PETITION FOR APPOINTMENT OF GUARDIAN AND/OR CONSERVATOR

(West Virginia Guardianship & Conservatorship Act, W. Va. Code § 44A-1-1 et seq.)

IN THE CIRCUIT COURT OF [COUNTY] COUNTY, WEST VIRGINIA
Probate / Guardianship Division

Civil Action No.: [______]

IN RE: [FULL LEGAL NAME OF ALLEGED PROTECTED PERSON],
An Alleged Protected Person.

PETITION FOR APPOINTMENT

[DATE]

COMES NOW [PETITIONER’S FULL LEGAL NAME] (the “Petitioner”), by and through undersigned counsel [LAW FIRM / BAR #], and respectfully petitions this Honorable Court, pursuant to the West Virginia Guardianship and Conservatorship Act, W. Va. Code § 44A-1-1 et seq., for the entry of an Order appointing a Guardian and/or Conservator for [ALLEGED PROTECTED PERSON’S NAME] (the “Alleged Protected Person” or “APP”), and in support thereof states as follows:

TABLE OF CONTENTS

1. Document Header & Jurisdiction.............................................. 1
2. Definitions................................................................ 2
3. Operative Provisions (Relief Requested).................................... 3
4. Representations & Warranties of Petitioner................................. 5
5. Covenants & Restrictions Applicable to Guardian............................ 6
6. Default, Removal, & Remedies............................................... 7
7. Risk Allocation (Bond & Fiduciary Duty).................................... 8
8. Dispute Resolution & Continuing Jurisdiction............................... 9
9. General Provisions........................................................ 10
10. Execution, Verification, Notarization, & Service.......................... 11

// GUIDANCE: Word-processing software will auto-paginate; update page numbers after final edits.

1. DOCUMENT HEADER & JURISDICTION

1.1 Parties
a. Petitioner: [PETITIONER NAME, DOB, last four SSN, residence address, phone, email]
b. Alleged Protected Person (APP): [APP NAME, DOB, last four SSN, current residence, phone]
c. Proposed Guardian/Conservator: [IF DIFFERENT FROM PETITIONER, INSERT DETAILS]

1.2 Court Jurisdiction
This Court has subject-matter jurisdiction under W. Va. Code § 44A-2-1 and personal jurisdiction over the APP who resides at [ADDRESS] within [COUNTY] County, West Virginia.

1.3 Venue
Venue is proper in this Circuit Court pursuant to W. Va. Code § 44A-2-2 as the county of the APP’s domicile.

1.4 Relief Sought
Appointment of:
☐ Guardian of the Person
☐ Conservator of the Estate
☐ Both Guardian and Conservator

1.5 Effective Date & Duration
Unless otherwise ordered, the requested appointment shall become effective upon entry of the Court’s Order and shall continue until modified or terminated as provided by law.

2. DEFINITIONS

For purposes of this Petition, the following capitalized terms shall have the meanings set forth below:

“Act” – the West Virginia Guardianship and Conservatorship Act, W. Va. Code § 44A-1-1 et seq.

“Alleged Protected Person” or “APP” – the individual for whom guardianship and/or conservatorship is sought.

“Bond” – the surety bond required under W. Va. Code § 44A-2-7 and Section 7 herein.

“Conservator” – a person appointed by the Court to manage the estate and financial affairs of the APP.

“Court” – the Circuit Court of [COUNTY] County, West Virginia, Probate / Guardianship Division.

“Guardian” – a person appointed by the Court to make personal, medical, and residential decisions for the APP.

“Interested Persons” – individuals and entities entitled to notice under W. Va. Code § 44A-2-7(b) including, without limitation, the APP, immediate family, durable POA, medical POA, and any governmental agency providing benefits.

// GUIDANCE: Add or delete defined terms to mirror any customization.

3. OPERATIVE PROVISIONS (RELIEF REQUESTED)

3.1 Finding of Incapacity
Petitioner requests a judicial determination that the APP is incapable of:
a. Managing personal affairs; and/or
b. Effectively handling property and financial matters,
due to [medical diagnosis / cognitive impairment / functional limitations], as set forth in the Physician’s Report attached hereto as Exhibit A.

3.2 Appointment of Guardian and/or Conservator
Petitioner seeks the appointment of [NAME OF PROPOSED FIDUCIARY] as:
• Guardian of the Person with the powers enumerated in W. Va. Code § 44A-3-1; and/or
• Conservator of the Estate with the powers enumerated in W. Va. Code § 44A-3-1, subject to the reporting requirements in W. Va. Code §§ 44A-3-14 & -17.

3.3 Scope of Authority
Unless expressly limited herein, Petitioner requests full plenary authority. If limited guardianship/conservatorship is more appropriate, Petitioner proposes the following specific powers and limitations:
• [LIST LIMITED POWERS OR RESTRICTIONS]

3.4 Protective Orders & Injunctive Relief
Pursuant to W. Va. Code § 44A-2-7(f), Petitioner requests issuance of protective orders to safeguard the APP’s person and estate, including but not limited to:
a. Immediate freeze of certain financial accounts;
b. No-contact order against [NAME];
c. Authority to relocate APP to [FACILITY] pending final hearing.

3.5 Bond Requirement
Petitioner requests that a Bond in the amount of $[__] be set, with corporate surety acceptable to the Clerk, as security for the faithful discharge of fiduciary duties.

3.6 Temporary (Emergency) Appointment
☐ Not requested
☐ Requested pursuant to W. Va. Code § 44A-2-4 for a period not to exceed thirty (30) days due to immediate risk to the APP’s health, safety, or assets.

3.7 Ancillary Relief
Petitioner further requests:
a. Waiver of inventory or accounting deadlines until after appointment;
b. Authority to marshal assets and establish an FBO (“for-benefit-of”) account;
c. Other relief deemed just and proper.

4. REPRESENTATIONS & WARRANTIES OF PETITIONER

4.1 Competency & Capacity
Petitioner is over eighteen (18) years of age, is of sound mind, and has not been convicted of a felony or misdemeanor involving dishonesty.

4.2 Relationship to APP
Petitioner is the [relationship] of the APP and has had substantial personal contact within the preceding twelve (12) months.

4.3 No Conflict of Interest
Petitioner affirms that no material conflict of interest exists between Petitioner and the APP, except as disclosed in Schedule 1 attached hereto.

4.4 Suitability
Petitioner possesses the necessary skills, time, and resources to perform fiduciary duties and is willing to submit to the jurisdiction and ongoing supervision of this Court.

4.5 Accuracy of Information
All statements contained in this Petition and its exhibits are true and correct to the best of Petitioner’s knowledge, information, and belief, and are made under penalty of perjury.

5. COVENANTS & RESTRICTIONS APPLICABLE TO GUARDIAN/CONSERVATOR

The Guardian/Conservator, upon appointment, shall:

5.1 Fiduciary Standards
Faithfully discharge duties in good faith, in the best interests of the APP, exercising reasonable care, diligence, and prudence consistent with W. Va. Code § 44A-3-1.

5.2 Reporting Requirements
a. File an Initial Inventory within ninety (90) days of qualification (W. Va. Code § 44A-3-4).
b. File Annual Accountings and Reports every twelve (12) months and at such other times as directed by the Court (W. Va. Code § 44A-3-17).
c. Provide copies of all reports to Interested Persons contemporaneously with filing.

5.3 Notice & Consent
Provide at least fourteen (14) days’ prior written notice to the Court and Interested Persons before any change in residence of the APP or disposition of real property.

5.4 Record-Keeping
Maintain contemporaneous records of all receipts, disbursements, and significant decisions, and preserve supporting documentation for not less than five (5) years.

5.5 Confidentiality
Protect the confidentiality of the APP’s personal and financial information, disclosing only as necessary to fulfill fiduciary duties or as ordered by the Court.

6. DEFAULT, REMOVAL, & REMEDIES

6.1 Events of Default
a. Failure to file required reports or accountings;
b. Mismanagement or commingling of funds;
c. Breach of fiduciary duty;
d. Criminal conviction relevant to fiduciary fitness.

6.2 Notice & Cure
Upon written notice of default, the Guardian/Conservator shall have thirty (30) days to cure, unless immediate suspension is warranted for the APP’s protection.

6.3 Remedies
a. Suspension or removal pursuant to W. Va. Code § 44A-4-1;
b. Forfeiture of Bond;
c. Surcharge and personal liability for losses;
d. Contempt sanctions and attorney’s fees.

7. RISK ALLOCATION (BOND & FIDUCIARY DUTY)

7.1 Bond Amount & Surety
The Guardian/Conservator shall obtain and file a Bond in the amount established in Section 3.5, conditioned on faithful performance, with premiums payable from the APP’s estate unless otherwise ordered.

7.2 Indemnification
The Guardian/Conservator shall be personally liable to the APP for any breach of fiduciary duty, but shall be indemnified from the APP’s estate for expenses incurred in good-faith performance, except to the extent of gross negligence, willful misconduct, or breach of duty.

7.3 Insurance
☐ Not required
☐ Required: The Guardian/Conservator shall maintain fiduciary liability insurance with limits of not less than $[__] per occurrence.

8. DISPUTE RESOLUTION & CONTINUING JURISDICTION

8.1 Governing Law
All matters arising under or relating to this guardianship shall be governed by West Virginia law, including the Act and any applicable Rules of Practice and Procedure for Financial Exploitation and Guardianship/Conservatorship Proceedings.

8.2 Forum Selection
Exclusive jurisdiction and venue shall lie with the Circuit Court of [COUNTY] County, West Virginia, Probate / Guardianship Division. Arbitration is not available in guardianship proceedings.

8.3 Injunctive Relief
The Court retains inherent power to issue temporary and permanent protective orders to safeguard the APP and the APP’s estate.

9. GENERAL PROVISIONS

9.1 Amendment
Any modification of guardianship powers or reporting requirements shall be by written order of this Court upon proper motion and notice.

9.2 Assignment
Fiduciary duties are personal to the appointed Guardian/Conservator and may not be assigned or delegated without prior Court approval.

9.3 Severability
If any provision herein is determined unenforceable, the remaining provisions shall remain in full force to the extent permitted by law.

9.4 Integration
This Petition, together with all exhibits, schedules, and proposed orders, constitutes the entire request for relief; no oral statements shall vary its terms.

9.5 Electronic Signatures & Filings
Electronic signatures and e-filings conforming to the West Virginia Rules of Electronic Filing are hereby authorized.

10. EXECUTION, VERIFICATION, NOTARIZATION, & SERVICE

10.1 Signature of Petitioner

[PETITIONER NAME]
Date: //______

10.2 Counsel of Record

[ATTORNEY NAME], Esq. (WV Bar #_____)
[FIRM NAME]
[ADDRESS] • [PHONE] • [EMAIL]

10.3 Verification

I, [PETITIONER NAME], being duly sworn, depose and say that I have read the foregoing Petition and that the factual statements contained herein are true and correct to the best of my knowledge, information, and belief.

Petitioner

State of West Virginia, County of [COUNTY], to-wit:
Subscribed and sworn before me this ___ day of _, 20.

Notary Public
My Commission Expires: ____

10.4 Certificate of Service

I hereby certify that a true and correct copy of the foregoing was served this ___ day of _, 20, upon all Interested Persons listed on Schedule 2 by ☐ U.S. Mail ☐ hand delivery ☐ electronic service.

[ATTORNEY / PETITIONER]

LIST OF EXHIBITS & SCHEDULES

Exhibit A – Physician’s or Licensed Psychologist’s Report (W. Va. Code § 44A-2-6)
Exhibit B – Proposed Order of Appointment
Schedule 1 – Disclosure of Potential Conflicts of Interest
Schedule 2 – List of Interested Persons & Service Addresses
Schedule 3 – Proposed Bond Form

// GUIDANCE: Attach mandatory Supreme Court-approved forms where available; cross-check local rules for any county-specific scheduling orders or standing guardianship plans.