Approved, SCAO
JIS CODE: OAG
STATE OF MICHIGAN PROBATE COURT COUNTY
CIRCUIT COURT - FAMILY DIVISION
ORDER REGARDING APPOINTMENT OF TEMPORARY GUARDIAN OF INCAPACITATED INDIVIDUAL
FILE NO.
In the matter of 1. Date of hearing: Judge:
, an alleged incapacitated individual
Bar no.
THE COURT FINDS: 2. Notice of hearing was given to the incapacitated individual. 3. The individual is not in need of a guardian. 4. The individual does not have a guardian, an emergency exists, and no other person appears to have the authority to act in the circumstances. The individual, by reason of mental illness, chronic use of drugs, mental deficiency, chronic intoxication, physical illness or disability, other:
is impaired to the extent that he/she lacks sufficient understanding or capacity to make or communicate informed decisions and is an incapacitated individual. 5. The appointed guardian is not effectively performing his/her guardianship duties, and the welfare of the incapacitated individual requires immediate action. 6. There is no qualified, suitable individual willing to act as temporary guardian, and the appointment of a nonprofit corporation as temporary guardian is in the best interest of the adult. A personal bond must be filed. 7. Other: IT IS ORDERED: 8. The petition for appointment of temporary guardian is 9.
Name (type or print) Address City
granted.
denied on the merits.
dismissed/withdrawn.
, whose address and telephone number are ,
State Zip Telephone no.
is appointed temporary guardian of the adult and shall qualify by filing an acceptance of appointment. Personal bond at $ must be filed. 10. The temporary guardian shall have the following powers and responsibilities only:
11. This temporary guardianship shall terminate on
Date (Not later than 28 days after date of order.)
.
12. IT IS FURTHER ORDERED:
Date
Judge
Attorney name (type or print) Address
Bar no. City State Zip Telephone no.
Do not write below this line - For court use only
MCL 700.5312, MCL 700.5313, MCR 5.403(C) PC 632 (9/08)
ORDER REGARDING APPOINTMENT OF TEMPORARY GUARDIAN OF INCAPACITATED INDIVIDUAL