Free CG 907 - West Virginia

IN THE CIRCUIT COURT OF _______________ COUNTY, WEST VIRGINIA
For Clerk's Use Only IN RE: ______________________________________________, AN ALLEGED PROTECTED PERSON DATE FILED: _____________________________________ CASE NUMBER ___________ - G - __________

ORDER OF APPOINTMENT OF CONSERVATOR AND/OR GUARDIAN
[West Virginia Code: § 44A-2-13]

On the ______ day of _____________________________, 20______, a hearing in this matter was held before The Honorable _________________________________________________________, Mental Hygiene Commissioner/Judge of this Court pursuant to the provisions of West Virginia Code: § 44A-2-9; Based upon the aforementioned hearing the Commissioner/Judge issued a [Initial applicable filed findings]: __________ __________ Findings and Recommendations of Mental Hygiene Commissioner Findings and Conclusions of Circuit Court

the contents of which are incorporated herein by reference as if fully set forth herein. The Court hereby [Check applicable action taken by the Court and attach additional pages as required or necessary]: __________ accepts and adopts the entire Findings and Recommendations, without amendment, of the Mental Hygiene Commissioner, which constitutes the basis of this Order. __________ accepts and adopts the Findings and Recommendations of the Mental Hygiene Commissioner, with the exception of certain findings and/or recommendations which the Court declines to accept and which are detailed in an attachment page annexed hereto. [If this item is checked, attach an additional page or pages listing the specific finding(s) and/or recommendations not accepted and include any substituted or new findings adopted by the Court.] __________ rejects the entire Findings and Recommendations of the Mental Hygiene Commissioner and enters its own Findings and Conclusions. [If this item is checked, complete Form 906CC and attach to this Order.] __________ notes the hearing was conducted by the Court and not a mental hygiene commissioner. The Findings and Conclusions entered is the basis for this Order.

Order of Appointment of Conservator and/or Guardian - Page 1 of 4 Pages SCA-CG 907-1 / 6-00

Based upon the foregoing action, and the findings, recommendations and/or conclusions adopted herein as aforesaid, the Court hereby finds and determines that _______________________________________________, the individual alleged to be a protected person, is a "protected person" and meets the definition of a "protected person" under West Virginia Code: § 44A--1-4, and hereby ORDERS and makes the following appointment(s): [Name]_______________________________________ as either [check] _____ limited conservator or _____ conservator.

[Name]_______________________________________ as either [check] _____ limited guardian or _____ guardian.

If a "limited conservator" is appointed under the terms of this Order, said limited conservator shall be limited to the following responsibilities in managing the estate and financial affairs of the Protected Person and shall extend to no other area: ____________

____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ If a "limited guardian" is appointed under the terms of this Order, said limited guardian shall be limited to the following responsibilities in the personal affairs of the Protected Person and shall extend to no other area: ________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ A guardian and/or conservator, appointed herein without limitation shall discharge all of the duties and assume all of the responsibilities set forth under West Virginia Code: § 44A-3-1, et seq, other provisions of Chapter 44A as may be applicable, and any other duties and responsibilities more particularly set forth in this Order. The guardian/limited guardian is hereby granted the following specific areas of protection and assistance: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________

The conservator/limited conservator is hereby granted the following specific areas of management and assistance: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________

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Upon consideration of the Statement of Financial Resources [Form 903] hereinbefore filed, the requirements of § 44A-1-9 and arguments made during the hearing, it is hereby ORDERED that [Initial applicable finding and, if appropriate, insert amount of required bond]: __________ __________ __________ __________ Bond of the guardian/limited guardian is hereby waived. The posting of Bond by the conservator/limited conservator is excused under the provisions of § 31A-4-18. Bond is set and shall be posted by the guardian/limited guardian in the amount of: Bond is set and shall be posted by the conservator/limited conservator in the amount of: $ ___________________. It is further ORDERED that the form of the Bond(s) herein required shall be: ____________________________________ $ ________________.

___________________________________________________________________________________________________________. The Court notes that bond, as required above, has been posted as required by § 44A-2-13(a)(2), prior to the issuance of this order as follows in the following amount(s) and form(s): ______________________________________________________________ ____________________________________________________________________________________________________________ ___________________________________________________________________________________________________________. It is ORDERED that the mandatory education required by § 44A-1-10 has been [Initial one of the following]: __________ completed prior to the entry of this order of appointment as required under § 44A-2-13(a)(3). [Attach required Affidavit to this order - see § 44A-1-10(b).] __________ completed within the last three years and thus such individual does not require such education.

Pursuant to the terms of West Virginia Code: § 44A-3-8, if a conservator has been appointed under the terms of this Order, it is hereby ORDERED that such Conservator shall, within sixty (60) days of the entry of this Order, file with the Court and with the fiduciary supervisor of ____________________________ County, or the fiduciary commissioner named herein, as the case may be, the inventory required under subsection (a) and shall mail copies thereof to the parties entitled thereto as required by subsection (b). If a conservator has been appointed under the terms of this Order, the Court hereby refers this matter to the following: The Fiduciary Supervisor of ____________________________, County, West Virginia, or to _________________________________ _______________________ a Fiducuary Commissioner of ______________________________ County, West Virginia. In addition to filing the reports and accountings required by law with this Court, the conservator shall also file such reports and accounting with said Supervisor or the within named Commissioner who shall perform the duties required by West Virginia Code Chapter 44, Articles 3, 3A and 4, and Chapter 44A, with respect to the Protected Person's estate. The conservator shall likewise file a true copy of the bond posted and approved by the Court with said Supervisor/Commissioner. The Clerk of this Court shall enter the foregoing as of the ________ day of ________________________, 20 ______, and shall transmit attested copies to counsel of record for the parties, to any guardian and/or conservator appointed by this Order, and to the Petitioner. Pursuant to West Virginia Code: § 44A-2-13(c), the guardian and/or conservator SHALL, within FOURTEEN (14) DAYS OF THE DATE OF THE ENTRY OF THIS ORDER, mail a copy of this order of appointment, together with the statement of the right to appeal for a modification or termination which is annexed hereto, to the Protected Person and to all individuals and entities who were given notice of the Petition filed in this cause. SO ORDERED. ___________________________________________________ JUDGE OF THE CIRCUIT COURT

Order of Appointment of Conservator and/or Guardian - Page 3 of 4 Pages SCA-CG 907-3 / 6-00

STATEMENT OF RIGHTS TO APPEAL FOR A MODIFICATION OR TERMINATION
Pursuant to the provisions of West Virginia Code: § 44A-4-6, and other applicable law, the Protected Person named herein, any guardian and/or conservator of the Protected Person, or any other "interested person" as defined by law, has the right to, and may, seek an appeal to the Circuit Court to modify or terminate the appointment(s) and/or the powers of the guardian and/or conservator appointed by this Order.

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