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STATE OF INDIANA COUNTY OF IN RE THE (Indiana Legal Help)

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Page 1 of 1 Approved by the Coalition for Court
Access CCA-GF-0520-4001
www.indianalegalhelp.org
STATE OF INDIANA
COUNTY OF
IN THE _____________________________COURT
CASE NO: _______________________________
IN RE THE GUARDIANSHIP OF
____________________________
APPEARANCE BY UNREPRESENTED PERSON
1. My name is _________________________________ and in this case I am not represented
by a lawyer.
2. My contact information for receiving legal service of documents and case information as
required by Court Rules is:
Address:
Email address:
☐ I will accept service at the above email address.
Phone: _______________________ Fax:
OR, if in a related case, you have used the Attorney General confidential address, you may
check the box below:
☐ Attorney General confidential address
3. This is a GU case type as defined in Administrative Rule 8(B)(3).
4. There are other cases related to this case: (If yes, please indicate below)
☐ Yes ☐ No
Caption and case number of related cases:
Caption: Case No.:
Caption: Case No.:
Additional information as required by local rule:
Signature
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this document on ________________________ by
☐ e-service using the e-filing system
☐ first-class U.S. mail, postage prepaid
☐ hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
______________________________
Signature
___________
Page 1 of 3 Approved by the Coalition for Court
Access CCA-GU-1120-4002
www.indianalegalhlep.org
STATE OF INDIANA
COUNTY OF ___________________
IN THE ___________________________ COURT
CASE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
________________________
Minor Child
VERIFIED PETITION FOR APPOINTMENT OF GUARDIAN(S) OF THE PERSON OF MINOR
Come now the Petitioner(s) ________________________________________________, and
respectfully petitions the Court to appoint Petitioner(s) as guardian(s) of
______________________________________, a minor child. In support of this request, Petitioner(s)
would show the Court as follows:
1. __________________________________ was born on _____________________, is
_______ years old and is incapacitated due to minority and resides at the following address:
_____________________________________________________________________________________.
2. Petitioner(s) reside at
_____________________________________________________________________________________
_____________________________________________________________________________________.
3. The child has been in the physical custody and care of Petitioner(s) since
___________________________, because:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________.
4. Petitioner(s) is/are the child’s ________________________. Petitioner(s) has/have been
supporting and caring for the child in the following ways:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
5. A Child In Need Of Services (CHINS) petition
☐ has been filed regarding this child and is ☐ open ☐ closed
☐ has not been filed regarding this child.
6. A program of informal adjustment
☐ has been filed regarding this child and is ☐ open ☐ closed
☐ has not been filed regarding this child.
___________
Page 2 of 3 Approved by the Coalition for Court
Access CCA-GU-1120-4002
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7. Petitioner(s):
☐ are aware of another guardian appointed for or acting as the custodian of the minor child
and their name is _______________________________________________________ and
address is: _______________________________________________________________.
☐ are not aware of another guardian appointed for or acting as the custodian of the minor
child.
8. A protective order:
☐ has been issued for the minor.
☐ has not been issued for the minor.
9. The child has the following real or personal property. The lines below should include a
description and approximate value of the property. Property includes any compensation, pension,
insurance or allowance to which the minor child may be entitled:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
10. As far as Petitioner(s) know or can reasonably discover, the names and addresses of the
persons most closely related by blood or marriage to the minor child are:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
11. The appointment of a guardian is sought for the following reasons:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
12. If appointed as guardian(s) of the child, Petitioner(s) can provide the following for the
child:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Page 3 of 3 Approved by the Coalition for Court
Access CCA-GU-1120-4002
www.indianalegalhlep.org
13. The filing fee for this proceeding:
☐ has been paid. ☐ has not been paid. ☐ has been waived.
14. Petitioner(s) request that no bond be required of Petitioner(s) since the minor child has no
asset(s).
15. ☐ Petitioner(s) have been appointed guardian(s) of another person in this state.
☐ Petitioner(s) have not been appointed guardian(s) of another person in this state.
16. Less restrictive alternatives are not sufficient to meet the needs of the child because
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________.
Wherefore, Petitioner(s) respectfully requests to be appointed guardian(s) of
______________________________________________ after notice and a hearing.
The undersigned affirms under penalties for perjury that the foregoing representations and
statements are true.
______________________________ ______________________________
Signature Signature
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this document on ________________________ by
☐ e-service using the e-filing system
☐ first-class U.S. mail, postage prepaid
☐ hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
I hereby certify that I sent a copy of this document on ________________________ by
☐ e-service using the e-filing system
☐ first-class U.S. mail, postage prepaid
☐ hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
______________________________ ______________________________
Signature Signature
Page 1 of 2 Approved by the Coalition for Court Access
CCA-GU-0520-4003
www.indianalegalhelp.org
CONFIDENTIAL DOCUMENT *TREAT AS IF FILED ON GREEN PAPER*
Guardianship Registry Information Sheet-Trial Rule 3.1 (A)(10)
(☐ Individual ☐ Estate ☐ Estate and Individual)
Choose One* (☐ Minor ☐ Adult) Choose One*(☐ Temporary ☐ Permanent)
Related Cases (List any cases in which the Protected Person is a party, e.g., CHINS)
___________________________ ___________________________ __________________________
Petitioner Relationship to Protected Person* ______________________________
La
st:*______________________ Suffix:_____ First:*____________________ Middle:_____________
DOB:_______________ Gender:*_____ Race:*___________________________ Hispanic?: ______
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:*_______________________________________________________________________
Attorney Name:____________________ Bar Number:___________ App. Filed Date: _______________
Protected Person Estimated Value $___________
La
st:*______________________ Suffix:_____ First:*____________________ Middle:_____________
DOB:*______________ Gender:*_____ Race:*___________________________ Hispanic?: ______
Eye Color:__________ Hair Color:__________ Height:__________ Weight:__________ lbs
Scars, Marks, and Tattoos: _______________________________________________________________
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
Attorney Name:____________________ Bar Number:___________ App. Filed Date: _______________
Guardian Ad Litem Full Name:____________________________________________________________
Interpreter required? ______ Language: ___________
Guardian ☐ Check if same as petitioner ☐ Certified (Only check if Federal or State Certified)
La
st:*______________________ Suffix:_____ First:*____________________ Middle:_____________
DOB:_______________ Gender:*_____ Race:*___________________________ Hispanic?: ______
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:*_______________________________________________________________________
Attorney Name:____________________ Bar Number:___________ App. Filed Date: _______________
Guardian Institution
Na
me:*______________________________________________________________________________
Address:*_____________________________________________________________________________
Phone:_________________ Fax:_________________ Agent Name:_____________________________
Close Relative (Entitled to Notice) Relationship to Protected Person ________________________
Last:*______________________ Suffix:_____ First:*____________________ Middle:_____________
Gender:*_____ Race:*_______________________________________________ Hispanic?: _______
Mailing Address:*______________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
X
X
_______________
____
_____
_______________
____
_____
_____
_______________
____
_____
_______________
____
Page 2 of 2
Approved by the Coalition for Court
Access CCA-GU-1120-4003
www.indianalegalhelp.org
CONFIDENTIAL DOCUMENT *TREAT AS IF FILED ON GREEN PAPER*
Guardianship Registry Information Sheet- Trial Rule 3.1 (A)(10)
(Additional)
Petitioner Relationship to Protected Person ________________________
Last:*_____
_________________ Suffix:_____ First:*____________________ Middle:_____________
DOB:_______________ Gender:*_____ Race:*___________________________ Hispanic?: ______
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
Attorney Name:____________________ Bar Number:___________ App. Filed Date: _______________
Guardian ☐ Check if same as petitioner ☐ Certified (Only check if Federal or State Certified)
Last:*_____
_________________ Suffix:_____ First:*____________________ Middle:_____________
DOB:_______________ Gender:*_____ Race:*___________________________ Hispanic?: ______
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
Attorney Name:____________________ Bar Number:___________ App. Filed Date: _______________
Close Relative (Entitled to Notice) Relationship to Protected Person ________________________
Last:*______________________ Suffix:_____ First:*____________________ Middle:_____________
Gender:*_____ Race:*_______________________________________________ Hispanic?: _______
Mailing Address:*______________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
Interested Party
Last:*______________________ Suffix:_____ First:*____________________ Middle:_____________
Gender:*_____
Race:*_______________________________________________ Hispanic?: _______
Address:*____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell phone:__________________
Email Address:_________________________________________________________________________
Interested Party
Last:*______________________ Suffix:_____ First:*____________________ Middle:_____________
Gender:*_____ Race:*________________________________________________ Hispanic?: ______
Address:*_____________________________________________________________________________
Home Phone:_________________ Work Phone:_________________ Cell Phone:__________________
Email Address:_________________________________________________________________________
_____
_______________
____
_____
_______________
____
_____
_______________
____
_____
_______________
____
_____
_______________
____
Page 1 of 1 Approved by the Coalition for Court
Access CCA-GU-1120-4004
www.indianalegalhelp.org
Form ACR (Access to Court Records)
STATE OF INDIANA
COUNTY OF ___________________
IN THE ___________________________ COURT
CASE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
_____________________________
Minor Child
Notice of Exclusion of Confidential Information from Public Access
(FILED WITH TRIAL COURT CLERK)
Contemporaneous with the filing of this notice, _______________________________ has filed
confidential information under the Indiana Rules on Access to Court
Records._______________________________________, provides this notice that the confidential
information is to remain excluded from public access in accordance with the authority listed below:
Name or description of document
ACR grounds for exclusion
Guardianship Registry Information Sheet
Access to Court Records Rule 5(b)(2)
________________________________
Signature
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this document on ________________________ by
☐ e-service using the e-filing system
☐ first-class U.S. mail, postage prepaid
☐ hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
I hereby certify that I sent a copy of this document on ________________________ by
☐ e-service using the e-filing system
☐ first-class U.S. mail, postage prepaid
☐ hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
______________________________ ______________________________
Signature Signature
___________
Cert Name 2
Cert Address
addafd
adfasdf
Page 1 of 1 Approved by the Coalition for Court
Access CCA-GU-1120-4014
www.indianalegalhelp.org
STATE OF INDIANA
COUNTY OF ___________________
IN THE ___________________________ COURT
CASE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
________________________
Minor Child
NOTICE OF VERIFIED PETITION FOR APPOINTMENT OF GUARDIAN(S) OF
THE PERSON OF THE MINOR
TO: ___________________________________
___________________________________
___________________________________
___________________________________
The following notice is given pursuant to I.C. 29-3-6-2:
On_____________________________ (date) at___________________(time) in
_____________________________ (place of hearing) at ___________________________(city),
Indiana, the _____________________________________________________________(name
and address of court) will hold a hearing to determine whether a guardian should be appointed or
a protective order should be issued for _________________________________________(name
of alleged incapacitated person or minor).
A copy of the petition requesting appointment of a guardian or for the issuance of a
protective order is attached to this notice.
At the hearing the court will determine whether _________________________________
(name of alleged incapacitated person or minor) is an incapacitated person or minor under
Indiana law. This proceeding may substantially affect the rights of
_______________________________________(name of alleged incapacitated person or minor).
If the court finds that_________________________________________________(name
of alleged incapacitated person or minor) is an incapacitated person or minor, the court at the
hearing shall also consider whether ___________________________________________(name
of proposed guardian, if any) should be appointed as guardian of
____________________________________________________(name of alleged incapacitated
person or minor). The court may, in its discretion, appoint some other qualified person as
guardian. The court may also, in its discretion, limit the powers and duties of the guardian to
allow _____________________________________________________(name of alleged
incapacitated person or minor) to retain control over certain property and activities. The court
may also determine whether a protective order should be entered on behalf of
_______________________________________(name of alleged incapacitated person or minor).
The court may, where required, appoint a guardian ad litem to represent
_____________________________________________________(name of alleged incapacitated
person or minor) at the hearing.
The court may, on its own motion or on request of any interested person, postpone the
hearing to another date and time.
__________________________________________
Clerk of the Court
___________
Page 1 of 1
Approved by the Coalition for Court Access
CCA-GU-1120-4006
www.indianalegalhelp.org
STATE OF INDIANA
COUNTY OF ___________________
IN THE ___________________________ COURT
CASE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
________________________
Minor Child
ORDER SETTING HEARING ON PETITION FOR APPOINTMENT OF
GUARDIAN
Comes now, ___________________________________________________________,
and files a Verified Petition for Appointment of Guardian of the Person of
_____________________________________________________________________________.
The Court schedules the Verified Petition for hearing on:
____________________________________________________________________________at
__________________________________________.
Date: ____________________________ ____________________________________
Judicial Officer
Distribution:
______________________________
______________________________
______________________________
______________________________
______________________________
___________
Page 1 of 1
Approved by the Coalition for Court Access
CCA-GU-1120-4007
www.indianalegalhelp.org
STATE OF INDIANA
COUNTY OF ___________________
IN THE ___________________________ COURT
CASE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
________________________
Minor Child
ORDER APPOINTING GUARDIAN FOR MINOR
The Court now finds as follows:
1. The individual for whom the Guardian is sought is a child.
2. The appointment of a Guardian is necessary to provide care and
supervision of the Minor Child’s physical person.
IT IS THEREFORE ORDERED as follows:
1. ____________________________________________ is adjudicated a Minor
Child.
2. ____________________________________________ is appointed Guardian.
3. No bond is required except on further Order.
4. The Clerk shall issue Letters of Guardianship to the Guardian upon
qualification.
SO ORDERED ________________________________________________________________
__________________________________________
Judicial Officer
Distribution:
______________________________
______________________________
______________________________
______________________________
______________________________
___________
Page 1 of 1
Approved by the Coalition for Court Access
CCA-GU-1120-4008
www.indianalegalhelp.org
STATE OF INDIANA
COUNTY OF ___________________
IN THE ___________________________ COURT
CASE NO. _______________________________
IN RE THE GUARDIANSHIP OF:
________________________
Minor Child
OATH OF GUARDIAN
I/We ___________________________________________________________________
swear and affirm that I/we will faithfully discharge my/our duties as guardian(s) of
______________________________________________________________________________
according to law.
___________________________________ ___________________________________
__________________________,Guardian __________________________,Guardian
Address: Address:
___________________________________ ___________________________________
___________________________________ ___________________________________
___________________________________ ___________________________________
Date of birth: _______________________ Date of birth: _______________________
STATE OF INDIANA
COUNTY OF__________________
Before me, ___________________________a notary public in and for
_________________________County, State of Indiana, personally appeared
___________________________________, and he/she having been first duly sworn upon
his/her oath, says that the facts all alleged in the foregoing instrument are true.
Date _____________________________ ____________________________________
Notary Public
My Commission Expires: ___________________________
___________
Page 1 of 1 Approved by the Coalition for Court
Access CCA-GU-1120-4009
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LETTERS OF GUARDIANSHIP OF THE PERSON
CASE NUMBER ______________________________________________
STATE OF INDIANA, _____________________ COUNTY, ___________________________
This is to CERTIFY that the Judge of the ______________________________________,
_____________________________ County, Indiana, has this day granted to
________________________, Guardian
The authority to administer to as Guardian, the guardianship of:
________________________, Protected Person
A guardian of the person is authorized to exercise those powers set out in Indiana Code
29-3-8-2(a), Subsections (2), (3) and (4) only.
A guardian of the estate is authorized to exercise those powers set out in Indiana Code
29-3-8-4, Subsections 1-8 only.
A guardian has no authority to do any act not specifically authorized herein except with
the prior written permission of the court.
Further limitations on the guardian’s authority are as follows:
Said guardianship shall extend until terminated as provided by law, and the said
guardian(s), ______________________________________, having duly qualified as such, is
authorized to take upon themselves the performance of their duties of the trusts of this
Guardianship according to law.
Witness my hand and seal of the Court, as ___________________, Indiana.
This __________________________________________________________________.
__________________________________________
Clerk, ____________________ County
__________________________ Court
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STATE OF INDIANA COUNTY OF IN RE THE (Indiana Legal Help)

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Completed 31 December 2021

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