Approved, SCAO

STATE OF MICHIGAN

PROBATE COURT
COUNTY
CIRCUIT COURT - FAMILY DIVISION

In the matter of

1. Date of hearing:

ORDER APPOINTING GUARDIAN FOR
INDIVIDUAL WITH A
DEVELOPMENTAL DISABILITY

JIS CODE:   OAG

FILE NO.

, an individual with a developmental disability

Judge:

Bar no.

2. Findings of fact are more fully stated on the record regarding the individual's nature and extent of general intellectual functioning,
extent of impairment of adaptive behavior, capacity to manage his/her estate and financial affairs, and capacity to care for
self by making and communicating responsible decisions concerning his or her person.

THE COURT FINDS:

3. Notice of hearing was given to or waived by all interested parties.

4.

a. The individual was present at the hearing.
b. The individual was not present at the hearing.  His/her presence was excused upon showing by testimony and affidavit of

a

psychologist,
physician,

for the report.

that the individual's attendance would subject him/her to serious

physical
emotional      harm.

5. Testimony was given by the person who prepared the report or person who performed an evaluation serving, in part, as the basis

6. Upon the presentation of clear and convincing evidence and

the verdict of a jury, the individual is an individual

with a developmental disability and requires guardianship services.

with
without

7. The individual named above is

totally
partially without capacity to care for his/her

person
estate

as to the following necessary

tasks, responsibilities, or judgments but is otherwise legally competent and has the capacity to perform in other areas.

8. The most appropriate and the least restrictive living arrangement suited to the individual's condition is

The individual presently resides in the following facility:

9. A reasonable effort was made to question the individual and he/she indicated

no preference as to who should be appointed guardian.

    .
   .

that he/she preferred

Name (type or print)

and

Name (type or print)

to serve as guardian

as standby guardian.

(PLEASE SEE OTHER SIDE)

Do not write below this line - For court use only

PC 660  (9/08)   ORDER APPOINTING GUARDIAN FOR INDIVIDUAL WITH DEVELOPMENTAL DISABILITY

MCL 330.1617, MCL 330.1618, MCL 330.1620, MCL 330.1623, MCL 330.1626

10. There is no qualified, suitable individual or agency willing to act as guardian and the appointment of an agency directly

providing services to the individual is necessary at present.

11. A reasonable effort was made to orally inform the individual of his/her right to request the guardianship to be dismissed

or modified at any time.  A written notice of these rights was also served on him/her.

12. Other:

IT IS ORDERED:
13. The petition is

14.

Name (type or print)

Address

 is appointed

granted.

denied on the merits.

dismissed/withdrawn.

, whose address and telephone number are

City

State

Zip

 Telephone no.

    ,

a. plenary guardian of the

until further order of the court

and shall qualify by filing

an acceptance of appointment.
a bond in the amount of $

.

b. partial guardian of the

for the term of

years

individual
estate

individual
estate

and shall qualify by filing

an acceptance of appointment.
a bond in the amount of $

, and shall have only the following powers:

The individual retains all legal and civil rights except those which have been specifically granted to the partial guardian.
After qualification, the guardian shall comply with all relevant requirements under the law.

15. The guardian is authorized to execute an application to admit the individual named above to

Name of facility

16.

Name (type or print)

.

, whose address and telephone number are

Address

City

State

Zip

   ,
Telephone no.

is appointed standby guardian.  In case of death, incapacity, or resignation of the initially-appointed guardian or an emergency
situation during the absence and unavailability of the initially appointed guardian, the standby guardian shall file

an acceptance of appointment
bond in the amount of $

and shall assume the powers and duties of the initially-appointed guardian.

Date

Address

Attorney name (type or print)

Judge

Bar no.

City

State

Zip

Telephone no.