Petition For Appointment Of Temporary Guardian For Disabled Person {171-210}

IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT, LAKE COUNTY, ILLINOIS Probate Division Estate of ) ) ) ) No. Alleged Disabled Person PETITION FOR APPOINTMENT OF TEMPORARY GUARDIAN FOR DISABLED PERSON _____________________________________________________, hereby certifies: 1. On ________________, 20_____, a petition was filed herein for the appointment of a guardian of the ____________________________________of _______________________________an alleged disabled (Estate and Person, Estate, Person) person whose date of birth is _____________and whose place of residence is _______________________ ______________________________________________________________________________________ (Address) (City) (County) (State) 2. A temporary guardian is necessary for the welfare and protection of the respondent because: _______________________________________________________________________________________ _______________________________________________________________________________________ 3. Petitioner is ________________________________________________to the alleged disabled person. (State relationship and interest to respondent) 4. The name and address of the respondent's *(a) guardian (b) Agent under the Durable Power of Attorney Law is _____________________________________________________________________________________ 5. The name and addresses of the respondent's nearest relatives are as follows: (if none, respondent's nearest adult kindred known to Petitioner) Spouse and Adult Children: Name Address Relationship to respondent _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ 6. Name and address of the person with whom or the facility in which the respondent is residing _______________________________________________________________________________________ 7. The approximate value of the respondent's personal estate is $_______________________; 171-210 Rev. 09/00 Page 1 of 2 2002 © American LegalNet, Inc. approximate value of real estate is $_______________________; and the amount of anticipated annual gross income and other receipt is $_______________________. 8. Petitioner asks that ____________________________________________________________________ (Name) (Address) (City and State) _________________years, _______________________________, qualified and willing to act, be appointed as (Age) (Occupation) temporary guardian of the _________________________________________of the alleged disabled person. (Estate and Person, Estate, Person) Name Attorney for Address City & Zip Telephone Atty No The undersigned certifies that the statements set forth in this instrument are true and correct, except as to matters therein stated to be on information and belief and as to such matters the undersigned certifies as aforesaid that he/she verily believes the same to be true. _____________________________________________ Petitioner *strike either (a) or (b) 171-210 Rev. 09/00 Page 2 of 2 2002 © American LegalNet, Inc.