© 2018 Nevada Supreme Court
Page 1 of 2 – Individual Consent and Waiver (Guardianship)
COURT CODE: _____________________
Your Name:
Address:
City, State, Zip
Telephone:
Email Address:
Self-Represented
DISTRICT COURT
_______________ COUNTY, NEVADA
In the Matter of the Guardianship of the:
Person
Estate
Person and Estate
of:
___________________________________
(name of person alleged to need a guardian)
A Proposed Protected Person.
CASE NO.: ____________________
DEPT: ____________________
CONSENT AND WAIVER
I, (name of person signing) _______________________________________, am the
(your relationship to the proposed protected person) _____________________________ of the
above-named proposed protected person who is the subject of the above-captioned guardianship
matter.
(initial the sections below that you agree with; you can initial one or both)
Do not mark an “x” – your consent is invalid without your initials next to one or both
statements.
_____ I consent to (name of proposed guardian) _____________________________________
and (second proposed guardian, or “n/a”) ____________________________________
being appointed as legal guardian(s) of the above-named person.
THIS FORM MUST BE SIGNED IN FRONT OF A NOTARY.
Once you complete the form, print it out and sign it in front of a notary. The persons's original signature and
the notary's stamp and signature must appear on the document that is filed with the court.
