Case No. Dept. No. 1 IN THE FOURTH JUDICIAL DISTRICT …

1 1234567891011121314151617181920212223242 526 Case No. 1IN THE FOURTH JUDICIAL DISTRICT COURTOF THE STATE OF NEVADA, IN AND FOR THE COUNTY OF ELKOIn the Matter of the Guardianship of:_____,_____,_____, A Minor An AdultGUARDIAN SACKNOWLEDGMENT OF DUTIES ANDRESPONSIBILITIES UNDER NRS 159 TEMPORARY GUARDIANSHIPGENERAL GUARDIANSHIP Person Person Estate Estate Person and Estate Person and EstateSPECIAL GUARDIANSHIPNOTICES/SAFEGUARDS Person Blocked Account Required Estate Bond Required Person and Estate Summary AdministrationI, (your name) _____, Guardian, hereby declare thatI understand there are certain duties and responsibilities required of me in the administration ofthe above guardianship.

2 By initialing each item below, I understand my guardianship duties and1234567891011121314151617181920212223 242526responsibilities include but are not limited to the following: (You must read and initial all itemson this form to acknowledge that you understand your duties and responsibilities): I. Required duties and functions [ALL GUARDIANS] _____Filing an order appointing Guardian within ten (10) days of the undersigned sappointment as guardian; _____Filing a Notice of Entry of order appointing Guardian within two (2) days of thefiling of the order appointing Guardian; _____Filing of General Letters of Guardianship within fourteen (14) days of the filing ofthe order appointing Guardian; _____Seeking the advice and assistance of an attorney if the Guardian needs legaladvice or does not understand his/her duties and responsibilities to ensure he/sheremains in full compliance with the laws of the State of Nevada.

3 [NRS ] _____Filing a petition, setting a hearing and noticing all persons entitled to notice if thequalifications of the Guardian change after appointment as Guardian, , ahearing must be held if: _____The Guardian plans to move or has moved out of state; [NRS (5)] _____The Guardian is judicially determined to have committed abuse, neglect orexploitation of a child, spouse, parent, or other person; [NRS (6)] _____The Guardian is convicted of a felony; [NRS (I); NRS (3)] _____The Guardian is suspended for misconduct or disbarred from the practiceof law, the practice of accounting , or any other profession which involvesthe management or sale of money, investments, securities or real property,and requires licensure in Nevada or any other state; [NRS (4)] _____ The Guardian is in the process of filing for bankruptcy, or has filed forbankruptcy; [NRS (t)] _____Guardian must notify the Court, and certain other persons, within thirty (30) daysof the death of a Ward; [NRS (c)(1)(v)] _____Guardian is required to respond to the inquiries of a duly appointed GuardianshipCompliance Administrator.

4 [NRS ]/ / // / // / /212345678910111213141516171819202122232 42526II. Duties of the Guardian of the Person [REQUIRED FOR GUARDIAN(S) OFTHE PERSON ONLY OR OF THE PERSON AND ESTATE]_____Guardian is required to file an annual Report of the Guardian every year tobring the Court up to date on the health and well-being of the Ward. TheReport must be filed within one (1) year and sixty (60) days of theanniversary of the Guardian s appointment as guardian of the person of theWard; [NRS ]_____Guardian shall supply the Ward with proper care, including food, shelter, clothing,and necessities; maintenance; support; and education, including training for aprofession if applicable; [NRS (1)(a)]_____Guardian shall supply the Ward with surgical, dental, psychiatric, psychological,hygienic, or other care and treatment as needed; [NRS (1)(b)]_____Guardian shall not consent to the experimental medical, biomedical, or behavioraltreatment of the Ward; the sterilization of the Ward.

5 Or the participation of theWard in any biomedical or behavioral experiment; [NRS (1)]_____Should the Guardian believe such treatment is of direct benefit to theWard, and intended to preserve the life of or prevent serious impairment tothe Ward the Guardian shall petition the Court to authorize suchtreatment as is required. _____Guardian shall obtain Court authority prior to authorizing the placement of aWard in a secured residential long-term care facility; [NRS (6)]_____Guardian shall petition the Court to obtain authority prior to removing the Wardfrom the State of Nevada; [NRS (5)]_____Guardian shall petition the Court to obtain authority prior to authorizing thechange of state of residence of or domicile of the Ward; [NRS (5)]II.

6 Duties of the Guardian of the Estate [REQUIRED FOR GUARDIAN(S) OF THEESTATE ONLY OR OF THE PERSON AND ESTATE]_____Guardian shall place assets into a blocked account, if required by the Court OrderGranting Guardianship, and obtain and file proof of the blocked account;[NRS (6)]_____Guardian shall obtain a bond, if required by the Court order GrantingGuardianship, and obtain and file notice of bond; [NRS ]_____Guardian is required to file an inventory and appraisement setting forth thedescription and valuation of the income and assets that comprise the Ward sestate within sixty (60) days of the undersigned s appointment as Guardianof the estate of the Ward; [NRS (1)]/ / // / /312345678910111213141516171819202122232 42526 Requirements of the Inventory and Appraisal:_____The appraisal or valuation must be done by a disinterested appraiser,certified public accountant, or expert in valuation, unless the value of anasset can be determined with reasonable certainty; [NRS (1)]_____Guardian may be able to file a verified record of value; [NRS (2)(a)]_____Guardian may use a statement of the assessed value of real property asdetermined by the County assessor for purposes, except that if the realproperty is to be sold, the Guardian must file an appraisal.

7 [NRS (2)(b)]_____Guardian must file an inventory unless the requirement of an inventorywas specifically waived in the Court order appointing the Guardian. Thisrequirement endures even if the Ward has no assets. The inventory mustbe a separate pleading filed after the grant of guardianship. _____Guardian is required to file an accounting every year within one (1) yearand sixty (60) days of the anniversary of the undersigned s appointment asGuardian of the estate of the Ward. Guardian shall contact the Court to setthe accounting on the Court s calendar for hearing and approval. [NRS (1)]Requirements of the accounting :The accounting shall set forth:_____The amounts received on behalf of the Ward; [NRS (1)(b)]_____The amounts disbursed on behalf of the Ward; [NRS (1)(b)]_____The balance of the Ward s estate which the Guardian continues to shall keep precise and accurate records of all funds received anddisbursed for the Ward s benefit, along with the source of all receipts and thepurpose of all disbursements.

8 The undersigned understands that this includes, butis not limited to balancing estate checkbooks and insuring that all records areclear, legible, and balance with the figures referenced in all bank accounts;_____Guardian shall protect, preserve, and manage the Ward s estate according to thelaws and in the best interest of the Ward; _____Guardian shall secure originals, when available, or copies of the followingdocuments:_____ Any contract executed by the Ward;_____Any power of Attorney for the Ward;_____Any estate planning documents;412345678910111213141516171819 20212223242526_____Any revocable or irrevocable trust in which the Ward has a vested interestas a beneficiary;_____Any writing depicting a present or future interest in any real or Investing and Managing Ward s Estate [GUARDIAN OF ESTATE OR OFPERSON AND ESTATE]_____When establishing bank accounts or holding property on behalf of the Ward, titledesignations shall read: Name of Guardian(s) as Guardian(s) of the estate of name of the Ward.

9 [NRS ]_____Guardian may not utilize any guardianship funds for his/her personal benefit orcommingle guardianship funds with his/her own funds;_____Guardian shall not place the guardianship funds in joint tenancy;_____Guardian may, without prior approval of the Court, invest the Ward s funds in anFDIC or FSLIC insured savings account in any bank, credit union, or savings andloan institution in the State of Nevada; interest bearing obligations of or fullyguaranteed by the United States, or the United States Postal Service; or interestbearing general obligations of any county, city, or school DISTRICT in Nevada, theState of Nevada, or Federal National Mortgage Association; or any money marketmutual funds which are invested only in those instruments described in thisparagraph.

10 [NRS (2)]_____Guardian is required to petition the Court prior to taking any of the following actions:_____Invest the property of the ward pursuant to NRS the business of the ward pursuant to NRS money for the ward pursuant to NRS Except as otherwise provided in NRS , enter into contracts for theWard or complete the performance of contracts of the ward pursuant toNRS gifts from the ward s estate or make expenditures for the ward srelatives pursuant to NRS , lease or place in trust any property of the ward pursuant to NRS or partition the ward s property pursuant to NRS the power of the ward as trustee, personal representative orcustodian for a minor or or release the power of the ward as a donee of a power the right of the ward to take under or against a to a trust created by the ward any property unintentionallyomitted from the a revocable trust to the jurisdiction of the court if: (1) The ward orthe spouse of the ward, or both, are the grantors and sole beneficiaries ofthe income of the trust.