Fillable MOTION FOR EMERGENCY TEMPORARY GUARDIAN (Vermont Judiciary)

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MOTION FOR EMERGENCY TEMPORARY GUARDIAN (Vermont Judiciary)

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PAG94 – Motion for Emergency Temporary Guardian (09/2014) Page 1 of 2
STATE OF VERMONT
SUPERIOR COURT
PROBATE DIVISION
Unit
Docket No.:
In re Guardianship of :
MOTION FOR EMERGENCY TEMPORARY GUARDIAN
I ask the Court to appoint an emergency temporary guardian for ____________________________________
Name of Respondent
The nature of the emergency guardianship is: (check one)
☐ Financial
☐ Medical
☐ Other:
In support of this request, I state:
1. The respondent’s mental state is:
2. Because of Respondent’s present mental state, Respondent is unable at this time to make the
following decisions: (check all boxes that apply)
☐ Medical
☐ Financial
☐ Other decisions related to Respondent’s well-being: (explain below)
3. The following serious and irreparable harm to respondent’s physical health or financial interests will
result if an emergency temporary guardian is not appointed.
PAG94 – Motion for Emergency Temporary Guardian (09/2014) Page 2 of 2
I request: (check one)
☐ A temporary emergency order with notice and hearing
I have filed a guardianship petition and request a hearing on the petition at the earliest date after
appointment of an attorney for the respondent and after notice of the petition has been given to the
respondent. I attach a sworn statement that I am unable to serve notice of the petition as required
by the Rules of Probate Procedure due to the emergency need for guardianship.
☐ A temporary emergency order without notice and hearing
I have filed a guardianship petition and request appointment of an emergency temporary guardian
without notice to the respondent and the opportunity for hearing. I attach a sworn statement with
specific facts showing that immediate, serious, and irreparable harm will result to the respondent
before a hearing on the appointment of an emergency temporary guardian can be held.
Date
Signature of Petitioner
Petitioner’s Mailing Address
Petitioner’s Phone Number
Attachments:
Petition for Adult Guardianship (Form no. PAG72 ) if not previously filed
List of Interested Persons (Form no. PG 73) if not previously filed
Statement of Respondent’s assets and income (Form no. PG 72) if not previously filed
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MOTION FOR EMERGENCY TEMPORARY GUARDIAN (Vermont Judiciary)

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Completed 30 July 2020

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