______County,
Tennessee / PETITION FOR A GUARDIANSHIP / Case Number
IN THE MATTER OF ______, RESPONDENT
Petitioner would show to the Court the following:
1. The name, date of birth, residence and mailing address of the Respondent are as follows:
2. The name, age, residence, and mailing address of the Petitioner and the relationship of the Petitioner to the Respondent are as follows:
3. The name(s), age(s), mailing address(es), and relationship(s) of the proposed Guardian(s) to the Respondent are as follows:
4. The name(s), mailing address(es), and relationship(s) of the closest relative(s) of the Respondent are as follows:
5. The name(s) and mailing address(es) of the present custodian(s) of the Respondent are as follows:
6. The facts supporting the Petitioner's allegation that a Guardian is needed are as follows:
7. The rights proposed to be exercised by the Guardian(s) are as [specify which]
q Guardian(s) of property q Guardian(s) of the person q both.
8. If the Petition requests that the Guardian(s) manage the property of the Respondent, the following financial information is attached:
· A list of the property of the Respondent together with the approximate fair market value of each item.
· A statement about whether the property listed is all of the Respondent's property.
· A list of the source, amount and frequency of each item of income, pension, social security benefit or other revenue received by the Respondent.
· A list of the usual monthly expenses of the Respondent.
· An explanation of how these expenditures were met prior to filing of this Petition.
· A description of the proposed plan for the management of the Respondent's property if a Guardian is appointed.
REQUESTS FOR RELIEF
Petitioner prays:
1. That the Court appoint the individual(s) named above as Guardian(s) of the person, property, or both (as specified above) of the Respondent.
2. That notice be served on the interested parties.
3. That the Court enter an order authorizing the Petitioner to investigate the Respondent's property if the financial information about the Respondent is unknown to the Petitioner.
4. That the Court set a time and place for the hearing of this cause.
5. For other, further and general relief.
Petitioner
STATE OF TENNESSEE
COUNTY OF ______
Personally appeared before me, the undersigned, a notary public in and for this county and state, the person named above with whom I am personally acquainted (or who proved his or her identity to me on the basis of satisfactory evidence) and who acknowledged that he or she executed this instrument for the purposes contained in it.
Witness my hand and official seal this day of ______, 20___.
My commission expires: Notary Public
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