SPOKANE TRIBAL COURT SPOKANE INDIAN RESERVATION Guardianship of: NO. DECLARATION OF GUARDIAN; LETTERS OF GUARDIANSHIP I. DECLARATION OF GUARDIAN I, __________________ declare under penalty of perjury this _______ day of _________, 20__ that: 1. I am the person who has been confirmed as guardian by this court of [the person and/or estate] of [________________________] who has been determined legally incapacitated person by this court. 2. I solemnly swear that I will perform, according to law, the duties of my trust as guardian of [_______________________]. 3. As guardian of [_____________] I understand that I must do the following: ______________________________________________________________________________ ______________________________________________________________________________ _______________________________________ (a) Exercise a high degree of care in managing the affairs of [_____________] and derive no personal benefit from doing so. (b) Within 45 days of my appointment, prepare and submit an inventory and appraisement of the estate in accordance with law. I must also make a yearly accounting to the court by [date] for each year I am guardian. (c) Comply with all of the provisions of Chapter 5 of the Law and Order Code of the Spokane Tribe of Indians. ______________________________ Guardian II. LETTERS OF GUARDIANSHIP A. BASIS 1. [__________________] was found to be incapacitated by this court on _____________. 2. [__________________] was appointed the guardian of [___________________'s] [estate and/or person]. 3. The guardian has qualified. 4. Limitations of appointment: B. AUTHORIZATION THIS CERTIFIES that: __________________________________ is authorized by this court to act as the guardian of _________________________________. DATED:_________________ [SEAL] ___________________________ JUDGE 54 Revised Spokane Law & Order Code, 5/14/2013

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