Free pc675.pmd - Michigan

Approved, SCAO

JIS CODE: PTG

STATE OF MICHIGAN PROBATE COURT COUNTY
CIRCUIT COURT - FAMILY DIVISION

PETITION TO TERMINATE MODIFY GUARDIANSHIP
LEGALLY INCAPACITATED INDIVIDUAL MINOR

FILE NO.

In the matter of
Court ORI Date of birth Race Sex Current address of legally incapacitated individual

1. I am interested in this matter as

State relationship/interest

.

NOTICE: In limited-minor guardianships, only the parent(s) with a right to custody of the minor may petition to terminate the guardianship. 2. a. The alleged incapacitated individual has a spouse whose name and address are listed below. adult child(ren) whose name(s) and address(es) are listed below. living parent(s) whose name(s) and address(es) are listed below. no spouse, child(ren), or parent(s). The names and addresses of presumptive heirs are listed below. none of the above (must notify the Attorney General*).
NAME RELATIONSHIP ADDRESS AND TELEPHONE NO.

*Notify the Attorney General by sending a copy of this form to: Attorney General, Public Administration, PO Box 30736, Lansing, MI 48909.

b. The interested persons for the minor, their relationship, and their addresses are:
NAME RELATIONSHIP ADDRESS

Father/Age Mother/Age Conservator Guardian Person with care/ custody of minor**
** Also list persons who had principal care and custody of minor during the 63 days preceding filing of petition

(PLEASE SEE OTHER SIDE)
Do not write below this line - For court use only

PC 675 (9/08)

PETITION TO TERMINATE/MODIFY GUARDIANSHIP

MCL 700.5208, MCL 700.5210, MCL 700.5219, MCR 5.125(C)(25), MCR 5.404(F)(4), (5), MCR 5.408

3. The reasons why the court should take action are:

I REQUEST that the court: 4. Terminate the guardianship. 5. Accept the guardian's resignation. 6. Remove the guardian who has 7. Appoint
Name (type or print) City, state, zip Address Telephone no.

has not

been suspended.

as successor guardian. 8. Appoint
Name (type or print) Address

City, state, zip

Telephone no.

as a temporary guardian pending appointment of a successor. 9. Modify the powers of the guardian as follows:

I declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best of my information, knowledge, and belief.

Date Attorney signature Name (type or print) Address City, state, zip Telephone no. Bar no. Petitioner signature Name (type or print) Address City, state, zip Telephone no.

NOMINATION BY MINOR: I am 14 years of age or older. I nominate
Name Address City State Zip

as my guardian, who lives at .

Date

Signature of minor