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 REMOVAL OF
GUARDIAN/CONSERVATOR
[West Virginia Code: § 44A-4-4]
NOW COMES the Petitioner ____________________________________________________
[name of person filing Petition] in the above captioned cause, and respectfully petitions this Honorable
Court to remove [insert name of guardian/conservator] ______________________________________
who is a [check applicable office] __________ guardian __________ conservator for
___________________________________________________, a protected person. Petitioner alleges the
following ground(s) for removal: [initial all that apply; at least one of these grounds must be initialed]
The guardian/conservator…
______(1) Is acting under an order entered pursuant to material misrepresentation or mistake, whether
fraudulent or innocent;
______(2) Has an incapacity or illness, including substance abuse, which affects his or her fitness to
perform or is adjudged to be a protected person in this or in any other jurisdiction;
______(3) Is convicted of a crime which reflects upon his or her fitness to perform;
______(4) Wastes or mismanages the estate, unreasonably withholds distributions or makes distributions
in a negligent or reckless manner or otherwise abuses powers or fails to discharge duties;
______(5) Neglects the care and custody of the protected person or legal dependents;
______(6) Has an interest adverse to the faithful performance of duties such that there is a substantial risk
that the guardian or conservator will fail to properly perform those duties;
______(7) Fails to file reports or accountings when required, or fails to comply with any court order;
C CL GC2010 Form 21 / SCA-CG 911M PETITION FOR REMOVAL OF G/C-Page 1 of 2
C CL GC2010 Form 21 / SCA-CG 911M PETITION FOR REMOVAL OF G/C-Page 2 of 2
______(8) Fails to file sufficient bond after being ordered by the court to do so;
______(9) Avoids service of process or notice;
_____(10) Becomes incapable of performing duties;
_____(11) Is not acting in the best interests of the protected person or of the estate, with or without fault.
The specific facts, circumstances and reasons in support of this petition and the above ground(s)
for removal are as follows:
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[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: ____________________________________________