Fill - Free fillable Instructions: Report of Guardian Cover Page All guardians (Cape May County) PDF form

Revised: 02/2017, CN: 11797 (Guardianship - Report of the Guardian Cover Page) page 1 of 2

Instructions: Report of Guardian Cover Page

All guardians required to file periodic reports must complete the Report of Guardian Cover Page. This

is a one-page document to which the appropriate report(s) will be attached.

The date of appointment should be filled in prior to the first numbered paragraph, even if the reporting

period is different than that date. The start date and end date of the reporting period must be stated in

the caption. Make sure to select appropriately as to the nature of your guardianship: Guardian of Person,

Guardian of Estate, or Guardian of Both Person and Estate. This selection will guide you in choosing

the appropriate reporting form(s) to attach to the Cover Page.

You must file the original report with the Surrogate. Check the judgment to see if you need to send

copies of the report to anyone else. In most cases, this is not required because other individuals

considered interested in the guardianship will be authorized to review the report at the Surrogate’s

Court. Remember that there is a fee of $5/page for all documents filed with the Surrogate, including the

Cover Page.

In a co-guardianship, all co-guardians must report as required by the judgment. Co-guardians may file a

single Cover Page with all required information, but if the co-guardians reside in different places, it may

be necessary to attach a separate page with the address and contact information for the additional co-

guardian(s).

Revised: 02/2017, CN: 11797 (Guardianship - Report of the Guardian Cover Page) page 2 of 2

Report of Guardian Cover Page

Superior Court of New Jersey

Chancery Division - Probate Part

County of

In the Matter of the Report of

Docket No.

, Guardian(s) for

Civil Action

Guardian’s Report

for the Period

, an Incapacitated Person.

This report must be filed by every Guardian

within fourteen (14) days of the anniversary date of your

appointment, which is , unless the Judge otherwise specifies. File the original with the Surrogate.

1. Guardian’s Current Information*

Street address:

City:

State:

Zip:

Include mailing address, if different

Mailing address:

City

State:

Zip:

Daytime Telephone Number:

Evening Telephone Number:

Select one:

Guardian of Person

Guardian of Estate

Guardian of Both Person and Estate

Guardian’s relationship to the Incapacitated Person? ____________________________________________

* If needed: attach a separate page with the current information for any co-guardian(s).

2. Incapacitated Person’s Current Information: does he/she reside with the guardian?

Yes

If No, complete the incapacitated person's residency information below. If Yes, continue to #3.

Incapacitated Person's address: If the incapacitated person lives in a residential facility, include the name

of the Director or person responsible for the incapacitated person’s care.

Address:

City:

State:

Zip:

Telephone Number:

Contact Name:

Telephone Number:

State the average number of visits you or your designee made to the Incapacitated Person during the

period: .

3. Identify all Guardianship responsibilities (check all that apply):

Manage financial affairs

Provide necessities

Feed

Take on outings

Provide transportation

Housekeeping

Bathe

Provide continuous care

List all other responsibilities assumed:

4. State if you believe the guardianship should continue? State reason:

Yes

5. Are any modifications or adjustments needed in the guardianship? If Yes, describe:

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Fillable Instructions: Report of Guardian Cover Page All guardians (Cape May County)

Fill Online, Printable, Fillable, Blank Instructions: Report of Guardian Cover Page All guardians (Cape May County) Form

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