Approved, SCAO
OSM CODE: RGW, DIS
STATE OF MICHIGAN PROBATE COURT COUNTY
CIRCUIT COURT - FAMILY DIVISION
FILE NO. RECEIPT OF WARD AND DISCHARGE
In the matter of
, a protected individual
1. I am an adult . I have received from
Name
,
my guardian or conservator, the following personal property:
It is the balance of the estate due me in full. 2. I REQUEST that my guardianship or conservatorship be terminated.
Date
Signature Address City, state, zip Telephone no.
ORDER IT IS ORDERED the guardianship and/or conservatorship is terminated, the guardian and/or conservator is discharged and the bond, if any, is cancelled.
Bar no.
Date
Judge
Attorney name (type or print) Address City, state, zip
Bar no.
Telephone no.
Do not write below this line - For court use only
PC 649 (3/00)
RECEIPT OF WARD AND DISCHARGE