Proposed Ward Information

  • Thank you in advance for filling out the form! If you have any questions about the form, please call us; otherwise, please complete as much of it as possible. Once you complete the form, send it to us at iva@difranzalaw.com.

     

    DIFRANZA LAW, P.A. GUARDIAN ADVOCACY INTAKE FORM

    INFORMATION ON THE PERSON NEEDING A GUARDIAN ADVOCATE (THE PROPOSED WARD)

  • Date Format: MM slash DD slash YYYY
  • The proposed ward lacks the following decision-making ability to do decision-making tasks necessary to care for his or her person or property (check all that apply): (if the person does not lack any of these abilities – please state whether the person has the understanding to sign a power of attorney and health care designation in the Other section below)
  • NEXT OF KIN (NoK) TO THE PROPOSED WARD:

    DEFINITION: Typically, the NoK to the proposed ward in guardian advocacy are the parents. However, if the proposed ward has children, the NoK will be the children.
    If there are no children or parents, then NoK will be the grandparents.

    If only one parent is applying, we must have information on the other parent. Florida Law requires that notice be provided to the next of kin. *

  • * Please let us know, if applicable:
    • If the next of kin will consent to the guardian advocacy
    • If there may be an issue with notifying the next of kin
    • If the other parent is deceased, and the date of death
  • * Please let us know, if applicable:
    • If the next of kin will consent to the guardian advocacy
    • If there may be an issue with notifying the next of kin
    • If the other parent is deceased, and the date of death
  • INCOME/SOURCE OF INCOME AND ASSETS OF THE PROPOSED WARD
    Is his/her income less than $25,520? If yes, complete this section. If no, strike through this section
  • INCOME

  • ASSETS

  • EXPENSES OF THE PROPOSED WARD
    (if person is currently receiving social security benefits, use the numbers you provide for expenses to social security)
  • Home/Shelter as defined by Social Security includes room, rent, mortgage payments, real property taxes, heating fuel, gas, electricity, water, sewerage, and garbage collection services.
    https://secure.ssa.gov/poms.nsf/lnx/0603020045
    • For the proposed ward living with others, this would be his/her share of these costs (4 people living in the household, the share would be ¼ the total cost.) However, keep in mind what someone with low income could afford. For example, if 1/3 the cost is $1,000/month, that is not considered a reasonable rent for someone only receiving ~$800/month). This will be discussed at your meeting with the attorney.
  • FMV of share of groceries, technology for education, rehabilitation, life enhancement, transportation, activities to enhance life, camp, etc
  • FMV = Fair market value

Thank you in advance for filling out the form! If you have any questions about the form, please call us; otherwise, please complete as much of it as possible. Once you complete the form, send it to us at iva@difranzalaw.com.