OPG MP App Form 1 /6
Ma nag eme nt Pla n
/GP FER SNAIDRAUG CILBUP
DATE OF APPOINTMENT
Adult
TITLE
SURNAME
FORENAME
Gua rdian
TITLE
SURNAME
FORENAME
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CURRENT ADDRESS
TELEPHONE NUMBER
EMAIL
(As per Court Order. If you had
interim financial powers, give
the date of the Interim Order)
ARE YOU THE PRIMARY
POINT OF CONTACT?
YES NO
If more than one Financial Guardian has been appointed, please tell us who will be the primary point of
contact. This will be helpful, particularly if clarification or further information is needed by this office.
A/1/2012/1
12/12/2012
Mr
Ash
John
Mr
Ash
Steven
OPG MP App Form 2 /6
Joint Guardian (If Applicable)
TITLE:
SURNAME:
FORENAME:
EMAIL:
TELEPHONE NUMBER:
YES NO
YES NO
Joint Guardian (If Applicable)
TITLE:
SURNAME:
FORENAME:
EMAIL:
TELEPHONE NUMBER:
ARE YOU THE PRIMARY
POINT OF CONTACT?
ARE YOU THE PRIMARY
POINT OF CONTACT?
Section 1A - Adult’s Regular Living Expenses
Gas
Electricity
Telephone
TV Licence
Mortgage Rent (Please select)
Insurances
Council Tax
Care Charges
Loan Repayments
Subscriptions
Food and Household Expenses
Clothing
Holidays
Other (please specify e.g. toiletries,
hairdressing, sweets, pocket money etc.)
TOTAL ANNUAL INCOME
£
ITEM
AMOUNT FREQUENCY
ANNUAL AMOUNT
Mrs
Ash
Susan
Select
OPG MP App Form 3 /6
Section 2 - Intended Use of Heritable Property
e.g. adult/adult's family/spouse will continue to live there or property to be sold or rented etc.
please give details.
Section 1 - Adult’s Regular Living Expenses
Gas
Electricity
Telephone
TV Licence
Mortgage Rent (Please select)
Insurances
Council Tax
Care Charges
Loan Repayments
Food and Household Expenses
Clothing
Holidays
£
ITEM
AMOUNT FREQUENCY
ANNUAL AMOUNT
Support for dependents
Other (please specify e.g. subscriptions,
toiletries, hairdressing, sweets, pocket
money etc.)
TOTAL ANNUAL EXPENDITURE
Satellite/Cable TV
25.00
Monthly
300.00
25.00
Monthly
300.00
15.00
Quarterly
60.00
21.00
Monthly
252.00
Select
0.00
Select
0.00
Select
0.00
Select
0.00
300.00
Monthly
3,600.00
Select
0.00
Select
0.00
40.00
Monthly
480.00
80.00
Monthly
960.00
150.00
Monthly
1,800.00
Pocket money for excursions with carer
50.00
Weekly
2,600.00
DVDs, video games
80.00
Monthly
960.00
Select
0.00
11,312.00
OPG MP App Form 4 /6
Section 3 - Proposed method of
Investment / Disposal of Moveable Assets
Is the moveable estate under £50,000?
Is the moveable estate over £50,000?
Is the moveable estate over £50,000, nancial advice is enclosed?
Is the moveable estate over £50,000, nancial advice is to follow?
In order to maintain the adult’s lifestyle and expenditure as appropriate and maximise the return from their
income and investments, use the space below to state what actions you propose to take. For example, with
regards to the adult’s bank/building society accounts do you intend to make any changes such as moving the
funds from one account to another type of account or perhaps intend making no changes at all?
If the adult has other income or investments such as stocks and shares, please outline below what you
propose to do. Also, if there is a shortfall between the adult’s annual income and expendit
ure, tell us
how you propose to deal with this.
It is our intention to leave the Lloyds TSB account as it currently is.
OPG MP App Form 5 /6
Section 4 - Tax Planning Proposals
(Please note this must be in line with the wishes of the adult as far as they can be ascertained and Inland
Revenue Guidelines)
Section 5 - Proposals for Provision of Gifts e.g.
Birthday, Anniversary, Christmas etc.
NO OF PURPOSE AMOUNT FREQUENCY ANNUAL
RECIPIENTS AMOUNT
TOTAL ANNUAL GIFTS £
Section 6 - Other Proposals
4
Aunt, uncle, cousin and friend for birthday
30.00
Yearly
120.00
4
Aunt, uncle, cousin and friend for Christmas
30.00
Yearly
120.00
Select
0.00
Select
0.00
Select
0.00
Select
0.00
Select
0.00
Select
0.00
Select
0.00
240.00
OPG MP App Form 6 /6
Section 7 - Proposals for Contact with Adult
and/or any other relevant persons
possible, it is good practice to meet the adult, nearest relative, primary carer, social worker, named person
Signature of Financial Guardian(s)
(Please note where more than one financial guardian is appointed all require to sign and date below)
FINANCIAL GUARDIAN DATE
FINANCIAL GUARDIAN DATE
FINANCIAL GUARDIAN DATE
THE FORM IS NOW COMPLETE, PLEASE PRINT IT AND SEND IT TO:
The Office of the Public Guardian
Hadrian House
Callendar Business Park
Callendar Road
Falkirk
FK1 1XR
DX: 550360 Falkirk 3
LP: LP-17 Falkirk
Telephone: 01324 678300
Fax: 01324 678301
E-mail: opg@scotcourts.gov.uk
Website: www.publicguardian-scotland.gov.uk
Vers
i
o
n
4
September
2
0
1
6
Our son lives with us, his parents.
We attend review meetings with the social worker every 3-4 months.
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