Ward of Court Consultation Proposed WardFull Name* Home Address*Current Residential Address*Marital Status* Religion* Occupation / Retired Occupation* PPS No.* A Ward of Court Application requires two Doctors to certify that the proposed ward is Incapacitated and unable to manage their own affairsName of Dr 1 who will certify incapacity* Address of Dr 1*Contact Number for Dr 1* Name of Dr 2 who will certify incapacity* Address of Dr 2*Contact Number for Dr 2* List of Assets including jointly owned property1. Bank Accounts (Include A/C No.’s and Sort Codes)*2. Building Society, Post Office*a. Account b. Savings Certs (Total Value) c. Index Linked Bonds 3. Prize Bonds*4. Credit Union*5. Cash in house*6. Household Goods*7. Car*8. Real / Leasehold property*8a. Valuation & Location of Deeds*9. Shares / Securities (total value / attach valuation)*10. Government Stock (if not included in value of shares)*11. Insurance Policies S72/23*12. Pension/gratuities: State Pension/Assistance*13. Medical Insurance Payments*Other*Foreign Assets Currency1. Bank Accounts*2. Shares [attach list] Drop files here or Select files Max. file size: 256 MB. 3. Property*List of LiabilitiesMortgage*Life Loan*Personal Loan*Car loan*Credit Card*Overdraft*Other*Income & OutgoingsIncome & OutgoingsNext of KinName Next of Kin 1 Next of Kin 1 - AddressNext of Kin 1 - Marital Status Next of Kin 1 - Religion Next of Kin 1 - Occupation Next of Kin 1 - Telephone No. Next of Kin 1 - Relationship to proposed Ward Name Next of Kin 2 Next of Kin 2 - AddressNext of Kin 2 - Marital Status Next of Kin 2 - Religion Next of Kin 2 - Occupation Next of Kin 2 - Telephone No. Next of Kin 2 - Relationship to proposed Ward Name Next of Kin 3 Next of Kin 3 - AddressNext of Kin 3 - Marital Status Next of Kin 3 - Religion Next of Kin 3 - Occupation Next of Kin 3 - Telephone No. Next of Kin 3 - Relationship to proposed Ward PetitionerName of Petitioner 1 Petitioner 1 - AddressPetitioner 1 - Marital Status Petitioner 1 - Religion Petitioner 1 - Occupation Petitioner 1 - Telephone No Petitioner 1 - Relationship to proposed Ward Name of Petitioner 2 Petitioner 2 - AddressPetitioner 2 - Marital Status Petitioner 2 - Religion Petitioner 2 - Occupation Petitioner 2 - Telephone No. Petitioner 2 - Relationship to proposed Ward STATEMENTStatement regarding the decline in capacity of the proposed Ward More forms: Client Instruction Sheet For Debt CollectionHouse Purchase FormHouse Sale FormPersonal Injury ConsultationProbate Short ConsultationWard of Court ConsultationWill Consultation