Guardianship Transfer Information Update {17.2A}

PC-G-17.2A (2-2008) PROBATE COURT OF FRANKLIN COUNTY, OHIO ROBERT G. MONTGOMERY,JUDGE LAWRENCE A. BELSKIS, JUDGE IN THE MATTER OF THE GUARDIANSHIP OF CASE NO. GUARDIANSHIP TRANSFER - INFORMATION UPDATE [R.C.2111.47.1] Updated information for the guardian and the ward is necessary in order for this Court to have an accurate guardianship record. 1. TYPE OF GUARDIANSHIP A. Non-Limited Person and Estate B. Limited Estate Only Person Only 2. IF LIMITED GUARDIANSHIP: The limited powers of the guardian are: As the Guardian, I am currently bonded. Amount $ Surety Agency Yes No I have informed the bonding company of the guardianship transfer. Yes No 4. A LIST OF THE NEXT OF KIN, FORM 15.0, OF THE WARD IS ATTACHED. 5. UPDATED GUARDIAN INFORMATION: Name and AKA Home Address Telephone No. E-mail Address D.O.B. Occupation Work Address Work Telephone City State Zip Relationship to Ward City State Zip FRANKLIN COUNTY FORM 17.2A - GUARDIANSHIP TRANSFER - INFORMATION UPDATE American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. I (have/have not) been charged with, or convicted of, a crime involving theft; physical violence; or sexual, alcohol, or substance abuse. If you have been so charged or convicted, list dates and places of the charge(s) or conviction(s), O.R.C. 2111.03(A). Charge/Conviction Date Place 6. UPDATED INFORMATION REGARDING WARD: A. Full Name and AKA Age Date of Birth Male Female Residence City, State, Zip Code in County, Ohio Telephone Number Length of time at that residence B. Name of person, other than ward, who may be contacted at the address where the ward is living. Telephone Number Best time to call C. In the event of the death or incapacity of the guardian, the Court should contact the nearest friends or relatives whose names and addresses are: Name Telephone Number Address City, State, Zip Code Name Telephone Number Address City, State, Zip Code Name Telephone Number Address City, State, Zip Code 7. FURTHER INFORMATION CONCERNING THE WARD: A. Rights 1. What rights has the Ward retained, if any: None Vote Marry Contract Execute a will Obtain driver's license / drive a vehicle Hold or convey property Other: (please specify) B. 1. Documents/Payeeship Does the Ward have a Last Will & Testament. If yes, where is it located? 2 American LegalNet, Inc. www.FormsWorkFlow.com CASE NO. 2. Does the ward have a safe deposit box? If so, where is it located? 3. Does the ward have a power of attorney? If so, who is the designated POA? 4. Does the ward have a living will? Where is the document? 5. Is there a DNR for the Ward? Yes No 6. Is there a Social Security payee for the ward? If yes, who. 7. Does the ward receive Veterans' Administration funds? If yes, who is the payee of VA funds? C. Medical 1. The ward suffers from the following disabilities: Infirmities of aging Developmentally disabled Other 2. Chronic mental illness Substance Abuse The most recent Guardian's Report and accompanying Statement of Expert Evaluation were filed on: I hereby certify that all the foregoing information and accompanying Forms 17.SSN, 17.0G, & 15.2A are correct to the best of my knowledge and belief. Signature Signature Attorney for Guardian and registration number Guardian Address Address City, State, Zip Code City, State, Zip Code Telephone Telephone 3 American LegalNet, Inc. www.FormsWorkFlow.com