Appendix C: Substitute Decisions Act, 1992 Forms

• Author: Richard D. Schneider
• Pages: 597-620

SUBSTITUTE DECISIONS ACT, 1992 Form 1

Form No. 236

1 of 4

APPLICATION TO REPLACE THE PUBLIC GUARDIAN AND TRUSTEE

AS STATUTORY GUARDIAN OF PROPERTY BY A PERSON

AUTHORIZED TO APPLY UNDER SUBSECTION 17(1)1, 2, 3, 4

(Please note: attach additional pages if more space is needed)

Name of Incapable Person (in full): ____________________________________________________________

(Surname, first and initials)

Address: __________________________________________________________________________________

__________________________________________________________________________________

Telephone: Residence_________________________________ Date of Birth: ___________________________

(Day, Month, Year)

Your relationship to the incapable person is:

1. spouse * 2. partner ** 3. relative ________________________________

(describe relation)

Or, you are a:

4. trust corporation

5. attorney under a continuing power of attorney made prior to the date the Certificate of Incapacity was

issued and which does not give the attorney authority over all of the incapable person’s property

Attachment(s) required:

if box 4 above is completed, copy of the consent of the incapable person’s spouse or partner

if box 5 above is completed, copy of continuing power of attorney

*'Spouse' means a person of the opposite sex,

(a) to whom the person is married, or

(b) with whom a person is living in a conjugal relationship outside marriage, if the two persons:

(i) have cohabited for at least one year,

(ii) are together the parents of a child, or

(iii) have together entered into a cohabitation agreement under Section 53 of the Family Law Act.

** Two persons are ‘partners’ if they have lived together for at least one year and have a close personal relationship that is

of primary importance in both persons’ lives.

Appendix C: Substitute Decisions Ac t, 1992 Forms, Form 1 597

598 ANNOTATED ONTARIO MENTAL HEALTH STATUTES

SUBSTITUTE DECISIONS ACT, 1992 Form 1

Form No. 236

2 of 4

Please list any other person who is entitled to apply under subsection 17(1) *** who is known to you.

Please state whether you have informed each person listed on your application for statutory guardianship and

indicate if they have informed you of whether they support or oppose your appointment.

*** Any of the following persons may apply to the Public Guardian and Trustee to replace the Public Guardian and Trustee as an

incapable person’s statutory guardian of property:

(i) the incapable person’s spouse or partner,

(ii) a relative of the incapable person,

(iii) the incapable person’s attorney under a continuing power of attorney, if the power of

attorney was made before the Certificate of Incapacity was issued and does not give

the attorney authority over all of the incapable person’s property, or

(iv) a trust corporation within the meaning of the Loan and Trust Corporations Act, if the

incapable person’s spouse or partner consents in writing to the application.

Name Person(s)

Informed

Yes/No

Relationship

to

Incapable Person

Address and

Telephone Number

Support or Oppose

Application

Applicant’s Statement:

1. Have you been in personal contact with the incapable person during the preceding 12-month period?

Or, if you are a trust corporation, has the incapable person’s spouse or partner been in personal contact with th

e

incapable person during the preceding 12-month period?

Yes No

2. Are you willing to perform all duties required of a guardian in respect of the incapable person’s property and

do you agree to act in accordance with the Management Plan?

Yes No

3. To the best of my knowledge and belief, the total approximate value of the property of the incapable person is

$______________. Particulars of the assets and their respective approximate value are listed on the attached

Management Plan, forming part of this application.

(If you are a trust corporation, please skip questions 4-8)

4. Is your relationship with the incapable person a friendly one?

Yes No

5. Have you been found guilty of any offence relating to financial mismanagement under the Criminal Code?