700-00093M Guardian’s Annual Personal Status Report for Minor (08/2018) Page 1 of 3
STATE OF VERMONT
SUPERIOR COURT
PROBATE DIVISION
Unit
Docket No.
In re Guardianship of :
GUARDIAN’S ANNUAL PERSONAL STATUS REPORT FOR MINOR
The following is a report to the Court concerning:
Name of Minor
for the period beginning
and ending
Mailing Address
*Physical Address (if different)
The minor resides (check one):
At my home.
Other (describe)
Physical Address (if different)
Age of Minor
*Please provide name of residential provider and address if minor does not reside with the guardian
700-00093M Guardian’s Annual Personal Status Report for Minor (08/2018) Page 2 of 3
700-00093M Guardian’s Annual Personal Status Report for Minor (08/2018) Page 3 of 3
8. Minor’s Financial Assets:
I am am not
managing the minor’s financial assets other than Social Security benefits.
If you are, an annual summary of account must be filed with this report.
I have attached a copy of the most recent report to Social Security regarding the
minor’s benefits.
9. Recommendations for changes to Guardianship Order:
I recommend that the Guardianship Order be changed: Yes No
If yes, attach a request to modify, amend or terminate Guardianship Order.
Date
Signature of Guardian
Guardian’s Mailing Address
____________________________________________
____________________________________________
Guardian’s Phone Number: ___________________________________________
Guardian’s Email Address: ____________________________________________
_____________________________________________
Date
Signature of Co-Guardian
Co-Guardian’s Mailing Address
____________________________________________
____________________________________________
Co-Guardian’s Phone Number: __________________________________________
Co-Guardian’s Email Address: ___________________________________________
Signed and sworn to before me:
Date Signature of Notary Public Expiration Date