STATE OF MICHIGAN
PROBATE COURT
COUNTY
PETITION TO
TERMINATE MODIFY
GUARDIANSHIP
LEGALLY INCAPACITATED INDIVIDUAL MINOR
CASE NO. and JUDGE
Court address Court telephone no.
In the matter of
First, middle, and last name
Court ORI Current age of ward Race Sex Current address of ward
Petitioner’s name, address, and telephone no. Petitioner’s attorney, bar no., address, and telephone no.
PCS Code: PTG
TCS Code: PMGC
Approved, SCAO
Form PC 675, Rev. 7/24
MCL 700.5208, MCL 700.5210, MCL 700.5219, MCL 700.5306(6),
MCR 5.125(C)(26), MCR 5.404(H)(4), (5), MCR 5.408
Page 1 of 3
1. I am interested in this matter as
State relationship/interest
.
2. a. The interested persons for the minor, their relationship to the minor, and their addresses are:
NAME RELATIONSHIP ADDRESS AND TELEPHONE NUMBER
Parent/Age
Street address
City State Zip Telephone no.
Parent/Age
Street address
City State Zip Telephone no.
Conservator
Street address
City State Zip Telephone no.
Guardian
Street address
City State Zip Telephone no.
Person with care/
custody of minor*
Street address
City State Zip Telephone no.
*Also list persons who had principal care and custody of the minor during the 63 days preceding filing the petition.
b. The minor is a member of an Indian tribe, or is eligible for membership in an Indian tribe. The name of the tribe
is
.
The minor is not an Indian child as defined by MCR 3.002(12).
It is unknown whether the minor is an Indian child as defined by MCR 3.002(12).
Petition to Terminate/Modify Guardianship (7/24)
Page 2 of 3
Case No.
2. (continued)
c. If this guardianship is terminated, the minor child will be returned to
.
3. The incapacitated individual, whose telephone number is
, has a guardian whose
address is
and has
a spouse adult child(ren) living parents whose name(s) and address(es) are listed below.
no spouse, adult child(ren), or parent(s). The names and addresses of presumptive heirs** are listed below.
none of the above (must notify the Attorney General***).
NAME RELATIONSHIP ADDRESS AND TELEPHONE NUMBER
Street address
City State Zip Telephone no.
Street address
City State Zip Telephone no.
Street address
City State Zip Telephone no.
Guardian
Street address
City State Zip Telephone no.
Standby
Guardian
Street address
City State Zip Telephone no.
**Presumptive heirs includes minor children, if any.
***Notify the Attorney General by sending a copy of this form to: Attorney General, Public Administration, PO Box 30755, Lansing, MI 48909.
4. The reasons why the court should take action are
.
I REQUEST that the court:
5. Terminate the guardianship.
6. Accept the guardian's resignation.
7. Remove the guardian who has has not been suspended.
8. Remove
Name (type or print)
as standby guardian.
9. Designate
Name (type or print) Address
City State Zip Telephone no.
as standby guardian.
Petition to Terminate/Modify Guardianship (7/24)
Page 3 of 3
Case No.
10. Appoint
Name (type or print) Address
City State Zip Telephone no.
as successor full guardian.
11. Appoint
Name (type or print) Address
City State Zip Telephone no.
as temporary guardian pending appointment of a successor.
12. Appoint
Name (type or print) Address
City State Zip Telephone no.
as successor limited guardian with only the following powers:
13. Modify the powers of the guardian as follows:
I declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best
of my information, knowledge, and belief.
Date
Petitioner signature
Date
Attorney signature
NOMINATION BY MINOR:
I am 14 years of age or older. I nominate
Name (type or print)
,
Address City State Zip
as my guardian.
Date
Signature of minor
