District Court Denver Probate Court ____________________County, Colorado Court Address: _________________________________________

In the Interest of: __________________________________________

COURT USE ONLY Case Number:_________________ Division _______ Courtroom _______

Respondent

ORDER APPOINTING EMERGENCY GUARDIAN FOR ADULT PURSUANT TO §15-14-312, C.R.S.
Upon consideration of the Petition for Appointment of Emergency Guardian for the above Respondent and/or hearing (date), on

The Court finds:
1. That venue is proper. 2. Notice pursuant to §15-14-312, C.R.S. was: Reasonable. Dispensed with because the Court finds from testimony that the Respondent will be substantially harmed if the appointment is delayed. The nature of the emergency is:

3. Pursuant to §15-14-312(1), C.R.S., it is necessary to appoint an Emergency Guardian for the Respondent because of the likelihood of substantial harm to the Respondent's health, safety, or welfare, and that no other person appears to have authority and willingness to act in the circumstances. 4. The emergency guardianship cannot exceed 60 days.

The Court appoints the following person as Emergency Guardian of the Respondent:
Name: Street Address: Mailing Address, if different: City: Home Phone #: State: Zip Code: Work Phone #: Email Address:

Appointment of Emergency Guardian, with or without notice, is not a determination of the Respondent's incapacity.

JDF 843

R7/09 ORDER APPOINTING EMERGENCY GUARDIAN FOR ADULT

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The Court directs the issuance of Letters of Guardianship as follows:
This emergency guardianship expires on (date not to exceed 60 days from appointment)

An Emergency Guardian may exercise only the powers specified in this Order. The powers and duties of the Emergency Guardian are as follows:

The Court orders the following:
1. The Court appoints the following attorney to represent the Respondent: Name: Address: City: Phone #: State: Zip Code: Attorney Registration #: Email Address:

2. If this Order was issued without notice, this Order Appointing Emergency Guardian along with Notice of Appointment of Emergency Guardian and Notice of Right to Hearing (JDF 844) must be personally served on the Respondent within 48 hours after the appointment. A copy of the completed Personal Service Affidavit (JDF 718) must be promptly filed with the Court.

3.

Powers of attorney, whether executed prior to or following the entry of this Order, are terminated, except as follows:

4. The Court further orders:

Date: __________________________

______________________________________ Judge Magistrate

JDF 843

R7/09 ORDER APPOINTING EMERGENCY GUARDIAN FOR ADULT

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