.0()(b)] To file an Accounting every year* within one (1) year and sixty (0) days of he anniversary of the undersigned s appointment as Guardian of the Estate of the Ward and to set the Accounting on the Court calendar for hearing and approval by the Court, setting forth: [NRS.(1)] The amounts received on behalf of the Ward; NRS.(1)(b) The amounts disbursed on behalf of the Ward; NRS.(1)(b) The balance of the Ward s estate which the Guardian continues to hold until the guardianship is in a position to be determined. *Unless the Guardianship has been designated as a Summary Administration. To keep precise and accurate records of all funds received and disbursed for the Ward s benefit, along with the source of all receipts and the purpose of all disbursements. The undersigned understands that this includes, but is not limited to balancing the estate checkbook and insuring that all records are clear, legible, and balance with the figures referenced in all bank accounts; [NRS.;.0;.] To protect, preserve, and manage the Ward s estate according to the laws and in the best interest of the Ward; [NRS.0] Page of Guardian s Acknowledgement of Duties and Responsibilities

Guardian shall secure originals, when available, or copies of the following documents: [NRS.0] Any contract executed by a Ward; Any power of Attorney for a Ward; Any estate planning documents; Any revocable or irrevocable trust in which the Ward has a vested interest as a beneficiary; Any writing depicting a present or future interest in any real or intangible property IV. Investing and Managing Ward s Estate [GUARDIAN OVER ESTATE OR OVER PERSON AND ESTATE] When establishing bank accounts or holding property on behalf of the Ward, title designations shall read: name of guardian(s) as Guardian(s) of the Estate of name of the Ward. [NRS.0] The Guardian(s) may not utilize any guardianship funds for his/her/their personal benefit or commingle guardianship funds with his/her/their own funds; [NRS.0(1)(c)(1)(IV)] The Guardian(s) shall not place the guardianship funds in joint tenancy; [NRS.0(1)(c)(1)(IV)] The Guardian(s) may, without prior approval of the Court, invest the Ward s funds in an FDIC or FSLIC insured savings account in any bank, credit union, or savings and loan institution in the State of Nevada; interest bearing obligations of or guaranteed by the United States or the United Postal Service; or interest bearing general obligations of any county, city, or school district in Nevada, the State of Nevada or Federal National Mortgage Association; or any money market mutual funds which are invested only in those instruments described in this paragraph. [NRS.1()] Page of Guardian s Acknowledgement of Duties and Responsibilities

Court authority is required prior to: Investing the Ward s assets in any manner other than those outlined in Section IV; [NRS.1] Continuing a business of a Ward; [NRS.1] Borrowing money for a Ward; [NRS.1] Entering into contracts or completing the performance of contracts of a Ward; [NRS.1] Making gifts from the Ward s estate or making expenditures for a Ward s relatives; [NRS.1] Selling, leasing, placing into any trust, or surrendering any property of a Ward; [NRS.1] Exchanging or partitioning the Ward s property; [NRS.] Making expenditures on behalf of the Ward for purposes other than providing the Ward with food, clothing, shelter, and other incidental necessities; [NRS.1] Making or changing the designation of a beneficiary in a will, trust, insurance policy, bank account, or any other type of asset of a Ward which includes a designation of beneficiary; [NRS.1] Exercising the right of the Ward to revoke or modify a revocable trust or to surrender the right to revoke or modify a revocable trust; [NRS.1] Removing the Ward s property from the State of Nevada [NRS.1] I certify that I have read and reviewed the Guardian s Acknowledgement of Duties and Responsibilities under NRS and that 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 Constitution and Government of the United States, and the Constitution and Government of the State of Nevada and any ordinance, resolution, or law of any state notwithstanding. I understand that failure to comply with the Guardianship statutes; or with any Page of Guardian s Acknowledgement of Duties and Responsibilities

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. DATED this day of,. (First Petitioner s Signature) (Printed Name) (Second Petitioner ssignature) (Printed Name) Page of Guardian s Acknowledgement of Duties and Responsibilities