Minnesota Adult Guardianship and Conservatorship Petition Packet

MINNESOTA ADULT GUARDIANSHIP AND CONSERVATORSHIP PETITION PACKET

PART 1 — PRE-PETITION CHECKLIST

☐ Confirm Respondent is an adult; Minnesota is home state or significant connection under UAGPPJA (§ 524.5-201)
☐ Obtain BCA background study on proposed guardian/conservator under Minn. Stat. § 524.5-118
☐ Obtain professional evaluation/physician's statement (Minn. Stat. § 524.5-303(b); § 524.5-308)
☐ Identify all interested persons under § 524.5-303(b)(2)
☐ Document less restrictive alternatives attempted (supported decision-making, POA, health-care directive) — § 524.5-303(b)(9)
☐ Determine whether limited or unlimited guardianship/conservatorship is appropriate (presumption of limited)
☐ Verify proposed fiduciary's qualifications (§ 524.5-303(c))
☐ Confirm Notice of Hearing complies with § 524.5-304 (14-day minimum)
☐ Prepare Notice of Rights to Alleged Incapacitated Person (AIP)
☐ Determine bond requirement under § 524.5-410
☐ Review Bill of Rights for Persons Subject to Guardianship/Conservatorship under § 524.5-120
☐ Confirm proposed guardian completes mandatory training (Minn. Stat. § 524.5-309)

PART 2 — VERIFIED PETITION FOR APPOINTMENT OF GUARDIAN AND CONSERVATOR

STATE OF MINNESOTA
DISTRICT COURT, [____________________] COUNTY
[____________________] JUDICIAL DISTRICT — PROBATE DIVISION

In the Matter of the Guardianship and Conservatorship of:

[FULL LEGAL NAME OF RESPONDENT], Respondent (Alleged Incapacitated Person).

Court File No.: [____________]

PETITION FOR APPOINTMENT OF GUARDIAN AND CONSERVATOR OF ADULT

(Minn. Stat. §§ 524.5-303, 524.5-403)

Petitioner, [__________________________], respectfully petitions the Court as follows:

I. PETITIONER (§ 524.5-303(b))

1.1 Name: [________________________________]
1.2 Residence: [________________________________]
1.3 Current address (if different): [________________________________]
1.4 Telephone: [____________] Email: [____________]
1.5 Relationship to Respondent: [________________________________]
1.6 Interest in the appointment: [________________________________]

II. RESPONDENT (§ 524.5-303(b)(1))

2.1 Full legal name: [________________________________]
2.2 Age: [____] Date of birth: [__/__/____]
2.3 Principal residence: [________________________________]
2.4 Current street address: [________________________________]
2.5 Proposed residence if appointment made: [________________________________]

III. INTERESTED PERSONS (§ 524.5-303(b)(2))

IV. INSTITUTIONS AND LEGAL REPRESENTATIVES (§ 524.5-303(b)(3)-(5))

4.1 Administrative head of hospital, nursing home, or other institution where Respondent resides: [________________________________]
4.2 Legal representative for Respondent (attorney-in-fact, conservator, etc.): [________________________________]
4.3 Guardian/conservator nominee under prior writing (including health care directive): [________________________________]

V. HEALTH CARE DIRECTIVE / POWER OF ATTORNEY (§ 524.5-303(b)(7))

5.1 Health care agent under Minn. Stat. ch. 145C: [________________________________]
5.2 Attorney-in-fact under financial POA: [________________________________]
5.3 Living will / advance directive on file: ☐ Yes ☐ No

VI. PROPOSED GUARDIAN / CONSERVATOR (§ 524.5-303(b)(6) and (c))

6.1 Proposed Guardian: [________________________________]
6.2 Proposed Conservator: [________________________________]
6.3 Address: [________________________________]
6.4 Telephone: [____________]
6.5 Reasons proposed fiduciary should be selected: [________________________________]
6.6 Whether ever removed for cause as guardian/conservator: ☐ No ☐ Yes — explain: [____________]
6.7 If professional guardian/conservator: educational background and relevant experience: [____________]
6.8 Any professional license: ☐ No ☐ Yes — agency, license number, status: [____________]
6.9 Ever found civilly liable for fraud, misrepresentation, theft, conversion: ☐ No ☐ Yes — explain: [____________]
6.10 Bankruptcy filings in last 5 years: ☐ No ☐ Yes — case number/court: [____________]
6.11 Criminal history requiring disclosure: ☐ No ☐ Yes — explain: [____________]
6.12 BCA background study completed: ☐ Yes (date: [__/__/____]) ☐ Pending

VII. NATURE AND EXTENT OF ALLEGED INCAPACITY (§ 524.5-303(b)(8))

7.1 Brief description: [________________________________]
7.2 Diagnosis: [________________________________]
7.3 Functional impairments:
☐ Inability to meet personal needs for medical care, nutrition, clothing, shelter, safety
☐ Inability to manage property and financial affairs
☐ Vulnerability to abuse, neglect, exploitation
☐ Other: [________________________________]

VIII. LESS RESTRICTIVE ALTERNATIVES (§ 524.5-303(b)(9))

8.1 Less restrictive alternatives attempted and considered:
☐ Supported decision-making agreement
☐ Financial power of attorney
☐ Health care directive
☐ Representative payee
☐ Trust arrangement
☐ Case management
☐ Other: [____________]
8.2 How long attempted: [____________]
8.3 Why insufficient to meet Respondent's needs: [________________________________]

IX. LIMITED vs. UNLIMITED (§ 524.5-303(b)(10))

9.1 ☐ Unlimited guardianship requested — reason limited is INAPPROPRIATE: [____________]
9.2 ☐ Limited guardianship requested — powers requested: [____________]
9.3 ☐ Unlimited conservatorship requested — reason limited is INAPPROPRIATE: [____________]
9.4 ☐ Limited conservatorship requested — powers requested: [____________]

X. GENERAL STATEMENT OF PROPERTY (§ 524.5-303(b)(11))

Anticipated income source(s) and amounts: [________________________________]

XI. PRAYER FOR RELIEF

WHEREFORE, Petitioner requests:

(a) Setting of hearing under § 524.5-304;
(b) Appointment of court visitor under § 524.5-305;
(c) Appointment of counsel for Respondent under § 524.5-304(b) and § 524.5-307;
(d) Ordering a professional evaluation under § 524.5-308;
(e) Findings of incapacity by clear and convincing evidence;
(f) Appointment of guardian and conservator as requested;
(g) Issuance of Letters of Guardianship and Conservatorship;
(h) Setting of bond under § 524.5-410;
(i) Such other relief as is just.

VERIFICATION (Minn. Stat. § 358.116)

I, [__________________________], declare under penalty of perjury that everything I have stated in this document is true and correct.

Dated: [__/__/____] County: [____________] State of: [____________]

[________________________________]
Petitioner Signature

[________________________________]
Printed Name

PART 3 — NOTICE OF HEARING AND NOTICE OF RIGHTS TO ALLEGED INCAPACITATED PERSON (§ 524.5-304)

TO: [RESPONDENT NAME], Alleged Incapacitated Person

YOU ARE NOTIFIED that a Petition for Appointment of Guardian and Conservator has been filed concerning you. The hearing will be held:

Date: [__/__/____]
Time: [____]
Location: [________________________________]
Courthouse: [________________________________]
Judge/Referee: [________________________________]

YOUR RIGHTS — MINN. STAT. § 524.5-304(b) & § 524.5-120 (Bill of Rights):

☐ Right to be present at all hearings (Court may not hold hearing in your absence absent good cause)
☐ Right to attorney representation; Court must appoint counsel if you do not have one (§ 524.5-304(b))
☐ Right to a jury trial on incapacity
☐ Right to present evidence and cross-examine witnesses
☐ Right to an independent professional evaluation
☐ Right to closed hearing upon request
☐ Right to least restrictive alternative
☐ Right to participate in decisions to maximum extent of ability
☐ Right to associate with persons of your choice
☐ Right to communicate privately
☐ Right to vote unless specifically removed by court
☐ Right to marry (subject to limitations)
☐ Right to petition for restoration, modification, or termination at any time

If you wish to object, you must file a written objection with the Court or appear at the hearing.

Date: [__/__/____]
[________________________________]
Petitioner / Attorney for Petitioner

PART 4 — NOTICE TO INTERESTED PERSONS (§ 524.5-304)

TO: All interested persons identified in Part III.

NOTICE IS GIVEN that a Petition for Appointment of Guardian and Conservator for [RESPONDENT NAME] is scheduled for hearing on [__/__/____] at [____] in [________________________________].

Any interested person may appear and be heard. Notice must be served at least 14 days before the hearing (Minn. Stat. § 524.5-304).

Service certified: [________________________________] Date: [__/__/____]

PART 5 — PHYSICIAN'S/PROFESSIONAL'S STATEMENT (Minn. Stat. § 524.5-303(b); § 524.5-308)

PHYSICIAN'S / PSYCHOLOGIST'S / QUALIFIED PROFESSIONAL'S STATEMENT

Re: [RESPONDENT NAME]
DOB: [__/__/____]
Date(s) of examination: [____________]
Evaluator name: [________________________________]
License type and number: [________________________________]
Specialty: [________________________________]

1. Diagnosis: [________________________________]
2. Description of nature, type, and extent of incapacity: [________________________________]
3. Functional assessment:

4. Cause of incapacity (medical, developmental, traumatic, etc.): [________________________________]
5. Prognosis and expected duration: [________________________________]
6. Recommendations for least restrictive intervention: [________________________________]
7. Whether Respondent should be present at hearing: ☐ Yes ☐ No — explain: [____________]

Signature: [________________________________] Date: [__/__/____]

PART 6 — APPOINTMENT OF COURT VISITOR AND COUNSEL (§§ 524.5-305, 524.5-307)

ORDER APPOINTING COURT VISITOR AND COUNSEL

The Court appoints:

Court Visitor: [________________________________]
Duties: interview Respondent, explain proceedings, visit residence and proposed dwelling, interview proposed guardian, investigate alternatives, file written report by [__/__/____]

Counsel for Respondent: [________________________________]
Counsel is appointed pursuant to § 524.5-304(b) (counsel must be appointed unless Respondent has retained counsel)

Date: [__/__/____]
[________________________________]
Judge / Referee, District Court

PART 7 — LESS RESTRICTIVE ALTERNATIVE ANALYSIS (§ 524.5-303(b)(9))

PART 8 — BOND (Minn. Stat. § 524.5-410)

BOND OF CONSERVATOR

Conservator name: [________________________________]
Bond amount: $[____________]
Surety: [________________________________]
Bond number: [____________]
☐ Bond required ☐ Bond waived (state basis): [____________]

PART 9 — NOTICE OF HEARING

NOTICE IS HEREBY GIVEN that a hearing on the Petition for Appointment of Guardian and Conservator for [RESPONDENT NAME] will be held on:

Date: [__/__/____]
Time: [____]
Location: [________________________________]
Before: Judge/Referee [________________________________]

Dated: [__/__/____]
[________________________________]
Court Administrator

PART 10 — FINDINGS, ORDER OF APPOINTMENT, AND LETTERS (§ 524.5-310)

FINDINGS AND ORDER APPOINTING GUARDIAN AND CONSERVATOR

THIS MATTER came before the Court on [__/__/____]. The Court, having reviewed the petition, professional evaluation, court visitor's report, and other evidence, FINDS:

☐ Proper notice was given under § 524.5-304.
☐ Counsel was appointed/retained for Respondent: [____________]
☐ Court visitor's report was filed and considered.
☐ Respondent is an incapacitated person within the meaning of Minn. Stat. § 524.5-102, subd. 6, as shown by clear and convincing evidence.
☐ Respondent's identified needs cannot be met by less restrictive means (by a preponderance).
☐ Proposed fiduciary is qualified and willing to serve.
☐ BCA background study is complete and satisfactory.

IT IS ORDERED:

1. [________________________] is appointed ☐ Limited ☐ Unlimited Guardian of [RESPONDENT NAME].
2. [________________________] is appointed ☐ Limited ☐ Unlimited Conservator of the Estate of [RESPONDENT NAME].
3. Specific powers granted to Guardian: [________________________________]
4. Specific powers granted to Conservator: [________________________________]
5. Rights specifically retained by Person Subject to Guardianship/Conservatorship: [________________________________]
6. Bond: $[____________] (☐ Waived)
7. Initial Inventory due within 60 days under § 524.5-417.
8. Annual Personal Well-Being Report due under § 524.5-316.
9. Annual Account due under § 524.5-420.
10. Anniversary date for filings: [__/__/____]
11. Next review: [__/__/____]

Dated: [__/__/____]

[________________________________]
Judge / Referee, District Court

LETTERS OF GUARDIANSHIP

These Letters certify that [________________________] has been appointed Guardian of [RESPONDENT NAME] on [__/__/____] with the powers specified in the foregoing Order.

[Court Seal]
Court Administrator: [________________________________]

LETTERS OF CONSERVATORSHIP

These Letters certify that [________________________] has been appointed Conservator of the Estate of [RESPONDENT NAME] on [__/__/____] with the powers specified in the foregoing Order.

[Court Seal]
Court Administrator: [________________________________]

PART 11 — INITIAL INVENTORY (§ 524.5-417) AND ANNUAL ACCOUNTING (§ 524.5-420)

INITIAL INVENTORY — Due within 60 days of issuance of Letters

Conservator certification under penalty of perjury:

[________________________________] Date: [__/__/____]

ANNUAL REPORT (Guardian) — § 524.5-316: Address ward's residence, services received, well-being, recommended changes, and continued necessity of guardianship.

ANNUAL ACCOUNTING (Conservator) — § 524.5-420: Beginning balance, receipts, disbursements, ending balance, transactions, fees, status of bond. Subject to Conservator Account Auditing Program (CAAP) or Conservator Account Review Program (CARP).

Reporting period: [__/__/____] to [__/__/____]
Filing deadline: [__/__/____] (anniversary date)

SOURCES AND REFERENCES

• Minn. Stat. ch. 524, Article 5 (Uniform Guardianship and Protective Proceedings Act)
• 2020 Minn. Laws ch. 86 (UGPPA reform)
• Minnesota Judicial Branch GAC forms (statewide guardianship/conservatorship forms)
• Office of the Legislative Auditor, Guardianship of Adults (2025 report)
• Minnesota Association for Guardianship and Conservatorship (MAGiC)
• Minn. R. Gen. Prac. (rules governing guardianship/conservatorship)