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RULE 10-112. PETITION FOR GUARDIANSHIP OF ALLEGED DISABLED PERSON

West's Annotated Code of MarylandMaryland RulesEffective: January 1, 2020

West's Annotated Code of Maryland
Maryland Rules
Title 10. Guardians and Other Fiduciaries
Chapter 100. General Provisions
Effective: January 1, 2020
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
(1) Use this form of petition when a guardianship of an alleged disabled person, as defined in Code, Estates & Trusts Article, § 13-101(f) and Rule 10-103 (b) is sought.
(2) If the subject of the petition is a minor including a disabled minor, use the form petition set forth in Rule 10-111.
(3) If guardianship of more than one alleged disabled person is sought, a separate petition must be filed for each alleged disabled person.
(4) If the petition is to be filed in the Circuit Court for Baltimore City, use “Baltimore City” as the name of the county.
[ ]
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:
1. The alleged disabled person __________, age ___, born on the ___ day of __________ (month), __________ (year), a [ ] male or [ ] female resides at __________.
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.
3. The relationship of petitioner to the alleged disabled person is __________.
4. The alleged disabled person
[ ] is a beneficiary of the Veterans Administration and the guardian may expect to receive benefits from that Administration.
[ ] is not a beneficiary of the Veterans Administration.
5. Complete Section 5 if the petitioner is asking the court to appoint the petitioner as the guardian.
(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: __________.
6. Complete Section 6 if the petitioner is asking the court to appoint an individual other than the petitioner as the guardian.
6 a. Prospective Guardian of the Person (Complete Section 6 a if seeking guardianship of the person.)
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:
 
.
6 b. Prospective Guardian of the Property (Complete Section 6 b if the prospective guardian of the property is different from the prospective guardian of the person or if guardianship of the person is not sought.)
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: __________.
7. If the alleged disabled person resides with petitioner, then state the name and address of any additional person on whom initial service shall be made: __________.
8. The following is a list of the names, addresses, telephone numbers, and e-mail addresses, if known of all interested persons (see Code, Estates and Trusts Article, § 13-101(k)):
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:
 
 
 
 
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.
9. The names and addresses of the persons with whom the alleged disabled person resides or has resided over the past five years and the approximate dates of the alleged disabled person's residence with each person are as follows:
Name
Address
Approximate Dates
 
 
 
 
 
 
10. A brief description of the alleged disability and how it affects the alleged disabled person's ability to function is as follows: __________.
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
):
 
.
13. If this Petition is for Guardianship of the Property, the following is the list of all the property in which the alleged disabled person has any interest including an absolute interest, a joint interest, or an interest less than absolute (e.g. trust, life estate):
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
 
.
15. If a guardian or conservator has been appointed for the alleged disabled person in another proceeding, the name and address of the guardian or conservator and the court that appointed the guardian or conservator are as follows:
 
 
Name
Address
 
Court
16. All other proceedings regarding the alleged disabled person (including criminal) are as follows:
 
.
17. All exhibits required by the Instructions below are attached.
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
1. The required exhibits are as follows:
(a) A copy of any instrument nominating a guardian;
(b) A copy of any power of attorney (including a durable power of attorney for health care) which the alleged disabled person has given to someone;
(c) Signed and verified certificates of two physicians licensed to practice medicine in the United States who have examined the alleged disabled person, or of one licensed physician, who has examined the alleged disabled person, and one licensed psychologist or licensed certified social worker-clinical, who has seen and evaluated the alleged disabled person. 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, § 13-103 and § 1-102 (a) and (b)).
2. Attach additional sheets to answer all the information requested in this petition, if necessary.
Source: This Rule is new.

Credits

[Adopted Sept. 17, 2015, eff. Jan. 1, 2016. Amended Oct. 10. 2017, eff. Jan. 1, 2018.]. Amended Nov. 19, 2019, eff. Jan. 1, 2020.
MD Rules, Rule 10-112, MD R GUARD AND FIDUCIARIES Rule 10-112
Current with amendments received through August 1, 2020.
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