New Jersey Adult Guardianship / Conservatorship Petition Package

NEW JERSEY ADULT GUARDIANSHIP / CONSERVATORSHIP PETITION PACKAGE

Action for Guardianship of an Incapacitated Person or Appointment of a Conservator

Statutory Framework: N.J.S.A. § 3B:12-1 et seq.; R. 4:86

Standard of Proof: Clear and convincing evidence (N.J.S.A. § 3B:12-24.1)

Court of Jurisdiction: Superior Court of New Jersey, Chancery Division, Probate Part, in the county where the alleged incapacitated person ("AIP") resides; records maintained by the County Surrogate (R. 4:86-1).

PART 1 — PRE-PETITION CHECKLIST

☐ Confirm AIP is domiciled in New Jersey or is a nonresident with property in New Jersey (R. 4:86-8 governs nonresidents).

☐ Confirm venue: Superior Court, Chancery Division, Probate Part, in the county of the AIP's residence.

☐ Identify and analyze less-restrictive alternatives BEFORE filing:
☐ Existing durable power of attorney (N.J.S.A. § 46:2B-8.1 et seq.)
☐ Health care representative / proxy directive (N.J.S.A. § 26:2H-53 et seq.)
☐ Representative payee (SSA)
☐ Supported decision-making arrangement
☐ Trust (revocable, special needs, or third-party)
☐ Joint accounts / authorized signers
☐ Conservatorship (consensual, less restrictive than guardianship — N.J.S.A. § 3B:13A-1 et seq.)

☐ Determine whether limited guardianship is appropriate (favored under N.J.S.A. § 3B:12-24.1(b)).

☐ Identify all interested parties for service (spouse, adult children, parents, siblings, custodian, agents under POA / HCD, trustees).

☐ Obtain two qualifying affidavits / certifications under R. 4:86-2(b):
☐ Two physicians, OR
☐ One physician + one licensed practicing psychologist (N.J.S.A. § 45:14B-2)
☐ Each examination within 30 days of filing (good-cause extension by ex parte motion)
☐ No affiant related by blood or marriage to AIP or financially connected to institution

☐ If the AIP or the person in charge refuses an examination, use the one-qualified-affiant alternative under R. 4:86-2(c)(2), document the timely examination effort and refusal, and request any needed good-cause relaxation ex parte.

☐ Prepare affidavit of assets (real estate, personal property, accounts, pensions, retirement, annuities).

☐ Identify proposed guardian / conservator and confirm fitness (no disqualifying conflicts).

☐ Calculate proposed bond amount under R. 4:86-6 / N.J.S.A. § 3B:15-1 et seq.

☐ Prepare proposed Order to Show Cause (R. 4:83-1; R. 4:86-4).

☐ Prepare proposed Judgment of Incapacity and Letters of Guardianship.

PART 2 — VERIFIED COMPLAINT FOR GUARDIANSHIP

SUPERIOR COURT OF NEW JERSEY
CHANCERY DIVISION — PROBATE PART
COUNTY OF [____________________]
DOCKET NO.: [____________________]

VERIFIED COMPLAINT FOR JUDGMENT OF INCAPACITY AND APPOINTMENT OF GUARDIAN

Plaintiff [____________________________________], residing at [_______________________________________________], by way of Verified Complaint, says:

1. Plaintiff's Identification.
(a) Name: [____________________________________]
(b) Age: [____]
(c) Domicile and address: [_______________________________________________]
(d) Relationship to AIP: [____________________________________]
(e) Interest in this action: [____________________________________]

2. Alleged Incapacitated Person.
(a) Name: [____________________________________]
(b) Date of birth / age: [__/__/____] / [____]
(c) Domicile: [_______________________________________________]
(d) Current address: [_______________________________________________]
(e) Spouse (name and address, if any): [_______________________________________________]

3. Family Members and Nearest of Kin (R. 4:86-2(a)(4); names, addresses, ages of children; names and addresses of parents and nearest of kin of the same degree as Plaintiff):

4. Care and Custody. Name and address of person or institution having care and custody of AIP:
[_______________________________________________]

5. Institutional History (R. 4:86-2(a)(6)). If AIP has lived in an institution, describe period(s), date(s) of commitment / confinement, and authority:
[_______________________________________________]

6. Existing Fiduciaries / Agents (R. 4:86-2(a)(7)):
(a) Attorney-in-fact under any POA: [____________________________________]
(b) Health care representative under advance directive: [____________________________________]
(c) Trustee of any trust for benefit of AIP: [____________________________________]

7. Nature of Alleged Incapacity. AIP is impaired by [☐ mental illness ☐ mental deficiency ☐ physical illness or disability ☐ chronic drug use ☐ chronic alcoholism ☐ developmental disability ☐ other: __________] to the extent that AIP lacks sufficient capacity to govern himself / herself and manage his / her affairs. Specific functional limitations:
[_______________________________________________]

8. Less Restrictive Alternatives Considered and Rejected (N.J.S.A. § 3B:12-24.1):
[_______________________________________________]

9. Type of Guardianship Sought.
☐ General (plenary) guardianship of the person
☐ General (plenary) guardianship of the estate
☐ General (plenary) guardianship of person and estate
☐ Limited guardianship — retained rights: [_______________________________________________]
☐ Conservatorship (consensual) under N.J.S.A. § 3B:13A-1 et seq.
☐ Special Medical Guardian under R. 4:86-12

10. Proposed Guardian.
(a) Name: [____________________________________]
(b) Address: [_______________________________________________]
(c) Relationship to AIP: [____________________________________]
(d) Qualifications and reason for selection: [____________________________________]

WHEREFORE, Plaintiff demands judgment:
(a) Adjudging [Name of AIP] to be an incapacitated person under N.J.S.A. § 3B:12-24.1;
(b) Appointing [Proposed Guardian] as [☐ general ☐ limited ☐ medical] guardian of the [☐ person ☐ estate ☐ person and estate];
(c) Setting bond in an amount the Court deems appropriate;
(d) Directing issuance of Letters of Guardianship; and
(e) Granting such other relief as is just and equitable.

Verification (R. 1:4-7). I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment.

Dated: [__/__/____] Signature: [_______________________________]

PART 3 — AFFIDAVIT OF ASSETS (R. 4:86-2(b)(1))

I, [____________________], of full age, being duly sworn, depose and say:

A. Real Estate. Nature, location, description, fair market value, and assessed valuation of all real estate in which AIP has or may have a present or future interest:
[_______________________________________________]

B. Personal Estate. Nature, description, and fair market value of:
(1) Stocks, bonds, mutual funds, securities, investment accounts: [____________________]
(2) Cash, checking and savings accounts, CDs: [____________________]
(3) Notes / indebtedness due AIP: [____________________]
(4) Pensions, retirement accounts, annuities, profit-sharing plans: [____________________]
(5) Insurance (life, long-term care, other): [____________________]
(6) Anticipated income / receipts: [____________________]

Total estimated estate value: $[____________________]

Sworn and subscribed before me this [____] day of [__________], 20[____].

[____________________] Notary Public / Attorney at Law of NJ

PART 4 — PHYSICIAN / PSYCHOLOGIST CERTIFICATIONS (R. 4:86-2(b)(2), (c)(2))

Ordinary route: two affidavits or certifications: (i) two physicians qualified under N.J.S.A. § 30:4-27.2t, OR (ii) one such physician and one licensed practicing psychologist as defined in N.J.S.A. § 45:14B-2. Refusal alternative: if examination is refused, R. 4:86-2(c)(2) permits one qualified affiant's certification documenting the timely effort and refusal.

AFFIDAVIT OF EXAMINING [☐ PHYSICIAN ☐ LICENSED PSYCHOLOGIST]

I, [____________________], being duly sworn, depose and say:

1. Qualifications. I am a [☐ physician licensed under N.J.S.A. § 30:4-27.2t ☐ licensed practicing psychologist under N.J.S.A. § 45:14B-2]. License No. [____________].

2. Examination. I personally examined [Name of AIP] on [__/__/____] at [____________________]. (Examination must be within 30 days of filing; R. 4:86-2(b).)

3. Treatment vs. Examination. I have [☐ treated ☐ merely examined] the AIP.

4. Non-Disqualification (R. 4:86-3). I am NOT related by blood or marriage to the AIP, NOT a proprietor / director / chief executive officer of any institution (other than state, county, or federal) where the AIP is or will reside, NOT professionally employed by such institution as resident physician or psychologist, and NOT financially interested in such institution.

5. Diagnosis and Prognosis. Diagnosis: [____________________________________]. Prognosis: [____________________________________]. Factual basis: [____________________________________].

6. Physical Description of Person Examined. Sex: [____]. Age: [____]. Weight: [____]. Other identifying features: [____________________________________].

7. Opinion on Incapacity. In my professional opinion, AIP is unfit and unable to govern himself / herself and manage his / her affairs to the following extent: [____________________________________]. Circumstances and conduct supporting this opinion, including history of AIP's condition: [____________________________________].

8. Retained Capacities (Limited Guardianship Analysis). AIP retains sufficient capacity to manage the following specific areas:
   ☐ Residential decisions
   ☐ Educational decisions
   ☐ Medical decisions
   ☐ Legal decisions
   ☐ Vocational decisions
   ☐ Financial decisions
   ☐ Voting
   ☐ Marriage
   Explanation: [____________________________________]

9. Ability to Attend Hearing. AIP [☐ is ☐ is not] capable of attending the hearing. If not, reason: [____________________________________].

Sworn and subscribed before me this [____] day of [__________], 20[____].

[____________________] Affiant
[____________________] Notary Public

ALTERNATIVE CERTIFICATION WHEN EXAMINATION IS REFUSED — R. 4:86-2(c)(2)

I, [____________________], certify that I am a qualified [☐ physician ☐ licensed practicing psychologist]. On [__/__/____], not more than 30 days before filing, I endeavored to personally examine [Name of AIP] at [PLACE] by [DESCRIBE EFFORTS]. The examination could not be completed because [☐ AIP ☐ PERSON IN CHARGE: ______] refused or was unwilling to permit it. The facts establishing the refusal are: [____________________________________].

☐ An ex parte good-cause request to relax the 30-day period is attached.

I certify that the foregoing statements are true. I am aware that if any statement is willfully false, I am subject to punishment.

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

PART 5 — ORDER TO SHOW CAUSE / APPOINTMENT OF COUNSEL FOR AIP

Upon filing of the Verified Complaint, the Court shall enter an Order to Show Cause that:

☐ Sets a return date for hearing (not less than 20 days after service unless shortened).
☐ Appoints counsel for the AIP under R. 4:86-4(b) (court-appointed attorney to represent the AIP, file a report, and protect the AIP's rights).
☐ Directs service on AIP personally and on all interested parties under R. 4:86-4(a).
☐ Authorizes counsel to obtain medical records.
☐ Permits AIP to demand a jury trial.
☐ Provides for appointment of a guardian ad litem if appropriate.

PART 6 — NOTICE TO ALLEGED INCAPACITATED PERSON

TO: [Name of AIP]
ADDRESS: [_______________________________________________]

You are hereby notified that a Verified Complaint has been filed in the Superior Court of New Jersey, Chancery Division, Probate Part, County of [__________], Docket No. [__________], seeking a judgment declaring you to be an incapacitated person and appointing a guardian over your person and / or estate.

A hearing will be held on [__/__/____] at [____] [☐ a.m. ☐ p.m.] at [_______________________________________________].

YOUR RIGHTS:

1. You have the right to be represented by an attorney. The Court has appointed [____________________] to represent you. You may, at your own expense, retain different counsel.
2. You have the right to be present at the hearing and to testify.
3. You have the right to present evidence and cross-examine witnesses.
4. You have the right to a trial by jury.
5. You have the right to an independent medical or psychological evaluation.
6. If a guardian is appointed, you may lose the right to make decisions about your medical care, finances, residence, marriage, voting, and other matters.

Dated: [__/__/____] [____________________] Plaintiff / Attorney for Plaintiff

PART 7 — NOTICE TO INTERESTED PARTIES (R. 4:86-4)

Service required on:
☐ Spouse / domestic partner
☐ Adult children
☐ Parents (if no spouse or adult children)
☐ Siblings / nearest of kin of same degree as Plaintiff
☐ Person or institution having care and custody
☐ Attorney-in-fact under any POA
☐ Health care representative under advance directive
☐ Trustee under any trust for benefit of AIP
☐ Office of the Public Guardian (if applicable; N.J.S.A. § 52:27G-20 et seq.)
☐ Division of Developmental Disabilities (if AIP is a DDD client)
☐ Veterans Administration (if AIP is a veteran; N.J.S.A. § 3B:13-1 et seq.)

PART 8 — LESS RESTRICTIVE ALTERNATIVE ANALYSIS

Under N.J.S.A. § 3B:12-24.1, the Court shall consider whether less restrictive alternatives would adequately address the AIP's needs. Plaintiff certifies that the following alternatives have been considered:

PART 9 — BOND (R. 4:86-6; N.J.S.A. § 3B:15-1 et seq.)

Bond required for guardian of the estate in an amount equal to the value of personal property plus one year's anticipated income, unless waived or reduced by the Court.

☐ Bond amount: $[____________________]
☐ Surety: [____________________________________]
☐ Bond waived / reduced (state reason): [____________________]
☐ Restricted accounts ordered in lieu of bond: [____________________]

PART 10 — SPECIAL MEDICAL GUARDIAN (R. 4:86-12)

Use when expedited appointment is needed for a single medical decision (e.g., consent to surgery, withdrawal of life-sustaining treatment) and no full guardianship is otherwise required.

☐ Verified emergency / expedited application
☐ Affidavit of one physician (in lieu of two) permitted on showing of urgency
☐ Limited authority — specific medical decision only
☐ Expires upon completion of the specific medical decision

PART 11 — JUDGMENT OF INCAPACITY AND APPOINTMENT OF GUARDIAN

THIS MATTER having been opened to the Court by Verified Complaint of [Plaintiff], on notice to [AIP] and all interested parties, and the Court having heard the testimony of the examining [physicians / psychologist], the report of court-appointed counsel under R. 4:86-4(b), and any other evidence; and having found by CLEAR AND CONVINCING EVIDENCE that [Name of AIP] is an incapacitated person under N.J.S.A. § 3B:12-24.1;

IT IS on this [____] day of [__________], 20[____], ORDERED AND ADJUDGED:

1. [Name of AIP] is hereby adjudged an incapacitated person.
2. [Name of Guardian] is appointed [☐ general ☐ limited] guardian of the [☐ person ☐ estate ☐ person and estate].
3. Guardian shall qualify by filing the oath and bond in the amount of $[____________________] with the Surrogate of [__________] County.
4. Letters of Guardianship shall issue upon qualification.
5. Guardian shall file an Initial Inventory within 90 days under R. 4:86-6(e).
6. Guardian shall file annual reports of well-being and annual financial accountings under R. 4:86-6(e).
7. The following rights are RETAINED by the incapacitated person (limited guardianship): [____________________]
8. The following rights are REMOVED: [____________________]

[____________________] J.S.C.

PART 12 — LETTERS OF GUARDIANSHIP

Issued by the Surrogate of [__________] County, certifying appointment of [Name of Guardian] as [☐ general ☐ limited] guardian of the [☐ person ☐ estate ☐ person and estate] of [Name of Incapacitated Person], pursuant to Judgment dated [__/__/____].

[____________________] Surrogate

PART 13 — INITIAL INVENTORY AND ANNUAL ACCOUNTING (R. 4:86-6(e))

Initial Inventory (file with Surrogate within 90 days of qualification):
☐ All real property — fair market value at date of appointment
☐ All bank, brokerage, retirement, and investment accounts
☐ Tangible personal property of significant value
☐ Income sources (Social Security, pension, annuity)
☐ Debts and liabilities

Annual Report of Well-Being (guardian of the person):
☐ AIP's current residence and living conditions
☐ Health status and medical providers
☐ Services / programs received
☐ Significant changes during reporting period
☐ Visits with AIP (frequency, duration)
☐ Recommendation regarding continuation, modification, or termination

Annual Financial Accounting (guardian of the estate):
☐ Beginning balance
☐ Income received (itemized)
☐ Disbursements (itemized)
☐ Investment gains / losses
☐ Ending balance
☐ Supporting documentation retained per AOC Guardianship Monitoring Program

Forms promulgated by the Administrative Director of the Courts; review by the vicinage Guardianship Monitoring Program under R. 4:86-1(c).

SOURCES AND REFERENCES

• N.J.S.A. § 3B:12-1 et seq. (Guardians of Incapacitated Persons)
• N.J.S.A. § 3B:12-24.1 (Limited / general guardianship)
• N.J.S.A. § 3B:13A-1 et seq. (Conservatorship — consensual)
• N.J. Court Rule 4:86 (Action for Guardianship)
• N.J. Judiciary, Guardianship Monitoring Program: https://www.njcourts.gov
• Office of the Public Guardian for Elderly Adults: N.J.S.A. § 52:27G-20 et seq.
• AOC Form CN 10557 (Verified Complaint); CN 10556 (OSC); CN 11792 (Annual Report of Well-Being)