Form 8-17

[Caption. See § 3 of the Introduction in this manual.]

Application to Contract for Goods or Services

[Name of applicant], Applicant, guardian of the estate of [name of ward], Ward, an inca­pacitated person, files this Application to Contract for Goods or Services for [specify goods or services], which are needed and will benefit Ward, and in support shows:

1.Ward’s [physical/mental/medical] condition is such that Ward would benefit from the services of [name of provider] for [specify]. The person[s] identified in the attached agree­ment [is/are] willing to provide these services and to enter into the contract attached as Exhibit [exhibit number/letter].

2.The [inventory/annual account] on file shows that available funds are adequate to provide for these services. Applicant believes that the costs for these services in the amount of $[amount] per month are reasonable.

Applicant asks for authority to execute the attached agreement on behalf of Ward’s estate and to expend the funds for these services in the monthly amount identified therein for the period from [date] to [date] and for all other relief to which Applicant is entitled.

Respectfully submitted,

   
[Name]
Applicant

   
[Name]
Attorney for Applicant
State Bar No.:
[E-mail address]
[Address]
[Telephone]
[Telecopier]