The Guardianship Tribunal

Application for Guardianship and/or Financial Management Order

This Plain Web format version of the content of the application is for people who access pages using assistive technologies. This form CAN NOT BE PRINTED and used as an application form. Please print out and complete the PDF version of this form and send it to the Guardianship Tribunal or go to the online application (to submit online).

WHO DO YOU THINK NEEDS A GUARDIAN AND/OR FINANCIAL MANAGER? ('THE PERSON')

NAME: Mr/Mrs/Ms/Miss/Dr:


Given names:


Family name:


DATE OF BIRTH:


AGE: 


CURRENT ADDRESS:


Suburb:


State:


Postcode:


TELEPHONE: Daytime:


After hours:


Mobile:


Fax No:


Pager No:


Email:


Does 'the person' know about the application?
Yes
No
Don't know

What is their attitude to the application?
Support
Oppose
Don't know 

The Tribunal must take into account the wishes of 'the 
person' the application is about.  The Tribunal always 
wants 'the person' to come to the hearing unless that is 
impossible due to ill-health or some other special reason.

YOUR DETAILS (APPLICANT)

NAME: Mr/Mrs/Ms/Miss/Dr:


Given names:


Family name:


CURRENT ADDRESS:


Suburb:


State:


Postcode:


TELEPHONE: Daytime:


After hours:


Mobile:


Fax No:


Pager No:


Email:


What is your relationship with the person you believe needs 
a guardian or financial manager?  Eg. Are you the person's 
parent, sister, son, doctor, social worker, community 
worker etc?


Relationship:

WHAT ARE YOU APPLYING FOR - GUARDIANSHIP &/OR FINANCIAL MANAGEMENT?

You can apply for whatever you believe the person needs.  
You will be able to discuss this at the hearing.

Do you wish to apply for the appointment of:
a guardian only;
a financial manager only;
a guardian and a financial manager?

Tick one box

A guardian is a person who is authorised to make 
decisions concerning personal matters eg. medical treatment, 
accommodation or services. A guardian will be appointed only 
if the person has a disability and problems arise from the 
person's inability to make decisions which cannot be resolved 
without the appointment of a substitute decision maker. 

A financial manager is a person who is authorised 
to make decisions concerning financial and legal affairs. A 
financial manager will be appointed only if financial or 
legal problems arise from the person's inability to make 
decisions which cannot be resolved without the appointment 
of a substitute decision maker.

NATURE OF 'THE PERSON'S' DISABILITY/IES:

What disability does 'the person' have?
Dementia
Intellectual disability
Stroke
Alcohol/drug related
Mental Illness
Brain Injury
Other 

How severe or advanced is the disability?:


Approximately how long has 'the person' had the 
disability?:

CONTACT DETAILS FOR WRITTEN REPORTS

The Guardianship Tribunal will need at least two written 
reports about 'the person's' disability. As applicant 
you are responsible for providing one or more reports 
from doctors or others about the person's ability to 
manage their personal or financial affairs. Please 
provide the names of health professionals involved:

NAME: Mr/Mrs/Ms/Miss/Dr:


Given names:



Family name:



ADDRESS:



Suburb:



State:



Postcode:



TELEPHONE: Daytime:



After hours:



Mobile:



Fax No:



Pager No:



Email:


Report forwarded
Report requested & to follow


NAME: Mr/Mrs/Ms/Miss/Dr:


Given names:


Family name:


ADDRESS:


Suburb:


State:


Postcode:


TELEPHONE: Daytime:


After hours:


Mobile:


Fax No:


Pager No:


Email:

Report forwarded
Report requested & to follow

If you would like to add more names please attach an 
extra sheet.

OTHER INFORMATION WHICH MAY ASSIST THE TRIBUNAL

Please identify 'the person's' cultural background as 
this may help the Tribunal to understand 'the person' 
and their situation.  For example, Aboriginal/Koori, 
Greek, Vietnamese.


Does 'the person' speak a language other than English at home?
Yes
No


If yes, what language?:



Does 'the person' identify as an Aboriginal/Torres Strait 
Islander?
Yes
No

WHY DO YOU THINK A GUARDIAN IS NEEDED?

(only complete this section if you are applying for a guardian)

Please explain what particular problems led you to make 
this application. Ie why do you think that 'the person' 
is in need of a guardian? Eg. is there a dispute within 
the family or between family and service providers about 
what is in the best interests of 'the person'? Is 'the 
person' objecting to a plan for their care that the family, 
friends or service providers believe is necessary? Is 'the 
person' at risk of neglect or abuse?




What attempts have already been made to resolve these 
problems?

WHY DO YOU THINK A FINANCIAL MANAGER IS NEEDED?


(only complete if you are applying for a manager)

Please explain what particular problems led you to make 
this application ie. Why do you think that 'the person' 
is in need of a financial manager? Eg. Is informal help 
from family or friends not working or is the person 
rejecting it? Is there a dispute about 'the person's' 
money or property, or is 'the person' being exploited? 
Is there a need to buy or sell property and no-one has 
authority to do this for 'the person'?


What attempts have already been made to resolve these problems?

GENERAL INFORMATION ABOUT 'THE PERSON'S FINANCIAL AFFAIRS

Income: 


Savings:


Real Estate:


Other Assets:

CONTACT LIST OF ALL PARTIES TO BE NOTIFIED OF THE HEARING

“Parties' is a term used in the Guardianship Act. 
'Parties' must be given a copy of this application and 
be invited to the hearing. Please help to identify the 
'parties' by answering the following questions. If there 
is more than one name for any question, write it on a 
separate sheet and attach it.

Does the person have a spouse or defacto spouse?
No
Yes (if yes provide details)


NAME: Mr/Mrs/Ms/Miss/Dr:


Given names



Family name


ADDRESS:



Suburb:



State:



Postcode:



TELEPHONE: Daytime:



After hours:



Mobile:



Fax No:



Pager No:



Email:



What is their likely attitude to this application?
Support
Oppose
Don't know


Does anyone other than their spouse provide or arrange 
care on a regular basis without payment? (Someone 
receiving the Carers payment is considered to be unpaid)
No
Yes(if yes provide details)


NAME: Mr/Mrs/Ms/Miss/Dr:



Given names:



Family name:



ADDRESS:



Suburb:



State:



Postcode:



TELEPHONE: Daytime:



After hours:



Mobile:



Fax No:



Pager No:

Email:

What is their likely attitude to this application?
Support
Oppose
Don't know.


If this is an application for financial management - Has 
the person signed a Power of Attorney or an Enduring 
Power of Attorney?
Don't Know
No
Yes (if yes provide details of the person appointed)

PLEASE SEND A COPY OF THE POWER OF ATTORNEY WITH THE 
APPLICATION.

NAME: Mr/Mrs/Ms/Miss/Dr:

Given names:

Family name:

ADDRESS:

Suburb:

State:

Postcode:

TELEPHONE: Daytime:

After hours:

Mobile:

Fax No:

Pager No:

Email:

Relationship of the attorney to 'the person'?:

What is their likely attitude to this application?
Support
Oppose
Don't know.

CONTACT LIST OF ALL OTHER INTERESTED PERSONS:

Staff of the Tribunal may contact people named in the 
application and other people who could provide information 
to help the Tribunal.

Please name any people not already mentioned who you 
think may have information which could help the Tribunal 
eg close friends, relatives etc. Include anyone who may 
be affected by the application and particularly anyone 
who may be opposed to the application.


NAME: Mr/Mrs/Ms/Miss/Dr:


Given names:


Family name:


ADDRESS:


Suburb:


State:


Postcode:


TELEPHONE: Daytime:


After hours:


Mobile:


Fax No:


Pager No:


Email:


Relationship:


What is their likely attitude to this application?
Support
Oppose
Don't know.


NAME: Mr/Mrs/Ms/Miss/Dr:


Given names:


Family name:



ADDRESS:



Suburb:



State:



Postcode:



TELEPHONE: Daytime:



After hours:



Mobile:



Fax No:



Pager No:



Email:



Relationship:


What is their likely attitude to this application?
Support
Oppose
Don't know.


NAME: Mr/Mrs/Ms/Miss/Dr:


Given names:



Family name:



ADDRESS

Suburb:

State:

Postcode:

TELEPHONE: Daytime:

After hours:

Mobile:

Fax No:

Pager No:

Email:

Relationship:

What is their likely attitude to this application?
Support
Oppose
Don't know.

IF YOU HAVE APPLIED TO HAVE A GUARDIAN APPOINTED - WHO DO YOU SUGGEST FOR THE ROLE OF GUARDIAN?

Yourself
Another person (please provide details below)
Public Guardian
Don't know

Before suggesting another person for the role of guardian 
you must discuss this application with them and establish 
their willingness to be considered for the role.  The 
suggested guardian must be over the age of 18, willing 
and able to fulfil the role. There must be no undue 
conflict of interest with 'the person'. The Tribunal will 
consider your suggestion, however the Tribunal is not 
bound to appoint the suggested person as guardian.


NAME: Mr/Mrs/Ms/Miss/Dr:



Given names:



Family name:



ADDRESS:



Suburb:



State:



Postcode:



TELEPHONE: Daytime:



After hours:



Mobile:



Fax No:



Pager No:



Email:



Relationship:

IF YOU HAVE APPLIED TO HAVE A FINANCIAL MANAGER APPOINTED - WHO DO YOU SUGGEST FOR THE ROLE OF FINANCIAL MANAGER?

Yourself
Another person (please provide details below)
Public Guardian
Don't know

Before suggesting another person for the role of 
financial manager you must discuss this application with 
them and establish their willingness to be considered for 
the role. Any potential conflict between the interests of 
the suggested financial manager and 'the person' must be 
revealed to the Tribunal. Private financial managers are 
supervised by the Protective Commissioner. The Tribunal 
will consider your suggestion, however the Tribunal is 
not bound to appoint the suggested person as financial 
manager.


NAME: Mr/Mrs/Ms/Miss/Dr:



Given names:



Family name:



ADDRESS:



Suburb:



State:



Postcode:



TELEPHONE: Daytime:



After hours:



Mobile:



Fax No:



Pager No:



Email:



Relationship:



If you consider the problems detailed in this application 
pose an immediate threat to the person, their quality of 
life and/or their estate and you believe this application 
should be given priority over other applications, please 
provide your reasons.

SPECIAL NEEDS AT HEARING:

Does anyone associated with the application need a 
language interpreter?


If so, which language?

 
Does anyone associated with the application have a 
hearing impairment?


If so, what would assist them at the hearing? (signing 
interpreter, hearing loop)


Is any other type of help needed at the hearing? (eg wheelchair) 
If so, what help is needed?

DECLARATION BY APPLICANT:

It is an offence to make a false or misleading statement 
in an application. Penalty up to $500.

I have read this completed application and believe that 
to the best of my knowledge all of the information 
provided is true, complete and accurate.

Signature of applicant: 


Signature of witness:


Date: 



Name of witness (please print):



Address of witness:



The Guardianship Tribunal :

Address: 2a Rowntree Street, Balmain, NSW, 2041
Postal Address: Locked Mailbag 9, Balmain NSW 2041
Phone: (02) 9555 8500
Fax: (02) 9555 9049
Tollfree: 1800 463 928
Email: gt@gt.nsw.gov.au
Website: www.gt.nsw.gov.au