RULE 10-112. PETITION FOR GUARDIANSHIP OF ALLEGED DISABLED PERSON
West's Annotated Code of MarylandMaryland RulesEffective: July 1, 2023
Effective: July 1, 2023
MD Rules, Rule 10-112
RULE 10-112. PETITION FOR GUARDIANSHIP OF ALLEGED DISABLED PERSON
A petition for guardianship of an alleged disabled person shall be substantially in the following form:
[CAPTION] |
In the Matter of | In the Circuit Court for |
(Name of Alleged Disabled Individual) | (County) |
(docket reference) |
PETITION FOR GUARDIANSHIP OF ALLEGED DISABLED PERSON
INSTRUCTIONS
[ ] | Guardianship of Person | [ ] | Guardianship of Property | [ ] | Guardianship of Person and Property |
The petitioner, __________ (name), ___ (age), whose address is __________, and whose telephone number is __________, represents to the court that:
2. If the alleged disabled person does not reside in the county in which this petition is filed, state the place in this county where the alleged disabled person is currently located
.
NOTE: For purposes of this Form, “county” includes Baltimore City.
[ ] is a beneficiary of the Department of Veterans Affairs and the guardian may expect to receive benefits from that Department.
[ ] is not a beneficiary of the Department of veterans Affairs.
(Check only one of the following boxes)
[ ] I have not been convicted of a crime listed in Code, Estates and Trusts Article, § 11-114.
[ ] I was convicted of such a crime, namely __________. The conviction occurred in ___ (year) in the __________ (name of court), but the following good cause exists for me to be appointed as guardian: __________.
The name of the prospective guardian of the person is __________ and that individual's age is __________. The relationship of that individual to the alleged disabled person is __________.
(Check only one of the following boxes)
[ ] __________ (Name of prospective guardian) has not been convicted of a crime listed in Code, Estates and Trusts Article, § 11-114.
[ ]
__________
was convicted of such a crime, namely
__________
.
The conviction occurred in
___
(year) in the
__________
(Name of court), but the following good cause exists for the individual to be appointed as guardian:
.
The name of the prospective guardian of the property is __________ and that individual's age is ___. The relationship of that individual to the alleged disabled person is __________.
(Check only one of the following boxes)
[ ] __________ (Name of prospective guardian) has not been convicted of a crime listed in Code, Estates and Trusts Article, § 11-114.
[ ] __________ was convicted of such a crime, namely __________. The conviction occurred in ___ (year) in the __________ (Name of court), but the following good cause exists for the individual to be appointed as guardian: __________.
Name | Address | Telephone Number | E-mail Address (if known) | |
Person or Health Care Agent Designated in Writing by Alleged Disabled Person: | ||||
Spouse: | ||||
Parents: | ||||
Adult Children: | ||||
Adult Grandchildren*: | ||||
Siblings*: | ||||
Any Other Heirs at Law: | ||||
Guardian (If appointed): | ||||
Any Person Holding a Power of Attorney of the Alleged Disabled Person: | ||||
Alleged Disabled Person's Attorney: | ||||
A Supporter Pursuant to a Supported Decision-Making Agreement: | ||||
Any Other Person Who Has Assumed Responsibility for the Alleged Disabled Person: | ||||
Any Government Agency Paying Benefits to or for the Alleged Disabled Person: | ||||
Any Person Having an Interest in the Property of the Alleged Disabled Person: | ||||
All Other Persons Exercising Control over the Alleged Disabled Person or the Person's Property: |
A Person or Agency Eligible to Serve as Guardian of the Person of the Alleged Disabled Person (Choose A or B below):
A. Director of the Local Area Agency on Aging (if Alleged Disabled Person is Age 65 or over): | ||||
B. Local Department of Social Services (if Alleged Disabled Person is Under Age 65): |
* Note: Adult grandchildren and siblings need not be listed unless there is no spouse and there are no parents or adult children.
Name | Address | Approximate Dates |
11. (a) Guardianship of the Person is sought because __________ (Name of Alleged Disabled Person) cannot make or communicate responsible decisions concerning health care, food, clothing, or shelter, because of mental disability, disease, habitual drunkenness, addiction to drugs, or other addictions. State the relevant facts: __________.
(b) Describe less restrictive alternatives that have been attempted and have failed (see Code,
Estates and Trusts Article, § 13-705 (b)
):
.
12. (a) Guardianship of the Property is sought because
__________
(Name of Alleged Disabled Person) cannot manage property and affairs effectively because of physical or mental disability, disease, habitual drunkenness, addiction to drugs or other addictions, imprisonment, compulsory hospitalization, detention by a foreign power, or disappearance.
State the relevant facts:
.
(b) Describe less restrictive alternatives that have been attempted and have failed (see Code,
Estates and Trusts Article, § 13-201
):
.
Property | Location | Value | Sole Owner, Joint Owner (specific type), Life Tenant, Trustee, Custodian, Agent, etc. |
14. The petitioner's interest in the property of the alleged disabled person listed in 13. is
.
Name | Address |
Court |
16. All other proceedings regarding the alleged disabled person (including criminal) are as follows:
.
WHEREFORE, Petitioner requests that this court issue an Order to direct all interested persons to show cause why a guardian of the
[ ] person [ ] property [ ] person and property of the alleged disabled person should not be appointed, and (if applicable) __________ (Name of prospective guardian) should not be appointed as the guardian.
Attorney's Signature | Petitioner's Name |
If There is No Attorney: | |
Attorney's Name | |
Attorney's Address | Petitioner's Address |
Attorney's Telephone Number | Petitioner's Telephone Number |
Attorney's E-mail Address | Petitioner's E-mail Address |
Petitioner solemnly affirms under the penalties of perjury that the contents of this document are true to the best of Petitioner's knowledge, information, and belief.
Petitioner's Name
Petitioner's Signature
ADDITIONAL INSTRUCTIONS
(d) Signed and verified certificates of two health care professionals who have examined or evaluated the alleged disabled person. The health care professionals shall be either two physicians licensed to practice medicine in the United States or one such licensed physician and one licensed psychologist, licensed certified social worker-clinical, or nurse practitioner . An examination or evaluation by at least one of the health care professionals must have occurred within 21 days before the filing of the petition (see Code, Estates and Trusts Article, § 13-303 and § 1-102 (a) and (b)).
Credits
[Adopted Sept. 17, 2015, eff. Jan. 1, 2016. Amended Oct. 10. 2017, eff. Jan. 1, 2018; Nov. 19, 2019, eff. Jan. 1, 2020; March 30, 2021, eff. July 1, 2021; April 21, 2021, eff. July 1, 2023.]
MD Rules, Rule 10-112, MD R GUARD AND FIDUCIARIES Rule 10-112
Current with amendments received through February 1, 2024. Some sections may be more current, see credits for details.
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