Free In the Matter of the Protective Proceeding of - Alaska

IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT____________________ In the Matter of the Protective Proceeding of ) ) ) ) ) ) )

, Ward.

CASE NO.

ACCEPTANCE OF APPOINTMENT AS TEMPORARY GUARDIAN AND ACKNOWLEDGEMENT OF DUTIES I, ward named above. , accept the duties of temporary guardian of the

I have read and understand the duties and powers of a guardian in Alaska Statute 13.26.150 (and the powers and duties of a conservator in AS 13.26.245 - .315 if I also have conservator powers). I understand that I am being granted only the powers set forth in the court's order appointing me temporary guardian. I solemnly swear to perform the duties set forth in my appointment order. I understand that I must complete at least one hour of education on guardianship (and conservatorship) and file the PG-120 Affirmation form with the court within 30 days after my appointment. I further understand that I must file any reports the court asks me to file. I understand that my temporary appointment will end when a long-term guardian is appointed for the ward or when the petition for a long-term guardian is dismissed.

Date

Guardian's Signature Mailing Address City State ZIP

Daytime Telephone Verification I state on oath or affirm that I have read the above Acceptance and that all statements made in it are true to the best of my knowledge and belief. Date Subscribed and sworn to or affirmed before me at on . Date (SEAL) Guardian's Signature , Alaska Clerk of Court, Notary Public, or other person authorized to administer oaths. My commission expires:
Probate Rule 16(c) AS 13.26.115

PG-433 (2/05)(cs) ACCEPTANCE OF APPOINTMENT AS TEMPORARY GUARDIAN