Guardianship and Guardian Advocacy what is the difference ...fdlrs.mysdhc.org/documents/ps/Ohall...

*Laurie E. Ohall Dana C. Kemper

[email protected] [email protected]

Elder Law · Medicaid Planning · Estate Planning · Probate · Guardianship

1464 Oakfield Drive, Brandon, Florida 33511 813.438.8503 www.ohalllaw.com

*Licensed in Florida and Ohio *Florida Board Certified Elder Law Attorney

Guardianship and Guardian Advocacy – what is the difference?

What is a guardianship? A court proceeding which determines whether a person is incapacitated, and whether a guardian must be appointed to make decisions about a person or their property. Generally, this is done for an individual who is subject to undue influence or who no longer has the ability to make or communicate sound decisions over their person or property. Common Terms: Guardian, Ward, court-appointed attorney, examining committee, incapacity, guardian over the person, guardian over the property, developmental disability, durable power of attorney, health care surrogate designation. What is the difference between guardianship and guardian advocacy? Generally, the difference is process of how one gains authority over the ward. In a Guardianship (which is governed by Florida Statute, 744.3201 and 744.334), the Ward must first be determined to be incapacitated, and then someone must be appointed the guardian (over the person, over the property or both). For Guardian Advocacy (which is governed by Florida Statute, 393.12), the process does not include an adjudication of incapacity. This process is only for someone with a “developmental disability” who can do some, but not all, of the decision-making tasks to be able to care for their person or property. What is a “developmental disability”? Florida Statute §393.063(9) defines “developmental disability” as a disorder or syndrome that is attributable to intellectual disability (f/k/a mental retardation), cerebral palsy, autism, spina bifida, Down syndrome, Phelan-McDermid syndrome, or Prader-Willi syndrome; that manifests before the age of 18; and that constitutes a substantial handicap that can reasonably be expected to continue indefinitely. How do you show a “developmental disability” if no examining committee is appointed? Obtain a statement from the child’s physician documenting the specific nature of their developmental disability. Can I become my child’s guardian advocate if the child is severely disabled? Yes, but the child must have some level of capacity. Can they feed themselves, toilet themselves, groom and/or dress themselves? Are they able to communicate to the court who they want to be their guardian advocate? Can they communicate at least some of their wants or needs? If the person is incapable of decision-making as to all rights pertaining to person or property, then you may need to proceed with a regular guardianship. What are the rights that are taken away from my child? Guardian over the person: determine residency, consent to medical and mental health treatment, make decisions about social environment or social aspects of life (this includes education), travel without assistance or supervision, and to personally apply for government benefits (technically, a property right); Guardian over the property: to contract, sue and defend lawsuits, manage property or make gifts or disposition of property. Rights they keep: vote, have driver’s license, seek/retain employment. What about marriage? If right to contract taken away, then court can make them come back to court to get seek approval to get married. Do I need an attorney to file to become my child’s guardian advocate? No, not if you are just filing to be guardian over the person. In Hillsborough county, if you want to be guardian over the person and property, you will need an attorney.

mailto:[email protected]

mailto:[email protected]

Guardian Advocacy Information Handbook

and Forms

For Use In The THIRTEENTH JUDICIAL CIRCUIT

HILLSBOROUGH COUNTY, FLORIDA

Materials prepared by:

1464 Oakfield Drive, Brandon, Florida 33511 813.438.8503 www.ohalllaw.com

© 2018 The Law Offices of Laurie E. Ohall, P.A.

HILLSBOROUGH COUNTY GUARDIAN ADVOCATE INFORMATION1

Hillsborough County Clerk Of Court; Probate Division: Phone: 813-276-8100 Where to file your paperwork: Brandon location: 311 Pauls Drive (in person is recommended) Downtown: 800 E. Twiggs Street, 1

st Floor,

Customer Service Center Plant City: 301 N. Michigan Ave. Ruskin: 410 30

th St., S.E.

Mailing address to use after Initial paperwork filed: P.O. Box 3360, Tampa, FL 33601-3360

What is a Guardian Advocate?

Often a Guardian Advocate needs to be appointed when a person with a developmental

disability turns 18 years old. Upon becoming an adult, the parent no longer has the legal ability

to make decisions for their child. To obtain guardian advocacy over an individual, the person

with a developmental disability must have a disorder or syndrome that is attributable to

intellectual disability (IQ below 70), cerebral palsy, autism, spina bifida, Prader‐Willi syndrome,

Down syndrome, Phelan-McDermid syndrome; that manifests before the age of 18; and

constitutes a substantial handicap that can reasonably be expected to continue indefinitely.

Guardian Advocacy is a process for families, caregivers, and friends of individuals with a

developmental disability to obtain a guardianship without having to have an examining

committee appointed to determine that the individual is incompetent. Why is this necessary?

The Florida legislature has recognized that a person with a developmental disability may not be

presumed incapacitated solely by reason of his or her acceptance in nonresidential services or

admission to residential care, and may not be denied the full exercise of all legal rights

guaranteed to citizens of this state and of the United States. (Florida Statute, Section

393.12(1)(a)).

Guardian Advocate appointments are governed by Florida Statute Section 393.12. The

appointment of a Guardian Advocate allows the guardian to make decisions for the person with

a developmental disability. Not everyone with a developmental disability needs a legal guardian.

One is necessary if the person is not able to make the necessary decisions relating to daily life

activities (where to live, financial decisions, educational decisions, etc.). During any Guardian

Advocate proceedings the Court will appoint an attorney for the person with a developmental

1 The information in these materials is for Hillsborough County residents only. Counties vary as to how

procedures are handled, such as the wording of the forms, criminal background checks and the types of forms filed. Additionally, if you are going to file these forms on your own, court staff function under certain service limitations. For example, they can assist you administratively and procedurally but are not able to act as your lawyer or give you legal advice.

disability to represent the developmentally disabled person and ensure their best interest is

protected.

The Guardian Advocate is responsible for only those duties approved by the Judge and

listed in the Court Order. The process of becoming a Guardian Advocate of the person does not

require the hiring of an attorney, unless there are assets involved. In other words, if the child

only has social security benefits or other government payee programs, no attorney is needed.

Please be advised that, if you are seeking to retain rights over the person with the

developmental disability’s rights to contract, seek or retain employment, sue or defend

lawsuits, or manage his/her property, these are property rights (not rights over the

person like the ability to determine residency, social environment, health care/treatment)

and will require you to have an attorney to represent you. Additionally, if the child has

assets such as a pending law suit, an estate inheritance, or other income or assets

coming to them, the parent (or other person) must file to become Guardian Advocate of

the person AND THE property, and in that case, an attorney must be hired. The Court can

expand the description of property rights by Petition and Order.

Background Check Requirements and who may NOT serve as

Guardian Advocate:

Florida Statute Section 744.3135 allows the court to require a non‐professional Guardian

Advocate to submit, at their own expense, to an investigation of the Guardian Advocate’s credit

history and to a level 2 background screening prior to being appointed to serve as Guardian

Advocate. In Hillsborough County (remember, counties are different in how they handle this),

the Court only requires the proposed Guardian Advocate to submit a Credit Report which can

be obtained for free from www.creditkarma.com or www.annualcreditreport.com. The credit

report must be a full credit report taken within the last six months prior to filing for the

proceeding from one of the three credit agencies. In Hillsborough County, the court will run a

criminal background check based on the information submitted in the proposed Guardian

Advocate’s application.

Those persons who may NOT be appointed as a Guardian Advocate include: Any

person who has been convicted of a felony; suffers from any incapacity or illness that makes

them incapable of discharging duties of a Guardian Advocate, or is otherwise unsuitable to

perform the duties of a Guardian Advocate; has been judicially determined to have committed

abuse, abandonment, or neglect against a child as defined in Florida Statutes, Sections 39.01

and 984.03(1), (2), and (37); any person who has been found guilty of, regardless of

adjudication, or entered a plea of no contest to any offense enumerated in Florida Statute,

Section 435.14, or under any similar statute of another jurisdiction; any person who provides

substantial services to the proposed Ward in a professional or business capacity, or is a creditor

of the proposed Ward; any person who is an employee of any person, agency, government, or

corporation that provides services to the proposed Ward in a professional or business capacity,

except that a person so employed may be appointed if he or she is the spouse, adult child,

parent, or sibling of the proposed Ward or the Court determines that the potential conflict of

http://www.creditkarma.com/

http://www.annualcreditreport.com/

interest is insubstantial and that the appointment would clearly be in the proposed Ward’s best

interest; and any provider of health care services to the proposed Ward, whether direct or

indirect, unless the Court specifically finds there is no conflict of interest with the proposed

Ward’s best interests.

Other Relevant Links and Information Florida Statutes

o Guardian Advocate Statute

http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute

&Search_String=&URL=0300-0399/0393/Sections/0393.12.html

o Other Links – Thirteenth Judicial Circuit – link to Administrative Order for

Guardianship Procedures, S-2017-012 – the Court’s procedures for handling

both probate and guardianship matters –

http://www.fljud13.org/Portals/0/AO/DOCS/S-2017-012.pdf?ver=2017-02-01-

103040-317

The Step-by-Step Process of Becoming a Guardian Advocate:

Step One: Complete Necessary Paperwork And File With The Court

Please note that neither the Court nor the staff will help you fill out any of these documents. Do

not ask them to help you fill this out as they cannot provide legal advice to you.

Application for Appointment as Guardian Advocate (Form A)

This includes basic information about the person requesting to be appointed Guardian Advocate

of the person with developmental disabilities such as name, address, phone number, date of

birth, education, employment, etc..

Application for Appointment as Co-Guardian Advocate (Print Form A again)

Application for Determination of Civil Indigent Status (Form B)

if your child cannot afford the filing fees and court appointed attorney fee, then you will need to fill

this out. This needs to be answered as if it is the child’s assets, income, etc., but the parent is the

Petitioner and the one signing as the Affiant. An applicant (the child) is considered indigent if

his/her income is equal to or below 200% of the federal poverty guidelines. There is a

presumption that the applicant is not indigent if he/she owns, or has equity in, any intangible or

tangible personal property or real property or the expectancy of an interest in any such property

having a net equity value of $2,500 or more, excluding the value of the person’s homestead and

one vehicle having a net value not exceeding $5,000. You can also download this form from the

Hillsborough County Clerk of Court website (separately from the GA forms packet).

Waiver and Consent (Form C)

signed by the parent not being appointed Guardian Advocate; use only if both parents are not

going to serve as co-Guardians. If the other parent has died, you will need to provide a copy of

his/her death certificate and use Notice of Filing (Form O) to go with death certificate

Petition for Appointment of Guardian (or Co-Guardian) Advocate of the Person (Form D)

The Petition must state the following:

o Name, age, present address of individual filing petition and their respective relationship to

the person with the developmental disability.

http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0393/Sections/0393.12.html

http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0393/Sections/0393.12.html

http://www.fljud13.org/Portals/0/AO/DOCS/S-2017-012.pdf?ver=2017-02-01-103040-317

http://www.fljud13.org/Portals/0/AO/DOCS/S-2017-012.pdf?ver=2017-02-01-103040-317

o Name, age, county of residence and present address of the person with the

developmental disability.

o State why the person filing the petition feels a Guardian Advocate is necessary.

o Include specific, factual information

o State specific areas where the person lacks decision-making ability

o Specify the legal disabilities as defined in Florida Statute §393.063(9).

o State the name of the proposed Guardian and Co-Guardian Advocate (if applicable) and

the relationship to the person with the developmental disability.

o State any relationship the proposed Guardian Advocate and Co-Guardian Advocate (if

applicable) has or had with any provider of health services, residential services or other

services to the person with the developmental disability.

o Pursuant to Probate Rule 5.649(a)(7), the petition must state whether the petitioner has

knowledge, information or belief that the person with a developmental disability has

created an advanced directive or a durable power of attorney.

o Complete and sign the Guardian Education (if required) and Background Check

Requirement. These forms confirm the petitioner is aware they must submit to a

complete background screening (FL Statute §744.3135) and complete the education

requirement (if not waived) prior to appointment.

Report of Attending Physician (Form E)

Guardian advocate must submit a report from a doctor, school records, individual

education plan, or other professional report which documents the condition and needs of the

person with the developmental disability. If submitting a doctor’s report, it must be signed by an

M.D., and not an ARNP). It must be one of the disabilities as listed in Florida Statute

§393.063(9). If you do not have a report to submit, you can use this form to have the M.D. fill out

and sign.

Oath of Guardian Advocate and Designation of Resident Agent (Form F)

Must be signed in front of a notary by each person seeking to be Guardian Advocate and ensures

that the proposed Guardian Advocate will faithfully perform his or her duties if selected and

certifies that all the information presented to the Court in this proceeding is true. The designation

and acceptance by the resident agent constitutes consent to service of process or notice on the

agent in its representative capacity in any action and in its personal capacity only in those actions

if the guardian is sued personally for claims arising from the administration of the guardianship,

pursuant to Florida Probate Rules 5.110.

Oath of Co-Guardian Advocate (Print Form F again)

Credit report of Guardian Advocate

Each proposed Guardian Advocate must submit a Credit Report which can be obtained for free

from www.creditkarma.com or www.annualcreditreport.com. The credit report must be a full

credit report taken within the last six months prior to filing for the proceeding from one of the three

credit agencies.

Notice of Confidential Filing Information (Form G)

You must file this to notify the Clerk of any confidential information that is in the forms you fill out.

This includes Social security numbers, bank account information, health record information, etc.

Notice of Petition to Appoint Guardian Advocate/Co-Guardian Advocate(s) Under

393.12, Florida Statutes (Form H)

If both parents are going to serve as co-Guardians, then this only needs to be read to the person

with the disability. If one parent is not serving as Guardian, and the parent has not signed the

Waiver and Consent form, this also needs to be mailed by certified mail to that parent (or next of

http://www.creditkarma.com/

http://www.annualcreditreport.com/

kin if parents are no longer alive). Next of kin means those persons who would be heirs of the

Ward, including parents, siblings, or children of the Ward.

Notice of Hearing Before General Magistrate (Form I)

This form must be served on the court appointed attorney, the Ward and any other interested

parties to notify them of the location, date and time of the hearing.

Order Appointing Guardian Advocate (Form J)

You must fill this out completely – the Court will sign the Order only if completed correctly. This

explains the Ward’s developmental disability, explains which rights the Ward lacks decision-

making ability in, and states which of those rights are being given to the guardian advocate to

exercise on behalf of the Ward.

Letters of Guardian Advocacy (Form K)

You must fill this out completely – the Court will sign the Letters only if completed correctly. This

is the paperwork that the Guardian Advocate must produce when presenting him/herself as the

appointed Guardian Advocate and when making decisions for the Ward. This (and the Order

Appointing Guardian Advocate) should be kept in a safe location and the Guardian Advocate

should carry copies when performing services for the Ward.

Initial Plan (Form L)

This must be filed within 60 days of being appointed as the Guardian Advocate. The initial plan

must include a statement of medical, mental, or personal care services of the Ward, and a

statement of the place and kind of residential setting best suited for the needs of the Ward.

Additionally, the Initial Plan must include any expected physical and mental examinations, if

necessary to determine the Ward’s medical and mental health treatment needs.

Annual Plan (Form M)

This must be filed every year within 90 days from the anniversary date of being appointed as

Guardian Advocate. This plan must include information concerning the residence of the Ward,

the medical and mental health conditions, treatment and rehabilitation needs of the Ward, and the

social condition of the Ward.

Miscellaneous Forms/Information (Not required; use only if applicable)

Application for Appointment as Standby Guardian Advocate (Form N)

This form asks for basic information about the person wanting to be Standby Guardian Advocate,

however, this person does not need to submit to any screening, education requirements, or

background check until such time as the Guardian Advocate can no longer serve due to death or

disability, and then the Standby Guardian Advocate must ask the Court to be appointed.

Standby Guardian’s Joinder in Petition (Form O)

Notice of Filing (Form P)

(to be used when filing death certificate of parent, doctor’s report or any document that does not

already have the Case Style at top of page).

Change of Guardian Contact Info/Ward Residence

Pursuant to Hillsborough County Court Administrative Order S-2017-012, all guardians must

promptly advise the court, via written notice filed with the clerk, of any change of his or her name,

address, telephone number, or e-mail address. The notice requirements in the Florida Probate

Rules must be complied with at all times. See also, Florida Probate Rule 5.060. This can be

found at http://www.fljud13.org/CourtPrograms/ElderJusticeCenter/Forms.aspx.

http://www.fljud13.org/CourtPrograms/ElderJusticeCenter/Forms.aspx

BE SURE TO MAKE COPIES OF EVERYTHING YOU FILE WITH THE COURT AGAIN, PLEASE NOTE THAT NEITHER THE COURT NOR THE STAFF WILL HELP YOU FILL OUT

THIS PAPERWORK. DO NOT ASK THEM TO HELP YOU FILL THIS OUT AS THEY CANNOT

PROVIDE LEGAL ADVICE TO YOU. IF YOU ARE UNABLE TO FILL OUT THE PAPERWORK ON

YOUR OWN, YOU SHOULD SEEK THE ADVICE OF AN ATTORNEY.

Step Two: Notice To Parties (Needed only if you do not have

Consent and Waiver of Parent or Next of Kin)

You must send the pleadings by certified mail to all next of kin (who do not sign a Waiver

& Consent). If both parents are alive and have consented or signed to be co-Guardians,

you do not need to send to anyone else. Next of kin may also be adult siblings or

grandparents, if there are no parents.

What to send?

o Consent and waiver letter (tell them why you are doing this and why this is

important)

o Include copy of the Petition for Appointment of Guardian Advocate

o If it is the parent of the child, include a consent and waiver for them to sign and

return to you so you can file with the court.

Send by certified mail, return receipt requested so you can prove to the court that you

mailed the pleadings to them (in case they do not respond)

If you cannot get the parent or other next of kin to give you a Consent and Waiver, and

have to mail to them by certified mail, file the consents with the court when you receive

them; if you do not receive consents, you must wait for the end of the “notice period” (20

days from the date you have proof the certified mail was received).

File proof of service with the Court once the 20 days has passed. You must wait out this

period before the court will allow you to schedule a hearing date.

Step Three: Call the Clerk’s office to confirm that:

The file was opened and Case Number assigned (you may already have received the

case number when you went to the courthouse to file your paperwork)

Confirm the court has everything they need so that you can schedule the hearing – the

court has “everything” when you have submitted everything correctly – the Petition, the

credit report, affidavit of indigency, etc.). Again, please remember that, although

Court staff they can assist you administratively and procedurally, they cannot act

as your lawyer nor can they give you legal advice.

Find out which Magistrate Judge is assigned to the case, and confirm their phone

number and name of the Magistrate Judge’s assistant.

o Sean O. Cadigan, 800 E. Twiggs Street, Room 418, Tampa, FL; 813-276-8517,

Judicial Assistant: Katherine Inglis

o Vicki L. Reeves, 800 E. Twiggs Street, Room 414, Tampa, FL; 813-276-8565,

Judicial Assistant: Joy Casper

The Court will appoint an attorney to represent the developmentally disabled person.

He/she will need to meet with the developmentally disabled person prior to the hearing.

If the attorney does not contact you within 10 days of being appointed, you should call

his/her office to find out when they will meet with your child.

o Also, ask the Court Appointed Attorney if he/she is waiving the appearance of

your child – if he/she says “yes” then your child does not have to come with you

to the hearing; if he/she says “no”, then you must bring your child to the hearing

The Clerk will send the file to the Magistrate Judge who is handling your file ONCE

EVERTHING HAS BEEN FILED CORRECTLY.

It is your responsibility to file all paperwork correctly and to clear a hearing date and time

with Judge’s Judicial Assistant and you must also coordinate the hearing time with the

court-appointed attorney.

Once the hearing date is cleared with the Judicial Assistant and the court-appointed

attorney, you must prepare a Notice of Petition to Appoint Guardian Advocate (Form G),

mail it to all parties and file it with the Clerk of Court.

Step Four: What is next?

Submit your proposed letters to the Clerk and to the Court Appointed Attorney at least

one week before the hearing (or ask the Judge’s Assistant the Judge’s preference);

3 days before the hearing, call the Judicial Assistant and confirm the file is ready for the

hearing and the proposed Letters are in the file (If you previously submitted them).

You will also need to be sure to provide the Judicial Assistant with envelopes and

postage for the Orders and Letters to be mailed to you, the Court Appointed Attorney,

and the Ward.

Step Five: Attend the Hearing

Confirm the date and time of the hearing as well as the location

Plan to wear clothes that are business casual to the hearing.

Be sure to bring your file with the copies of all of the pleadings that you have filed with

you as well as copies of the proposed letters. If you have not submitted these prior to the

hearing, then be sure to bring enough copies for all parties (the Court, the court-

appointed attorney, next of kin (if applicable) and yourself).

Plan to arrive at the courthouse AT LEAST 30 minutes prior to the hearing so that you

have plenty of time to get through security and to the waiting area outside the Judge’s

courtroom.

o You may have to check in with someone at the Judge’s chambers and/or hearing

room. Confirm this with the Judicial Assistant as to the procedure.

The court appointed attorney will meet you outside the courtroom and speak with you

briefly about the case/your child.

HOW TO ACT IN THE COURTROOM:

1. You will wait outside the hearing room/courtroom until you are told your case is ready.

2. You will go into the hearing room/courtroom and the court appointed attorney will direct

you to where you should be seated.

3. The Magistrate Judge will announce the case and then ask you to introduce yourself for

the record (all Guardian Advocacy court proceedings are recorded).

4. You will then briefly explain that you wish to be appointed as the guardian advocate for

your child.

5. The Magistrate Judge may ask you some questions about the documents you filed or

your child.

6. The Magistrate Judge may then ask the court appointed attorney some questions.

7. If the Magistrate Judge is going to grant your request, they will ask you for the proposed

letters and you should be ready to hand those to the Magistrate Judge (if you have not

previously mailed them).

a. If there is missing information or the Magistrate Judge needs something further

from you, they will then explain what else is needed in order to proceed.

b. The Court will sign an Order that states the powers, duties, and responsibilities of

the Guardian Advocate.

c. The person with the developmental disability retains all legal rights except those

which the Court gives to the Guardian Advocate.

8. Once the hearing is done, thank the Magistrate Judge and exit the courtroom.

AFTER THE HEARING

1. The Magistrate Judge will sign a Recommendation Report which the Probate Judge will

review.

2. The Probate Judge will then sign the letters and orders thereby appointing you as the

Guardian Advocate. This usually comes the same time as the Recommendation Report.

3. The process of receiving the letters and orders may take a few weeks. Once you

receive the signed, conformed copies, you will need to go to the Clerk’s office and get

certified copies of the letters.

a. “Conformed” means it will have the date that the judge signed the Letters and

Orders, but it may not have their actual signature.

b. “Certified” copy has the actual signature and date the letters and Orders were

signed, and is certified by the Clerk of Court to be an actual copy of what the

judge signed. You may need a certified copy of the letters to show to your child’s

school, doctors or a financial institution.

c. Bring cash to pay for the certified copies.

4. You must file an Initial Plan (Form K) within 60 days from the date the Judge signed the

Order Appointing Guardian Advocate.

You are now the Guardian Advocate for your child! But don’t forget: You must also file an annual plan with the Court every year within 90

days of the anniversary date of the appointment as Guardian Advocate.

Glossary of Terms which may be used in these forms

(as defined in 393.063 or 744.102, Florida Statutes)

Autism means a pervasive, neurologically based developmental disability of extended duration which

causes severe learning, communication, and behavior disorders with age of onset during infancy or

childhood. Individuals with autism exhibit impairment in reciprocal social interaction, impairment in

verbal and nonverbal communication and imaginative ability, and a markedly restricted repertoire of

activities and interests.

Cerebral palsy means a group of disabling symptoms of extended duration which results from damage

to the developing brain that may occur before, during, or after birth and that results in the loss or

impairment of control over voluntary muscles. For the purposes of this definition, cerebral palsy does

not include those symptoms or impairments resulting solely from a stroke.

Developmental disability means a disorder or syndrome that is attributable to intellectual disability,

cerebral palsy, autism, spina bifida, Down syndrome, Phelan-McDermid syndrome, or Prader-Willi

syndrome; that manifests before the age of 18; and that constitutes a substantial handicap that can

reasonably be expected to continue indefinitely.

Domicile means the place where a client legally resides and which is his or her permanent home.

Domicile may be established as provided in s. 222.17. Domicile may not be established in Florida by a

minor who has no parent domiciled in Florida, or by a minor who has no legal guardian domiciled in

Florida, or by any alien not classified as a resident alien.

Down syndrome means a disorder caused by the presence of an extra chromosome 21.

Guardian means a person who has been appointed by the court to act on behalf of a ward’s person or

property, or both.

Guardian advocate means a person appointed by a written order of the court to represent a person

with developmental disabilities under s. 393.12.

Intellectual disability means significantly subaverage general intellectual functioning existing

concurrently with deficits in adaptive behavior which manifests before the age of 18 and can

reasonably be expected to continue indefinitely. For the purposes of this definition, the term:

(a) “Adaptive behavior” means the effectiveness or degree with which an individual meets the

standards of personal independence and social responsibility expected of his or her age, cultural group,

and community.

(b) “Significantly subaverage general intellectual functioning” means performance that is two

or more standard deviations from the mean score on a standardized intelligence test specified in the

rules of the agency.

http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0200-0299/0222/Sections/0222.17.html

http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0393/Sections/0393.12.html

For purposes of the application of the criminal laws and procedural rules of this state to

matters relating to pretrial, trial, sentencing, and any matters relating to the imposition and execution

of the death penalty, the terms “intellectual disability” or “intellectually disabled” are

interchangeable with and have the same meaning as the terms “mental retardation” or “retardation”

and “mentally retarded” as defined in this section before July 1, 2013.

Phelan-McDermid syndrome means a disorder caused by the loss of the terminal segment of the long

arm of chromosome 22, which occurs near the end of the chromosome at a location designated q13.3,

typically leading to developmental delay, intellectual disability, dolicocephaly, hypotonia, or absent or

delayed speech.

Prader-Willi syndrome means an inherited condition typified by neonatal hypotonia with failure to

thrive, hyperphagia or an excessive drive to eat which leads to obesity usually at 18 to 36 months of

age, mild to moderate intellectual disability, hypogonadism, short stature, mild facial dysmorphism,

and a characteristic neurobehavior.

Relative means an individual who is connected by affinity or consanguinity to the client and who is 18

years of age or older.

Resident means a person who has a developmental disability and resides at a residential facility,

whether or not such person is a client of the agency.

Residential facility means a facility providing room and board and personal care for persons who have

developmental disabilities.

Spina bifida means a person with a medical diagnosis of spina bifida cystica or myelomeningocele.

Guardian Advocacy Forms

Table of Contents

A. Application for Appointment as Guardian/Co-Guardian Advocate(s)

B. Application for Determination of Civil Indigent Status (Clerk’s Form)

C. Waiver and Consent to Appointment of Guardian/Co-Guardian Advocate(s)

D. Petition for Appointment of Guardian/Co-Guardian Advocate(s)

E. Report of Attending Physician

F. Oath of Guardian/Co-Guardian Advocate, Designation of Resident Agent

and Acceptance

G. Notice of Confidential Filing Information

H. Notice of Petition to Appoint Guardian Advocate/Co-Guardian Advocate(s) Under

393.12, Florida Statutes.

I. Notice of Hearing Before General Magistrate

J. Order Appointing Guardian Advocate (Modify to Co-Guardian if applicable)

K. Letters of Guardian/Co-Guardian Advocacy

L. Initial Plan

M. Annual Plan

Miscellaneous Forms

N. Application for Appointment as Standby Guardian Advocate

O. Standby Guardian Advocate’s Joinder in Petition

P. Notice of Filing

FORM A

IN THE CIRCUIT COURT OF THE THIRTEENTH JUDICIAL CIRCUIT

FOR HILLSBOROUGH COUNTY, FLORIDA

Probate, Guardianship, Mental Health and Trust Division

IN RE: GUARDIAN ADVOCACY OF CASE NO.:

_________________________________,

A Person with a Developmental Disability/, DIVISION:

APPLICATION FOR APPOINTMENT AS GUARDIAN/CO-GUARDIAN ADVOCATE

Pursuant to Sections 744.3125 of the Florida Guardianship Law, the undersigned submits

this Application for Appointment as Guardian/Co-Guardian Advocate of ___________________

(the person with a development disability) and submits the following information (whenever the

space provided is insufficient, attach additional pages):

1. Name: ___________________________________________________

2. Social Security Number: ___________________________________________________

3. Date and Place of Birth: ___________________________________________________

4. Residence address: ______________________________________________________

5. Mailing address: ___________________________________________________

6. Email address: __________________________________________________

7. U.S. Citizen? Yes _____ No _____

8. Employer’s name and address: _____________________________________________

_____________________________________________________________________________

Applicant’s position: ______________________________________________________

9. Marital status and name of spouse, if any: ____________________________________

_____________________________________________________________________________

10. Home telephone number: ________________________________

Work telephone number: _________________________________

11. Length of residence in county wherein application is filed: ________________________

12. If currently serving as a guardian for any other ward, list names of each ward, court file

number(s), circuit court(s) in which the case(s) is/are pending and whether applicant is acting as

the limited or plenary guardian of the person or property or both: _________________________

_____________________________________________________________________________

_____________________________________________________________________________

______________________________________________________________________________

____________________________________________________________________________

13. If you are a professional guardian, please indicate month, day, and year in which you

were appointed on your third case:

_____________________________________________________________________________

14. Does applicant have any physical disabilities? Yes _____ No _____. If yes, please

describe and state whether such disability my affect applicant’s ability, in any degree, to serve as

guardian: _____________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

__________________________________________________________________________

15. Has applicant ever been treated for the following:

a. Mental condition? Yes _____ No _____

b. Alcohol? Yes _____ No _____

c. Drugs? Yes _____ No _____

d. Other? Yes _____ No _____

Nature of condition: ____________________________________________________________

If “yes” was answered to any of the above, please state date, time, location of treatment

and name of physician or professional involved: ______________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

__________________________________________________________________________

16. Has applicant ever been judicially determined to have committed abuse, abandonment, or

neglect against a child as defined by the Florida Statutes? Yes _____ No _____

17. Has applicant ever been the subject of a confirmed report of abuse, neglect, or

exploitation which has been uncontested or upheld pursuant to the provisions of Sections

415.104 and 415.1075, Florida Statutes? Yes _____ No _____

18. Has applicant ever been charged with fraud, misrepresentation or perjury in a judicial or

administrative proceeding? Yes _____ No ______ If yes, please give date and complete details:

______________________________________________________________________

______________________________________________________________________________

____________________________________________________________________________

19. Has applicant ever been charged with, arrested for, or convicted of a felony, even if the

record of such arrest or conviction has been expunged, unless the expunction was ordered

pursuant to Florida Statutes Section 943.0583? Yes _____No _____ If yes, please furnish

details including date, type of offense, location and final disposition:

_____________________________________________________________________________

20. Has applicant ever been charged with, arrested for, or convicted of any other crimes?

Yes ____ No ____. If yes, please furnish details, including date, type of offense, location, and

final disposition:

___________________________________________________________________

21. Has applicant ever held a position, which required bonding? Yes _____ No _____ If

yes, please describe position, date, amount of bond and name of surety:

______________________________________________________________________________

______________________________________________________________________________

__________________________________________________________________________

22. Has applicant, in the past, ever served as guardian of a person or of a person’s property?

Yes _____ No _____ If yes, please describe below, including reason for termination of fiduciary

position: ____________________________________________________________________

23. Has applicant ever been held in contempt of court or removed as guardian?

Yes _____ No _____ If yes, please describe below:

______________________________________________________________________________

____________________________________________________________________________

24. Has applicant ever filed for bankruptcy? Yes _____ No _____ If yes, please state date

and location of court:

______________________________________________________________________________

____________________________________________________________________________

25. Has the applicant ever been found guilty, plead nolo contendere or guilty of an offense

prohibited by Florida Statutes 435.04 or similar statute of another jurisdiction? Yes ____ No ___

If yes, please give details, to include date, type of offense, location, and final disposition:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

26. What is applicant’s relationship to the alleged the person with a developmental disability?

______________________________________________________________________________

27. Is applicant, or applicant’s business, corporation or other business entity a creditor of, or

providing substantial professional, personal, or business services to the person with a

developmental disability? Yes _____No _____ If yes, please furnish details:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

28. Is applicant employed by a person, agency, government, corporation or other business

entity, which is providing professional, personal or business services to the person with a

developmental disability?

Yes _____ No _____ If yes, please furnish details:

______________________________________________________________________________

______________________________________________________________________________

___________________________________________________________________________

29. Is applicant a health care provider for the person with a developmental disability?

Yes ________No ______

30. Educational history of applicant:

Name and address Degree Date

High school: ____________________________________________________________

College: _______________________________________________________________

Other: _________________________________________________________________

31. List applicant’s employment experience for the past ten (10) years beginning with the

most recent date:

Name and address Date(s) Reason for leaving

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

_______________________________________________________________

32. Has applicant ever been discharged from employment: Yes _____ No _____ If yes,

please explain:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

33. Has applicant ever been a member of the armed forces of the U.S.? Yes _____ No ____

If yes, what branch, dates and military serial number:

______________________________________________________________________________

______________________________________________________________________________

34. PERSONAL REFERENCES. Please give the names, addresses and telephone numbers

of three (3) responsible persons who have been closely associated with applicant and who have

known applicant for five (5) years or more, not including relatives or spouse:

Name and address Telephone number

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

35. Does applicant possess any special educational qualifications (financial, business or

otherwise) that uniquely qualifies applicant to be appointed as guardian? Yes _____ No ______

If yes, please describe below: _____________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________________________________________________

36. Has applicant received instruction and training, which covered the legal duties and

responsibilities of a guardian, the rights of a ward, the availability of local resources to aid a

ward, and the preparation of habilitation plans and annual guardianship reports, including

financial accounting for the ward’s property? Yes _____ No _____ If so, indicate when and

where training was received: _____________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged

are true, to the best of my knowledge and belief.

Signed on _________________________, 20___

Signature______________________________ Name_________________________________

Print Name:____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Petitioner)




________________________________,

In the Interest of Guardian Advocacy CASE NO.:

Of ______________________________ DIVISION:

APPLICATION FOR DETERMINATION OF CIVIL INDIGENT STATUS

Notice to Applicant: If you qualify for civil indigence you must enroll in the clerk’s office payment plan and pay a one-time administrative fee of $25.00. This fee shall not be charged for Dependency or Chapter 39 Termination of Parental Rights actions. 1. I have __ _dependents. (Include only those persons you list on your U.S. Income tax return.) Are you Married? Yes No Does your Spouse Work? ...Yes….No Annual Spouse Income? $_____________ 2. I have a net income of $ _______ paid ( ) weekly ( ) every two weeks ( ) semi-monthly ( ) monthly ( ) yearly ( ) other ______. (Net income is your total income including salary, wages, bonuses, commissions, allowances, overtime, tips and similar payments, minus deductions required by law and other court-ordered payments such as child support.) 3. I have other income paid ( ) weekly ( ) every two weeks ( ) semi-monthly ( ) monthly ( ) yearly ( ) other _____________. (Circle “Yes” and fill in the amount if you have this kind of income, otherwise circle “No”) Second Job ........................................... Yes $ __________ No Veterans’ benefits .................................................. Yes $ __________ No Social Security benefits Workers compensation........................................... Yes $ __________ No

For you .................................. Yes $ __________ No Income from absent family members ...................... Yes $ __________ No For child(ren) ......................... Yes $ __________ No Stocks/bonds ......................................................... Yes $ __________ No

Unemployment compensation................ Yes $ __________ No Rental income ........................................................ Yes $ __________ No Union payments ..................................... Yes $ __________ No Dividends or interest .............................................. Yes $ __________ No Retirement/pensions .............................. Yes $ __________ No Other kinds of income not on the list ...................... Yes $ __________ No Trusts .................................................... Yes $ __________ No Gifts ....................................................................... Yes $ __________ No I understand that I will be required to make payments for fees and costs to the clerk in accordance with §57.082(5), Florida Statutes, as provided by law, although I may agree to pay more if I choose to do so. 4. I have other assets: (Circle “yes” and fill in the value of the property, otherwise circle “No”) Cash ...................................................... Yes $ __________ No Savings account ..................................................... Yes $ __________ No Bank account(s) ..................................... Yes $ __________ No Stocks/bonds ......................................................... Yes $ __________ No Certificates of deposit or Homestead Real Property* ..................................... Yes $ __________ No money market accounts ......................... Yes $ __________ No Motor Vehicle* ........................................................ Yes $ __________ No Boats* .................................................... Yes $ __________ No Non-homestead real property/real estate* .............. Yes $ __________ No *show loans on these assets in paragraph 5 Check one: I ( ) DO ( ) DO NOT expect to receive more assets in the near future. The asset is__________________________. 5. I have total liabilities and debts of $_______ as follows: Motor Vehicle $__________, Home $__________, Other Real Property $__________, Child Support paid direct $__________, Credit Cards $__________, Medical Bills $__________, Cost of medicines (monthly) $______________, Other $__________. 6. I have a private lawyer in this case………… Yes No. A person who knowingly provides false information to the clerk or the court in seeking a determination of indigent status under s. 57.082, F.S.

commits a misdemeanor of the first degree, punishable as provided in s.775.082, F.S. or s. 775.083, F.S. I attest that the information I have

provided on this application is true and accurate to the best of my knowledge.

Signed this _________ day of _______________, 20____. _______________________________________________ Signature of Applicant for Indigent Status

_______________ ____________________________

Date of Birth Driver’s License or ID Number Phone Number: __________________________________

_______________________________________

Address, City, State, Zip Code

CLERK’S DETERMINATION

Based on the information in this Application, I have determined the applicant to be ( ) Indigent ( ) Not Indigent, according to s. 57.082, F.S.

Dated this _________ day of ______________, 20 ____. Clerk of the Circuit Court by

This form was completed with the assistance of: __________________________________________________

Clerk/Deputy Clerk/Other authorized person.

APPLICANTS FOUND NOT TO BE INDIGENT MAY SEEK REVIEW BY A JUDGE BY ASKING FOR A HEARING TIME.

THERE IS NO FEE FOR THIS REVIEW. Sign here if you want the judge to review the clerk’s decision __________________________________________

FORM C





________________________________,

A Person with a Developmental Disability/ DIVISION:

WAIVER AND CONSENT TO APPOINTMENT OF GUARDIAN ADVOCATE

The undersigned, _________________________, whose complete name and address are:

_____________________________________________________________________________

___________________________________________________________________________,

and who has an interest in the above Guardian Advocacy as the (brother/sister/parent/child)

_________________________ of the person with a developmental disability/Ward,

acknowledges receipt of a copy of the Petition for Appointment of Guardian/Co-Guardian

Advocate(s) and hereby waives hearing and notice of hearing thereon, and consents to the

settlement and entry of an order granting the relief requested in the Petition without notice or

hearing.

Signed this ______ day of __________________, 20____.

Signature_____________________________

Print Name_____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

FORM D





___________________________________,


PETITION FOR APPOINTMENT OF GUARDIAN/CO-GUARDIAN ADVOCATE(S)

Petitioner(s), _________________________________________________________, allege:

1. Petitioner_________________________________________’s residence is

________________________________________________ and mailing address is

_______________________________________________.

2. (If Co-Guardian Advocacy is sought, list 2nd

Petitioner here. If none, write “none”)

Petitioner_________________________________________’s residence is

________________________________________________ and mailing address is

_______________________________________________.

3. Petitioner’s date of birth is _______________ and is an adult, age ______.

Petitioner’s relationship to ______________________________, the person with a

developmental disability (hereinafter the “Ward”) is ___________________.

4. (If Co-Guardian Advocate, list 2nd

Petitioner here. If none, write “none”)

Petitioner’s date of birth is _______________ and is an adult, age ______. Petitioner’s

relationship to the Ward is _____________________________.

5. ______________________________________________ is a person with a

developmental disability, who was born on _______________, and who is _____ years of age.

The Ward’s primary language is ____________________ and the Ward’s Social Security

number is ______________________. (Requires filing of Notice of Confidential Information

Within Court Filing pursuant to FRJA 2.420(d)(2)). The Ward resides in Hillsborough County,

Florida, and his/her residential address is _________________________________________ and

his/her mailing address is: _________________________________________________.

6. The Ward’s next of kin is/are: (include names and addresses of any non-

petitioning parent and any adult siblings: ___________________________________________

___________________________________________________________________________

___________________________________________________________________________

7. The Petitioner(s) believe that the Ward is in need of a Guardian Advocate due to his/her

developmental disability which manifested itself prior to the age of eighteen (18), specifically

(choose one or all that apply): ( ) intellectual disability; ( ) cerebral palsy; ( ) autism;

( ) Spina Bifida; ( ) Prader‐Willi syndrome; ( ) Down syndrome; ( ) Phelan-McDermid

syndrome. As a result, the Ward essentially functions at the grade level of _______ and all

medical probability indicates that this condition will not change.

8. The Petitioner(s) believe(s) a Guardian Advocate is necessary because the Ward

lacks the decision-making ability to make informed decisions about the Ward’s own person,

specifically the following rights: (check all which apply)

(____) to personally apply for and manage government benefits

(____) to contract

(____) to sue and defend lawsuits

(____) to manage property or make any gift or disposition of property

(____) to determine his/her residency

(____) to consent to medical and mental health treatment

(____) to make decisions about his/her social environment/social aspects of

his/her life

(____) to marry

(____) to vote

(____) to travel without assistance or supervision

(____) to have a driver’s license

(____) to seek or retain employment

9. Petitioner(s) is/are willing and able to act as Guardian Advocate for the Ward, and

should be appointed as Guardian Advocate because Petitioner(s) is/are the Ward’s

________________________ (insert relationship to Ward), is willing to serve in that capacity,

and is best qualified to act on the Ward’s behalf.

10. The Petitioner(s) further state(s) that the Ward is unable to understand the concept

of legal representation and cannot afford an attorney for representation at this proceeding.

11. In accordance with Probate Rule 5.649(a)(7), Petitioner(s) has/have knowledge,

information or belief that the Ward (has) (has not) – CHOOSE ONE – created an advanced

directive or a durable power of attorney.

12. The Petitioner(s) further state(s) that the Ward is indigent, having no assets and no

income other than public assistance and requests that the Court waive all costs incurred

commencing this case and direct the Clerk of the Circuit Court to void all charges related to

same.

13. The Petitioner(s) request(s) this Court set a hearing to inquire into the capacity of

the Ward, and should the Court determine it is appropriate to do so, enter an Order appointing

_________________________________________________ (Insert Guardian/Co-Guardian’s

name(s)) as Guardian Advocate(s) for ___________________________________ (the Ward).

14. Petitioner(s) file(s) with this Court his/her/their Application(s) for Appointment as

Guardian Advocate which provides the Social Security Number of the proposed Guardian

Advocate(s), so that a criminal records check can be conducted by the Court, pursuant to the

applicable Administrative Order of the Court. Further, Petitioner(s) also submits his/her/their

credit report(s) to the Court for review prior to the hearing, pursuant to the applicable

Administrative Order of the Court.

15. The Petitioner(s) further request(s) that this Court allow the Guardian Advocate(s)

to file a Simplified Annual Plan without the necessity of a physician’s statement, after the filing

of and the Court’s approval of a full Initial Plan and the First Annual Plan.

Under penalties of perjury, I/We declare that I have read the foregoing, and the facts

alleged are true, to the best of my knowledge and belief.

Executed this __________ day of _____________________, 20____.

Signature______________________________

Print Name_____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Petitioner)

(If co-Guardians, both sign)

Signature______________________________

Print Name_____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Co-Petitioner)

CERTIFICATE OF SERVICE

I, ________________________________, do hereby certify that a true and correct copy of the attached

Petition to Appoint Guardian/Co-Guardian Advocate, has been furnished by (type of mail)

______________________, on this ____ day of _____________________, 20___ to the following persons, at the

address specified: ___________________________________________________________________________

_____________________________________________________________________________________________

_________________________________________________________________________________________

Signature__________________________________

Print Name________________________________

Address___________________________________

Phone ____________________________________

E-mail address _____________________________

(Petitioner)

FORM E



Probate Guardianship Division


DIVISION:

__________________________________,

A Person with a Developmental Disability/

REPORT OF ATTENDING PHYSICIAN

PHYSICIAN’S NAME:

__________________________________________________________________________________

PHYSICIAN’S PRACTICE, INCLUDING SPECIALITY:

__________________________________________________________________________________

__________________________________________________________________________________

FOR (Patient name): _________________________________________________________________

DATE: ____________________________________________________________________________

This will verify that (Patient) ___________________________________________________________

has been a patient of mine since (date) ____________________________________________________

and that my diagnosis and the associated disabilities are as follows (describe diagnosis and disabilities:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

With the extent of these problems, I feel that ______________________________________________

Is unable to handle personal matters regarding finances and physical well-being and that a guardian

advocate should be appointed to act on his/her behalf.

______________________________________

PHYSICIAN’S SIGNATURE

DATE:____________________________________

FORM F





________________________________, DIVISION:


OATH OF GUARDIAN/(CO)GUARDIAN ADVOCATE, DESIGNATION OF

RESIDENT AGENT & ACCEPTANCE

(Each Guardian Advocate must sign an Oath)

STATE OF FLORIDA

COUNTY OF HILLSBOROUGH

I, ___________________________ (Affiant), state under oath that:

1. I will faithfully perform the duties of Guardian/Co-Guardian Advocate of the Person of

_______________________________________ (the Ward), according to law and accept

the Designation as Resident Agent.

2. My place of residence is

________________________________________________________ and post office

address is _______________________________________________________.

Signature_____________________________ Name_________________________________

Signature______________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Affiant – Resident Agent)

Sworn to and subscribed before me on _________(month) ____(day), 20____, by

Affiant, who is personally known to me or who produced ________________________as

identification.

______________

Notary Public State of Florida

My Commission Expires:

FORM G





___________________________________,


NOTICE OF CONFIDENTIAL INFORMATION WITHIN COURT FILING

Pursuant to Florida Rules of Judicial Administration 2.420(d)(2), the filer of a court record at the time of

filing shall indicate whether any confidential information is included within the document being filed;

identify the confidentiality provision that applies to the identified information; and identify the precise

location of the confidential information within the document being filed.

Title/Type of Document(s):

( ) Petition for Appointment of Guardian/Co-Guardian Advocates of Person, Page(s)____________,

Paragraph(s)_________;

( ) Application of __________________________for Appointment as Guardian Advocate,

Page(s)____________, Paragraph(s)_________;

( ) Application of __________________________for Appointment as Co-Guardian Advocate,

Page(s)____________, Paragraph(s)_________; (if there is co-Guardian)

( ) Confidential Psychological Report, Entire report.

( ) Credit report(s) of____________________________________________________________

(if more than one Guardian, list both names), Entire Report.

( ) Copy of Death Certificate of deceased parent of Ward, Entire report.

Indicate the applicable confidentiality provision(s) below from Rule 2.420(d)(1)(B), by specifying the

location within the document on the space provided:

_____________________________________________________________________________________

_______________________________________________________________________

______________________________________________________________________________

Signature_____________________________ _ Name_________________________________

Print Name:____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Filer)

Note: The clerk of court shall review filings identified as containing confidential information to determine whether the

information is facially subject to confidentiality under the identified provision. The clerk shall notify the filer in writing within 5

days if the clerk determines that the information is NOT subject to confidentiality, and the records shall not be held as

confidential for more than 10 days, unless a motion is filed pursuant to subdivision(d)(3) of Rule 2.420.

FORM H





DIVISION:

__________________________________,


NOTICE OF PETITION TO APPOINT GUARDIAN ADVOCATE

UNDER 393.12, FLORIDA STATUTES

THIS NOTICE MUST BE READ TO THE PERSON WITH DEVELOPMENTAL

DISABILITY(IES)

(In the language of the Person and in English)

TO:[SUBJECT’S NAME]_______________________________________________

[Address for Service] _______________________________________________

[NEXT OF KIN’S NAME(S)]________________________________________

[Address(es) for Service] ____________________________________________

__________________________________________________________________

1. YOU ARE HEREBY NOTIFIED that a Petition has been filed seeking to

appoint a Guardian Advocate for the person (and government benefits, if applicable) of

________________. A copy of the Petition to Appoint Guardian Advocate, pursuant to

393.12(2) Fla. Stat., is either attached to this notice or has already been provided to you. There

will be a hearing on the Petition to Appoint Guardian Advocate before

_________________________________, in Courtroom/Hearing Room ____ of the Hillsborough

County Edgecomb Courthouse, Tampa, Hillsborough County, Florida, on the _____ day of

__________________, 20__, at ___:___a.m./p.m.

2. The reason for this hearing is to inquire into ______________________’s capacity

to exercise the rights enumerated in the petition and to determine whether a guardian advocate

should be appointed over ________________________’s person or government benefits or both.

3. For the person with a developmental disability ONLY: You have the right to an

attorney, and one has been appointed to represent you. The name, address and telephone number

of the attorney are as follows:

Name

Address

Phone

Email

You also have the right to substitute your own attorney for the attorney appointed by the court.


I HEREBY CERTIFY, under penalties of perjury, that a copy of the foregoing Notice was read to

the alleged developmentally disabled person on , 20__, and that a

copy of the Petition for Appointment of Guardian Advocate was furnished to the alleged

developmentally disabled person on ______.

Signature______________________________ Signature_____________________________ Name_________________________________

Print Name:____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Petitioner)

If you are a person with a disability who needs any accommodation in order to participate

in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance.

Please contact ADA Coordinator, Hillsborough County Courthouse, 800 E. Twiggs St.,

Room 604, Tampa, FL 33602 at (813) 272-7040, at least 7 days before your scheduled court

appearance, or immediately upon receiving this notification if the time before the

scheduled appearance is less than 7 days; if you are hearing or voice impaired, call 711.

FORM I





______________________________, DIVISION:

Developmentally disabled person/

NOTICE OF HEARING BEFORE GENERAL MAGISTRATE To: All interested parties and the court appointed attorney for the AIP: ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

YOU WILL PLEASE TAKE NOTICE there will be a hearing on the Petition to Appointment Guardian

Advocates on _____________________________(date) at ________ A.M./P.M. before General Magistrate

_________________________ in Courtroom __________ of the George E. Edgecomb Courthouse, 800 E. Twiggs

St., Tampa, Florida 33602.

TIME RESERVED: 15 minutes

PLEASE GOVERN YOURSELF ACCORDINGLY.

NOTICE: In the event that English/Spanish interpretative assistance is required for this hearing, you must immediately contact the Office of Court Interpreters at (813) 272-5947. No other interpretative assistance will be accepted by the court. In accordance with the American with Disabilities Act of 1990, persons needing a special accommodation to participate in this proceeding should contact the ADA Coordinator for proceedings in court or out of court proceedings no later than seven (7) days before the proceeding. Telephone (813) 272-7040 for assistance. If hearing impaired, telephone (TAD) 1-800-955-8770 for proceedings in court or Florida Relay Service 1-800-955-8771 for out of court proceedings.

YOU ARE HEREBY ADVISED THAT IN THIS CIRCUIT:

Electronic recording is provided by the court. A party may provide a court reporter at the party’s expense.

I HEREBY CERTIFY that a copy of the forgoing Notice of Hearing was electronically served to the above-named addressee on __________________________.

Signature______________________________ Signature_____________________________ Name_________________________________

Print Name:____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Petitioner)

FORM J





______________________________, DIVISION:

Developmentally disabled person/

ORDER APPOINTING GUARDIAN ADVOCATE

(developmentally disabled, person and property)

1. The nature of the incapacity of _______________________________(the Ward) is

developmental disability in the form of ___________________________________, the scope of the

Ward's disability being such that the Ward functions at the level of a young child, a condition that, in all

medical probability, will not change.

2. The Ward lacks the capacity to make informed decisions regarding any aspect of care or

treatment, is unable to meet any essential requirements for his own physical health and safety and cannot

exercise on his own behalf, any of the following rights: to contract; to sue and defend lawsuits; to apply

for government and other public benefits; to manage property or make any gift or disposition of the same;

to determine residence; to consent to medical, surgical and mental health treatment; and to consent to

marriage.

3. The Ward's specific legal disabilities are ___________________________ and other

related health conditions resulting in an operational level commensurate with that of a young child.

4. It is necessary for a Guardian Advocate to be appointed for the Ward, the Guardian

Advocate having the power and duty to exercise on behalf of the Ward the following rights:

a. To contract;

b. To sue and defend lawsuits; and

c. To apply for government and other public benefits; and

d. To manage property or make any gift or disposition of the same; and

e. To determine residence; and

f. To consent to medical, surgical and mental health treatment; and

g. To make decisions about his/her social environment/social aspects of his/her life; and

h. To consent to marriage.

It is, therefore,

ADJUDGED as follows:

____________________________________________ is qualified to serve, and is hereby

appointed as Guardian Advocate of the person and property of ___________________________, a

developmentally disabled person, with the power and duty to exercise on behalf of those rights described

in paragraphs 4a through 4h above.

DONE and ORDERED in Chambers at Tampa, Florida, this ___________________.

_____________________________

CIRCUIT COURT JUDGE

Copies to:

FORM K





____________________________, Ward. DIVISION: ________________________________________/

LETTERS OF GUARDIAN/CO-GUARDIAN ADVOCATE(S) OF THE PERSON

TO ALL WHOM IT MAY CONCERN:

WHEREAS, ____________________________________ has/have been appointed

Guardian/Co-Guardian Advocate(s) of the Person of

________________________________________, a person with a developmental disability who

lacks the decision-making capacity to do SOME/ALL of the tasks necessary to take care of his

person; and

WHEREAS, the Guardian/Co-Guardian Advocate(s) has taken and filed the prescribed

oath and performed all other acts prerequisite to the issuance of Letters of Guardian/Co-Guardian

Advocate(s) of the Person;

NOW, THEREFORE, I, the undersigned circuit judge, declare that

________________________________ is duly qualified under the laws of the State of Florida to

act as Guardian/Co-Guardian Advocate(s) of the Person of

________________________________________ with full power to exercise the following

powers and duties on behalf of the person with a developmental disability:

(____) to determine his/her residency

(____) to consent to medical and mental health treatment

(____) to make decisions about his/her social environment/social aspects of his/her life

(____) to act as representative payee of government benefits or seek such benefits

(____) Other:____________________________________________________________

________________________________________________________________________

________________________________________________________________________

Without first obtaining specific authority from the Court, as stated in section

744.3725, Florida Statutes, the Guardian/Co-Guardian Advocate(s) may not:

(a) commit the person with a developmental disability to a facility, institution, or licensed

service provider without formal placement proceedings, pursuant to Chapter 393, Florida

Statutes;

(b) consent to the participation of the person with a developmental disability in any

experimental biomedical or behavior procedure, exam, study, or research;

(c) consent to the performance of a sterilization or abortion procedure on the disabled

person;

(d) consent to termination of life support systems provided for the person with a

developmental disability

(e) initiate a petition for dissolution of marriage for the ward

(f) exercise any authority over any health care surrogate appointed by any valid advance

directive executed by the disabled person, pursuant to Chapter 765, Florida Statutes, except upon

further order of this Court.

_________________________________________ (the person with developmental

disability) shall retain all legal rights except those which are specifically granted to the

Guardian/Co-Guardian Advocate(s) pursuant to court order.

DONE AND ORDERED in chambers at ______________________, Hillsborough

County, Florida on ____________________________________.

______________________________________

Circuit Court Judge

FORM L





____________________________, Ward. DIVISION: ________________________________________/

INITIAL GUARDIANSHIP PLAN (GUARDIANSHIP REPORT)

OF GUARDIAN OF THE PERSON

________________________________________________________, the Guardian (s)

of the person of ________________________________, (the Ward), submits the following plan

as the Initial Guardianship Plan of this guardian:

1. During the period beginning ___________________, 20____ and ending

_____________________, 20_____, the Guardian(s) propose(s) the following plan for the

benefit of the ward, which is based upon the Order Appointing a Guardian/Co-Guardian

Advocate(s):

a. Medical, mental or personal care services to be provided for the welfare of

the Ward (Which doctor(s) does the ward visit regularly? What kind of assistance does

the ward require for activities of daily living? Does the ward require any mental health

care?):

b. Social and personal services to be provided for the welfare of the Ward

(The Guardian must detail all services provided to or for the ward, including any

services provided by friends, family, paid caregivers or facility staff.):

c. Place and kind of residential setting best suited for the needs of the Ward

(Please list the ward’s address, name and type of facility, if applicable, and describe why

this is the best, least restrictive, living arrangement for the ward):

d. Description of health and accident insurance and any other private or

governmental benefits to which the Ward may be entitled to meet any part of the costs of

medical, mental health or related services provided to the Ward (list all types of

income/benefits received by or for the ward, for example, Social Security, pensions,

Medicare, Medicaid, etc.)

:

e. Physical and mental examinations necessary to determine the Ward’s

medical and mental health treatment needs, including names of those who will provide

examinations and approximate dates for examinations (What care providers does the

guardian intend to have the ward see in the coming reporting period):

2. The Guardian(s) hereby attest(s) that the Guardian(s) has/have consulted with the

Ward and, to the extent reasonable, honored the Ward’s wishes consistent with the rights

retained by the Ward under the plan, and to the maximum extent reasonable, the plan is in

accordance with the wishes of the Ward.

3. This Initial Guardianship Plan does not restrict the physical liberty of the Ward

more than is reasonably necessary to protect the Ward or others from serious physical injury,

illness or disease and provides the Ward with medical care and mental health treatment for the

Ward’s physical and mental health.

Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged

are true to the best of my knowledge and belief.

Signed on the _____ day of ___________, 20___.

Signature:______________________________

Print Name_____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Guardian Advocate)

Signature:______________________________

Print Name_____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Co-Guardian Advocate)


I, ________________________________, do hereby certify that a true and correct copy

of the attached Initial Guardianship Plan of the Guardian/Co-Guardian Advocate of the Person,

has been furnished by (type of mail) ______________________, on this ____ day of

_____________________, 20___ to the following persons, at the address specified: _________

______________________________________________________________________________

______________________________________________________________________________

______________________

__________________________________________

Signature

(If Co-Guardians, only one needs

to sign Certificate of Service)

FORM M





____________________________, Ward. DIVISION: ___________________________________________/

ANNUAL GUARDIANSHIP PLAN (GUARDIANSHIP REPORT)

OF GUARDIAN/CO-GUARDIAN OF PERSON (adult)

__________________________________________________, the Guardian/Co-

Guardian of the person of __________________________________ (the ward), submits the

following plan as the Annual Guardianship Plan of this guardian/co-guardian:

The Annual Guardianship Plan for the period beginning ___________________, 20___,

and ending __________________, 20 _____, shall be as follows:

1. The ward’s address at the time of filing this plan is:

2. During the preceding year, the ward was maintained at (include dates, names,

addresses and length of stay at each place; include date ward began residing at this address and

date left {if applicable}; name{s} of caregiver/relative with whom the ward resides and the

physical address of the location. Also include a statement as to why this is the best living

arrangement for the ward):

3. Plans for ensuring that the ward is in the best residential setting to meet the

ward’s needs during the coming year are as follows (What will the guardian do to ensure the

ward is in the most appropriate living arrangement. For example, will the guardian attend care

plan meetings, visit with the ward, confer with caregivers/medical professionals, etc.):

4. The following is a resume of any medical treatment given to the ward during the

preceding year (the guardian must detail all medical and mental health providers the ward

visited and the reasons for these visits during the past year):

5. Attached is a report of a physician who examined the ward no more than ninety

(90) days before the beginning of the report period containing that physician’s evaluation of the

ward’s condition, a statement of the current level of capacity of the ward and a statement of

whether a guardian is still necessary. The report must be signed by a licensed physician,

preferably the ward’s primary care physician, psychiatrist, or a neurologist. Forms signed by an

ARNP will not be accepted, absent a change in the current law.

6. The plan for providing medical, mental health and rehabilitative services in the

coming year is as follows (what doctors or other medical/mental health providers does the

guardian expect the ward to visit in the upcoming year):

7. The following information is submitted concerning the social condition of the

ward:

a.) The social and personal services currently used by the ward are as follows (The

guardian must detail all services provided to, or for, the ward, including any services

provided by friends, family, paid caregivers or facility staff. In addition, the guardian

must explain how the ward spends his/her day.):

b.) The following is a statement of the social skills of the ward, including how well

the ward communicates and maintains interpersonal relationships (Does the ward

communicate verbally? How does he/she communicate his/her wants or needs?):

c.) The social needs of the ward (What does/would the ward require to

obtain/maintain social happiness and interaction?):

8. The following is a summary of activities during the preceding year designed to

enhance the capacity of the ward (What has the guardian done to maintain or increase the

ward’s quality of life?):

9. Is the ward now capable of having some or all of the ward’s rights restored? If so,

identify the rights that should be restored. (The guardian’s statement should agree with the

physician’s statement. If it does not, an explanation should be provided.)

10. Do you plan to seek the restoration of any rights to the ward?

11. This plan has/has not(circle one) been reviewed with the ward.

Under penalties of perjury, I/we declare that I/we have read the foregoing and the facts alleged

are true, to the best of my knowledge and belief.

Signed on________________________, 20___.

Signature:______________________________

Print Name_____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

Guardian Advocate

Signature:______________________________

Print Name_____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

Co-Guardian Advocate

Form N





_________________________________,

A Person with a Developmental Disability, DIVISION:

___________________________________/

APPLICATION FOR APPOINTMENT AS STANDBY GUARDIAN ADVOCATE

Pursuant to Sections 744.3125 of the Florida Guardianship Law, the undersigned submits

this Application for Appointment as Standby Guardian/Co-Guardian Advocate of

___________________ (the person with a development disability) and submits the following

information (whenever the space provided is insufficient, attach additional pages):

1. Name: ___________________________________________________

2. Social Security Number: ___________________________________________________

3. Date and Place of Birth: ___________________________________________________

4. Residence address: ______________________________________________________

5. Mailing address: ___________________________________________________

6. Email address: __________________________________________________

7. U.S. Citizen? Yes _____ No _____

8. Employer’s name and address: _____________________________________________

_____________________________________________________________________________

Applicant’s position: ______________________________________________________

9. Marital status and name of spouse, if any: ____________________________________

_____________________________________________________________________________

10. Home telephone number: ________________________________

Work telephone number: _________________________________

11. Length of residence in county wherein application is filed: ________________________

12. If currently serving as a guardian for any other ward, list names of each ward, court file

number(s), circuit court(s) in which the case(s) is/are pending and whether applicant is acting as

the limited or plenary guardian of the person or property or both: _________________________

_____________________________________________________________________________

_____________________________________________________________________________

______________________________________________________________________________

____________________________________________________________________________

13. If you are a professional guardian, please indicate month, day, and year in which you

were appointed on your third case:

_____________________________________________________________________________

14. Does applicant have any physical disabilities? Yes _____ No _____. If yes, please

describe and state whether such disability my affect applicant’s ability, in any degree, to serve as

guardian: _____________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

__________________________________________________________________________

15. Has applicant ever been treated for the following:

a. Mental condition? Yes _____ No _____

b. Alcohol? Yes _____ No _____

c. Drugs? Yes _____ No _____

d. Other? Yes _____ No _____

Nature of condition: ____________________________________________________________

If “yes” was answered to any of the above, please state date, time, location of treatment

and name of physician or professional involved: ______________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

__________________________________________________________________________

16. Has applicant ever been judicially determined to have committed abuse, abandonment, or

neglect against a child as defined by the Florida Statutes? Yes _____ No _____

17. Has applicant ever been the subject of a confirmed report of abuse, neglect, or

exploitation which has been uncontested or upheld pursuant to the provisions of Sections

415.104 and 415.1075, Florida Statutes? Yes _____ No _____

18. Has applicant ever been charged with fraud, misrepresentation or perjury in a judicial or

administrative proceeding? Yes _____ No ______ If yes, please give date and complete details:

______________________________________________________________________

______________________________________________________________________________

____________________________________________________________________________

19. Has applicant ever been charged with, arrested for, or convicted of a felony, even if the

record of such arrest or conviction has been expunged, unless the expunction was ordered

pursuant to Florida Statutes Section 943.0583? Yes _____No _____ If yes, please furnish

details including date, type of offense, location and final disposition:

_____________________________________________________________________________

20. Has applicant ever been charged with, arrested for, or convicted of any other crimes?

Yes ____ No ____. If yes, please furnish details, including date, type of offense, location, and

final disposition:

___________________________________________________________________

21. Has applicant ever held a position, which required bonding? Yes _____ No _____ If

yes, please describe position, date, amount of bond and name of surety:

______________________________________________________________________________

______________________________________________________________________________

__________________________________________________________________________

22. Has applicant, in the past, ever served as guardian of a person or of a person’s property?

Yes _____ No _____ If yes, please describe below, including reason for termination of fiduciary

position: ____________________________________________________________________

23. Has applicant ever been held in contempt of court or removed as guardian?

Yes _____ No _____ If yes, please describe below:

______________________________________________________________________________

____________________________________________________________________________

24. Has applicant ever filed for bankruptcy? Yes _____ No _____ If yes, please state date

and location of court:

______________________________________________________________________________

____________________________________________________________________________

25. Has the applicant ever been found guilty, plead nolo contendere or guilty of an offense

prohibited by Florida Statutes 435.04 or similar statute of another jurisdiction? Yes ____ No ___

If yes, please give details, to include date, type of offense, location, and final disposition:

______________________________________________________________________________

______________________________________________________________________________

____________________________________________________________________________

26. What is applicant’s relationship to the person with a developmental disability?

_____________________________________________________________________________

27. Is applicant, or applicant’s business, corporation or other business entity a creditor of, or

providing substantial professional, personal, or business services to the person with a

developmental disability? Yes _____No _____ If yes, please furnish details:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________

28. Is applicant employed by a person, agency, government, corporation or other business

entity, which is providing professional, personal or business services to the person with a

developmental disability?

Yes _____ No _____ If yes, please furnish details:

______________________________________________________________________________

______________________________________________________________________________

___________________________________________________________________________

29. Is applicant a health care provider for the person with a developmental disability?

Yes ________No ______

30. Educational history of applicant:

Name and address Degree Date

High school: ____________________________________________________________

College: _______________________________________________________________

Other: _________________________________________________________________

31. List applicant’s employment experience for the past ten (10) years beginning with the

most recent date:

Name and address Date(s) Reason for leaving

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

_______________________________________________________________

32. Has applicant ever been discharged from employment: Yes _____ No _____ If yes,

please explain:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

_____________________________________________________________

33. Has applicant ever been a member of the armed forces of the U.S.? Yes _____ No ____

If yes, what branch, dates and military serial number:

______________________________________________________________________________

____________________________________________________________________________

34. PERSONAL REFERENCES. Please give the names, addresses and telephone numbers

of three (3) responsible persons who have been closely associated with applicant and who have

known applicant for five (5) years or more, not including relatives or spouse:

Name and address Telephone number

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

__________________________________________________________________________

35. Does applicant possess any special educational qualifications (financial, business or

otherwise) that uniquely qualifies applicant to be appointed as guardian? Yes _____ No ______

If yes, please describe below: _____________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________________________________________________

36. Has applicant received instruction and training, which covered the legal duties and

responsibilities of a guardian, the rights of a ward, the availability of local resources to aid a

ward, and the preparation of habilitation plans and annual guardianship reports, including

financial accounting for the ward’s property? Yes _____ No _____ If so, indicate when and

where training was received: ______________________________________

______________________________________________________________________________

____________________________________________________________________________

Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true,

to the best of my knowledge and belief.

Signed on _________________________, 20___

Signature_____________________________ Name_________________________________

Print Name_____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Proposed Standby Guardian Advocate)

FORM O





__________________________________,

A Person with a Developmental Disability, DIVISION:

___________________________________/

STANDBY GUARDIAN ADVOCATE’S JOINDER IN PETITION

The undersigned, ______________________________, who is the _________________

(relation to) of the Ward, joins in the Petition for Appointment of Guardian Advocate of the

Person and Appointment of Standby Guardian Advocate; the undersigned is sui juris (over 18

years of age) and is otherwise qualified under the laws of the State of Florida to act in such

capacity and waives the requirement of a notice of hearing with respect to entry of an Order

Appointing Standby Guardian Advocate; and the undersigned is willing to serve as Standby

Guardian Advocate.

EXECUTED this ____________ day of _____________________, 20 ____.

Signature_____________________________ Name_________________________________

Print Name_____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Proposed Standby Guardian Advocate)

FORM P





_______________________________,

A Person with Developmental Disability, DIVISION:

___________________________________/

NOTICE OF FILING

PLEASE TAKE NOTICE that the Proposed Guardian/Co-Guardian Advocate,

___________________________________________, hereby gives notice of filing the following

documents:

Title/Type of Document(s): (choose which ones apply)

( ) Death certificate of Ward’s parent

( ) Confidential Psychological Report/Doctor Report/IEP

( ) Other

(describe):____________________________________________________________

Signature_____________________________ Name_________________________________

Print Name_____________________________

Address_______________________________

Phone ________________________________

E-mail address __________________________

(Guardian/Co-Guardian Advocate)

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