Within 30 days after each anniversary of appointment, a guardian for an adult protected person shall file with the court a written report. The report must include a declaration under penalty of perjury in the form required by ORCP 1 E. Copies of the guardian’s report must be given to those persons specified in ORS 125.060 (3). The report shall be in substantially the following form:
______________________________________________________________________________
IN THE _________ COURT ____________ COUNTY,
STATE OF OREGON
DEPARTMENT OF PROBATE
In the Matter of the)No. ______
Guardianship of)
____________,)
(Name of protected)
person))
A Protected)
Person.)
GUARDIAN’S REPORT
I am the guardian for the person named above, and I make the following report to the court as required by law:
1. My name is____________.
2. My address and telephone number are:
______________________
______________________
Phone ____________
3. The name, if applicable, and address of the place where the person now resides are:
______________________
______________________
4. The person is currently residing at the following type of facility or residence:
______________________
5. The person is currently engaged in the following programs and activities and receiving the following services (brief description):
______________________
6. I was paid for providing the following items of lodging, food or other services to the person:
______________________
______________________
7. The name of the person primarily responsible for the care of the person at the person’s place of residence is:
______________________
8. The name and address of any hospital or other institution where the person is now admitted on a temporary or permanent basis are:
______________________
______________________
9. The person’s physical condition is as follows (brief description):
______________________
______________________
10. The person’s mental condition is as follows (brief description):
______________________
______________________
11. I made the following contacts with the person during the past year (brief description):
______________________
12. I made the following major decisions on behalf of the person during the past year (brief description):
______________________
13. I believe the guardianship should or should not continue because:
______________________
14. At the time of my last report, I held the following amount of money on behalf of the person: $______. Since my last report, I received the following amount of money on behalf of the person: $______. I spent the following amount of money on behalf of the person: $______. I now hold the following amount of money on behalf of the person: $______.
15. A true copy of this report will be given to the person, any conservator for the person and any other person who has requested notice.
16. Since my last report:
(a) I have been convicted of the following crimes (not including traffic violations):
______________________
(b) I have filed for or received protection from creditors under the Federal Bankruptcy Code (yes or no):_____.
(c) I have had a professional or occupational license revoked or suspended (yes or no):_____.
(d) I have had my driver license revoked or suspended (yes or no):_____.
17. Since my last report, I have delegated the following powers over the protected person for the following periods of time (provide name of person powers delegated to):
______________________
I hereby declare that the above statement is true to the best of my knowledge and belief, and that I understand it is made for use as evidence in court and is subject to penalty for perjury.
Dated this ___ day of________, 2___.
______________________
Guardian
______________________________________________________________________________
[1995 c.664 §32; 1997 c.717 §6; 2007 c.284 §4]
Note: Section 5, chapter 284, Oregon Laws 2007, provides:
Sec. 5. The amendments to ORS 111.205, 116.083, 116.253 and 125.325 by sections 1 to 4 of this 2007 Act apply only to petitions, reports and accounts filed in proceedings before a probate court on or after the effective date of this 2007 Act [January 1, 2008]. [2007 c.284 §5]
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