STATE OF SOUTH CAROLINA )
) IN THE PROBATE COURT
ANNUAL REPORT OF GUARDIAN
IN THE MATTER OF:
) CASE NUMBER:
PLEASE ANSWER THE FOLLOWING QUESTIONS
(Attach additional sheets if necessary. Please type or print in ink)
1. Where is the incapacitated person living?
2. What is the general physical and/or mental condition of the incapacitated person? List any significant changes since you
last report or appointment.
3. Has the incapacitated person been seen by a physician this past year? NO YES
(If yes, please give doctor(s) names, approximate dates of visits, complaints and doctor’s findings.)
4. What medical or other professional care or treatment, housing, education, therapy, or training needs do you foresee
the incapacitated person as needing during the upcoming year?
5. Are you in control of any tangible property of the incapacitated person? NO YES
(If yes, describe and report on its condition.)
6. Are you also the Conservator for the incapacitated person? NO YES
(Answer the following questions
if your answer is
to the above.)
7. Did you receive any money from any source on behalf of the incapacitated person?
(If yes, attach a sheet detailing receipts and expenditures including dates.)
FORM #534PC (2/2004)
Page 1 of 2