Fillable PETITION FOR RELIEF, MODIFICATION OR TERMINATION (Administrative Office of the Courts)

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PETITION FOR RELIEF, MODIFICATION OR TERMINATION (Administrative Office of the Courts)

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BROWSE ADMINISTRATIVE OFFICE OF THE COURTS (KY) FORMS

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In the matter of the guardianship/conservatorship of _____________________________________________________
Comes the Petitioner __________________________________________________________ and requests the Court:
1. q Terminate q Modify the order of q partial disability q disability entered on ____________________, 2____
as follows: ________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
q Remove the present duciary and replace with _________________________________________________.
q Renew the appointment of the present duciary for a period of _____________________________________.
AOC-795 Doc. Code: PRMT
Rev. 7-18
Page 1 of 2
Commonwealth of Kentucky
Court of Justice www.courts.ky.gov
KRS 387.610; 387.620
PETITION FOR RELIEF,
MODIFICATION OR TERMINATION
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In support of this request, Petitioner states:
2. Ward's address: ______________________________________________________ County: ______________
Name and address of the individual or facility, if any, having custody of the ward:
Name: _____________________________________________________________
Address: ____________________________________________________________ County: ______________
3. Ward's present duciary: _____________________________________________________________________
Address: __________________________________________________________________________________
Appointed on: ______________________________________________________________________________
As: q Limited Guardian q Limited Conservator
q Guardian q Conservator
4. Ward's next of kin are:
Name Address Relationship
______________________________ ______________________________ _____________________________
______________________________ ______________________________ _____________________________
______________________________ ______________________________ _____________________________
5. The facts and reasons supporting this request:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Date
* * * * * * * * * * * *
Ward
Case No. ____________________
Court ____________________
County ____________________
Division ____________________
WHEREFORE, the Petitioner requests that this court conduct a hearing within thirty (30) days of the ling of this
petition in the county of the ward’s current residence or domicile, or, if the ward is a minor, where the parent of the ward
is domiciled. KRS 387.520(2).
If the foregoing petition is for a renewal of the appointment of a limited guardian or conservator, it shall be accompanied
by veried adavits of a physician, an advanced practice registered nurse, or a physician assistant; a licensed or certied
psychologist under KRS Chapter 319; and a licensed or certied social worker or an employee of the Cabinet for Health and
Family Services who is qualied under KRS 335.080(1)(a), (b), and (c) or KRS 335.090(1) (a), (b), and (c) in support of same
pursuant to KRS 387.610.
_____________________________________________
Petitioner
_____________________________________________
Address
_____________________________________________
Relationship to Ward
To be completed if Petitioner is represented by counsel:
_____________________________________________
Signature of Attorney
_____________________________________________
Address of Attorney
_____________________________________________
Telephone Number
A copy of this Petition was mailed this date to the Ward, the attorney of record, the county attorney and all persons named
in the Petition.
_________________________________________ _______________________________________ Clerk
Date
_____________________________________ By: D.C.
AOC-795
Rev. 7-18
Page 2 of 2
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PETITION FOR RELIEF, MODIFICATION OR TERMINATION (Administrative Office of the Courts)

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Completed 19 November 2020

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