Form Pc 654 - Annual Report Of Guardian On Condition Of Minor Page 2

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Annual Report of Guardian on Condition of Minor (12/17)
File No.
5. Education
a. The minor regularly attends school at
and is in grade
.
b. The minor attends alternative education at
and is in grade
.
c. The minor does not attend school because
.
6. Activities of Minor
a. The minor's social activities (including sports) are:
.
b. During the past year the minor has been in counseling with
at
.
c. During the past year the minor received in-patient services at
.
7. Parenting time between the minor and parents was as follows:
a. Parent’s name and current address:
Parenting time:
b. Parent’s name and current address:
Parenting time:
c. Comments about parenting time:
8. Parents complied with the
court-structured plan
limited guardianship placement plan
as follows:
Changes should be made to the plan as follows:
9. The guardianship
should
should not
be continued because:
10. I
am
am not
willing to continue to serve as guardian.
11. As guardian, I have been ordered by the court to file an annual account, which is attached.
Date
Date
Signature of guardian
Signature of co-guardian (if applicable)
Address
Address
City, state, zip
Telephone no.
City, state, zip
Telephone no.
Check here if this is a new address
Check here if this is a new address

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