ROBIN L. MILLER, Clerk & Master
Chancery Court of Tennessee
Eleventh Judicial District
Chattanooga, Tennessee / This document is for general information only and should not be relied upon or construed as legal advice. If you want specific information on legal issues or wish to address specific factual situations, you should seek advice from your lawyer.
Guardian ad litem Investigation Checklist
Part 1. Interview of Respondent[1] / Part 2. Interview of Proposed Fiduciary
Part 1. Interview of Respondent
Complete Name / Interview Day/Date: ______, ____/____ /____
Aliases
SSN: / DOB: / Age:
Has Respondent been: served? Yes  No notified? Yes No T.C.A. § 34-1-107(d)(2)(A).
AS SOON AS POSSIBLE
Discuss
with and explain
to
Respondent
34-1-107(d)(2)(C). / Substance of petition 34-1-107(d)(2)(C)(i).
Nature of the proceedings 34-1-107(d)(2)(C)(ii).
Respondent’s right to protest petition 34-1-107(d)(2)(C)(iii).
Identity of proposed fiduciary34-1-107(d)(2)(C)(iv).
Respondent’s rights as follows: 34-1-107(d)(2)(C)(v).
Demand a jury trial on issue of disability 34-3-106(1).
Present evidence and confront and cross examine witnesses 34-3-106(2).
Appeal the final decision on the petition with an attorney ad litem or other counsel34-3-106(3).
Attend any hearing 34-3-106(4).
Have an attorney ad litem appointed to advocate Respondent’s interests 34-3-106(5).
Request a protective order placing underseal Respondent’s health and financial information, including reports provided under 34-3-105(c).34-3-106(6)
Miscellaneous
Background / Where fromMarital backgroundEducationFamily Members
Religious activityStatus of driver’s licenseOther activities
Nature & Extent Of Respondent’s Property / Assets /  Automobiles / Monthly Income /  Cash On Hand
Real Estate /  Pension Plan /  IRA
 Stocks & Bonds /  Accounts /  Investments
 Jewelry / Checking /  Other assets not covered
Liabilities / Monthly obligations /  Accounts payable /  Notes due others
Notes due banks / Real estate mtgs. /  Taxes due
Other liabilities not covered
Property Management Plan? Yes No
Health & Medical Condition / Any physical disabilities  Alcohol consumption
 Any mental treatments or consultationsDrugs
Relationship With Proposed Fiduciary / What has proposed Fiduciary been doing to assist Respondent before the petition?
What is Respondent’s attitude toward proposed Fiduciary?
Is Respondent aware of any reason why proposed Fiduciary should not be appointed?
 Has Petitioner or proposed Fiduciary received any financial assistance/benefits from Respondent?
Part 2. Interview of Proposed Fiduciary
Complete Name / Interview Day/Date: ______, ____/____ /____
Aliases
SSN: / DOB: / Age:
Miscellaneous
Background /  Where from
 Lawsuits
 Religious activity
Family Members /  Marital background
 Fires in home
 Child/spouse abuse
 Other activities /  Education
 Status of driver’s license
 Criminal matters (Convicted felons cannot serve)
Experience handling assets
Nature & Extent Of Respondent’s Property / Assets /  Automobiles / Monthly Income /  Cash On Hand
Real Estate /  Pension Plan /  IRA
 Stocks & Bonds /  Accounts /  Investments
 Jewelry / Checking /  Other assets not covered
Liabilities / Monthly obligations /  Accounts payable /  Notes due others
Notes due banks / Real estate mtgs. /  Taxes due
Other liabilities not covered / Credit Reports* (Equifax, Experian, TransUnion)
Property Management Plan? Yes No
Health & Medical Condition / Any physical disabilities
Any mental treatments or consultations / Alcohol consumption
Drugs
Relationship with Respondent /  What has proposed Fiduciary been doing to assist Respondent before the petition?
Explore proposed Fiduciary’s attitude toward Respondent.
 Explore proposed Fiduciary’s attitude toward serving as Fiduciary.
Explore proposed Fiduciary’s Future plans for Respondent and management of Respondent’s funds.
Business And Money Management Background / If proposed Fiduciary is to manage Respondent’s estate, exploreproposed Fiduciary’s financial condition and business and money management background:
Work history Bankruptcy  Yes No * Financial Condition Good Fair Poor
ASSETS Automobiles Monthly Income Cash On Hand
 Real Estate Pension Plan IRA
 Stocks & Bonds Accounts Investments
 Jewelry Checking Other assets not covered
LIABILITIES Monthly obligations Accounts payable Notes due others
 Notes due banks Real estate mtgs.Taxes due
 Other liabilities not covered
Final Questions / Do you know, or are you aware of, any reason why you should not be Fiduciary?
Do you know, or are you aware of, anyone who might think you should not be Fiduciary and why?
 Have you received any financial assistance/benefits from Respondent?

Page 1 of 2 pages.

Guardian Ad Litem Investigation

Form019 Rev.2013.09.26

[1] If the current caretaker of respondent is not the proposed fiduciary, this format may also be used to interview the caretaker to fill in what the respondent may not know.