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IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL (Pinellas County Clerk of the Circuit Court and Comptroller)

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IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS/PASCO COUNTY, FLORIDA, PROBATE DIVISION
Case No.: _______________________
IN RE: THE INTEREST OF
_____________________________________________
A developmentally disabled person.
_______________________________/
SIMPLIFIED ANNUAL PLAN
The undersigned, as the Guardian(s) Advocate of the above-named ward, report(s) to the court as follows:
1.) The name and address of all places the ward has resided during the preceding year.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
2.) Why is this the best placement for the ward?
______________________________________________________________________________________
______________________________________________________________________________________
3.) List all professional medical/mental health treatment the ward has received during the past year (did the ward
see a doctor, dentist, or mental health professional, if so when?):
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
4.) What is/are the ward’s current condition(s) which cause(s) him/her to continue to need a guardian advocate?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
5.) What personal and social services were provided for the ward in the past year (i.e., programs attended,
vacations, in-home activities, out-of-the home activities, what does the ward like to do for entertainment or in
his/her free time)?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
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6.) In the past year, how has the ward interacted with others, including the guardian(s) advocate and family
members (if the ward is not able to interact, state why)?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
7.) Should any of the rights previously delegated to the guardian(s) advocate be restored to the ward at this time?
If so, identify the specific right(s) [such as to consent to medical treatment, to determine residence, to manage
property, etc.] and explain why.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Date____________________ ________________________________________________
Guardian Advocate Signature
Address___________________________________________________________________________________
Phone Number____________________________ E-mail ___________________________________________
I certify I have provided my attorney of record with a copy of this annual plan (if applicable)
Date____________________ ________________________________________________
Guardian Advocate Signature
Address___________________________________________________________________________________
Phone Number____________________________ E-mail ___________________________________________
I certify I have provided my attorney of record with a copy of this annual plan (if applicable)
DELIVERY:
The original copy of this Simplified Annual Plan must be filed with the appropriate Clerk of the Circuit Court:
Mailing address:
Pinellas County: 315 Court Street, Room 106, Clearwater, Florida, 33756
Pasco County: Paula S. O'Neil, Clerk & Comptroller, P.O. Box 338, New Port Richey, FL 34656-0338
ASSISTANCE:
Pinellas County: Clerk of the Court, phone (727) 464-3321 or email Probate@mypinellasclerk.org
Guardianship Division of the Circuit Court, phone (727) 582-7243 or email
Probateoffice@jud6.org
Pasco County: (727)-847-8031 or visit http://www.pascoclerk.com/public-gen-contact-info.asp
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IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL (Pinellas County Clerk of the Circuit Court and Comptroller)

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Completed 10 February 2021

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