PAG100 Motion/Affidavit/Notice/Certificate of Service - GAL (09/2014) Page 1 of 4
STATE OF VERMONT
SUPERIOR COURT
PROBATE DIVISION
Unit
Docket No.:
In re Guardianship of :
MOTION for APPOINTMENT of GUARDIAN AD LITEM
I have been appointed to represent the Respondent. I request that the Court appoint a Guardian Ad
Litem for the Respondent pursuant to V.R.F.P. 6.1. The reason for this motion is that the Respondent is
unable to communicate effectively with counsel about this case.
In accordance with the rule, I request that the Court set a hearing on this motion as quickly as possible
and sufficiently in advance of the hearing on the merits so as to allow the Guardian Ad Litem adequate
time to prepare for the hearing on the merits.
Respectfully submitted,
Dated
Signature of Attorney
Attorney’s Name Printed
Attorney’s Address
Attorney’s Phone Number
PAG100 Motion/Affidavit/Notice/Certificate of Service - GAL (09/2014) Page 2 of 4
STATE OF VERMONT
SUPERIOR COURT
PROBATE DIVISION
Unit
Docket No.:
In re Guardianship of :
AFFIDAVIT in SUPPORT OF MOTION FOR GUARDIAN AD LITEM
I hereby state under oath that:
1. I represent the Respondent in this matter.
2. I met with Respondent on _________________________, and found that the Respondent was not
Date
able to communicate effectively with me about this case.
Dated
Signature of Attorney
Attorney’s Name Printed
Subscribed and sworn before me on:
date
My commission expires on:
Date of Expiration
Signature of Notary
PAG100 Motion/Affidavit/Notice/Certificate of Service - GAL (09/2014) Page 3 of 4
STATE OF VERMONT
SUPERIOR COURT
PROBATE DIVISION
Unit
Docket No.
In re Guardianship of :
ATTENTION: ________________________________
Name of Respondent
These papers are a request by your attorney to have the Court appoint a Guardian Ad Litem for you.
You do not have to agree with this request.
You have the right to appear in person before the Court to object to this request, or you may object by
telephone or letter.
A hearing on this request will be held at the Probate Division of the Vermont Superior Court in the unit
named above. A notice of the hearing with the address of the Court, and the date and time of hearing
will be sent to you by the Court.
If you would like to object by telephone, you may call the Court at:
Or if you would like to object in writing, you may send mail to the Court at:
PAG100 Motion/Affidavit/Notice/Certificate of Service - GAL (09/2014) Page 4 of 4
STATE OF VERMONT
SUPERIOR COURT
PROBATE DIVISION
Unit
Docket No.
In re Guardianship of :
CERTIFICATE OF SERVICE
I certify that on _____________________________ I served ___________________________________
Date Name of Respondent
with a copy of the Motion for Appointment of a Guardian Ad Litem, with supporting Affidavit and
accompanying explanation of Respondent’s right to object to the Motion by mailing it to him/her at
his/her residence.
Dated
Signature of Attorney
Attorney’s Name Printed