Fill - Free fillable IN THE CIRCUIT COURT OF COUNTY, WEST VIRGINIA (West Virginia Supreme Court of Appeals) PDF form

IN THE CIRCUIT COURT OF _______________ COUNTY, WEST VIRGINIA

For Clerk’s Use Only

IN RE: ___________________________________________________________, A PROTECTED PERSON

DATE FILED: ____________________________________ CASE NUMBER ___________ - G - __________

PETITION FOR TERMINATION, REVOCATION OR MODIFICATION

OF GUARDIANSHIP/CONSERVATORSHIP

[West Virginia Code: § 44A-4-6]

NOW COMES the Petitioner [name of person filing Petition] _______________________________________

in the above captioned cause, and respectfully petitions this Court to [check the statement below which reflects what you

want the Court to do]:

__________ terminate or revoke the appointment of the guardian and/or conservator [Note: To remove a specific

individual serving as a guardian or conservator, but maintain the guardianship/conservatorship, use

CG Form 21 pursuant to West Virginia Code Section 44A-4-4.]

__________ modify the type of appointment of the guardian and/or conservator, or modify the areas of protection,

management or assistance previously granted

of [insert name of the Protected Person] _______________________________________________. The grounds

alleged for the termination, revocation or modification are [initial all grounds that apply; you must initial at least one

applicable ground below]:

__________(1) The protected person is no longer in need of the assistance or protection of a guardian or conservator;

__________(2) The extent of protection, management or assistance previously granted is either excessive or insufficient

considering the current need;

__________(3) The protected person's understanding or capacity to manage the estate and financial affairs or to provide

for his or her health, care or safety has so changed as to warrant such action;

__________(4) No suitable guardian or conservator can be secured who is willing to exercise the assigned duties; and/or

__________(5) It is otherwise in the best interest of the protected person.

C CL GC2010 Form 23 / SCA-CG 912M PETITION TO MODIFY GUARDIANSHIP/CONSERVATORSHIP-Page 1 of 2

C CL GC2010 Form 23 / SCA-CG 912M PETITION TO MODIFY GUARDIANSHIP/CONSERVATORSHIP-Page 2 of 2

The facts, circumstances and reasons in support of this petition and the ground(s) identified above are as follows:

__________________________________________________________________________________________________

_________________________________________________________________. [Attach additional pages, if necessary.]

Respectfully presented this _______ day of __________________________[month], _________[year].

____________________________________________________

PETITIONER'S SIGNATURE

Petitioner’s Address: ___________________________________________________

___________________________________________________

Petitioner’s Phone Number: ________________________________

Relationship of Petitioner to the Protected Person: _______________________________________________________

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IN THE CIRCUIT COURT OF COUNTY, WEST VIRGINIA (West Virginia Supreme Court of Appeals)

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