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Alberta Regulation 211/2009
Livestock Identification and Commerce Act
LIVESTOCK MARKET AND LIVESTOCK ASSEMBLING STATION 
OPERATOR'S LICENCE AMENDMENT REGULATION
Filed: July 20, 2009
For information only:   Made by the Minister of Agriculture and Rural Development 
(M.O. 17/2009) on July 14, 2009 pursuant to section 92(k) of the Livestock 
Identification and Commerce Act. 
1   The Livestock Market and Livestock Assembling Station 
Operator's Licence Regulation (AR 110/2009) is amended by 
this Regulation.

2   Section 4 is amended
	(a)	in subsection (1)
	(i)	by renumbering clause (i) as clause (a);
	(ii)	by renumbering clause (ii) as clause (b) and in 
clause (b) by striking out "$100.00" and 
substituting "$20";
	(b)	in subsection (2)
	(i)	by renumbering clause (i) as clause (a);
	(ii)	by renumbering clause (ii) as clause (b) and in 
clause (b) by striking out "$100.00" and 
substituting "$20".

3   Schedule 1 is amended by striking out "$100.00" and 
substituting "$20".

4   Schedule 2 is amended by striking out "$100.00" and 
substituting "$20".



Alberta Regulation 212/2009
Marketing of Agricultural Products Act
ALFALFA SEED COMMISSION AUTHORIZATION REGULATION
Filed: July 20, 2009
For information only:   Made by the Alberta Agricultural Products Marketing Council 
on June 26, 2009 pursuant to section 26 of the Marketing of Agricultural Products Act 
and approved by the Minister of Agriculture and Rural Development on July 14, 2009 
pursuant to section 26 of the Marketing of Agricultural Products Act.
Definitions
1(1)  In this Regulation,


	(a)	"Act" means the Marketing of Agricultural Products Act;
	(b)	"Commission" means the Alfalfa Seed Commission 
established under the Plan;
	(c)	"Plan" means the Alfalfa Seed Plan Regulation.
(2)  Words defined in the Act or the Plan have the same meaning when 
used in this Regulation.
Regulations made under section 26 of the Act
2   For the purposes of enabling the Commission to operate the Plan, 
the Commission is hereby authorized under section 26 of the Act to 
make regulations
	(a)	requiring any person who produces, markets or processes the 
regulated product to furnish to the Commission any 
information or record relating to the production, marketing or 
processing of the regulated product that the Commission 
considers necessary;
	(b)	requiring persons other than producers to be licensed under 
the Plan before they become engaged in the marketing and 
processing, or either of those functions, of the regulated 
product;
	(c)	governing the issuance, suspension or cancellation of a 
licence issued under the Plan;
	(d)	providing for
	(i)	the assessment, charging and collection of service 
charges from producers from time to time for the 
purposes of the Plan, and
	(ii)	the taking of legal action to enforce payment of the 
service charges;
	(e)	providing for the refund of service charges;
	(f)	requiring any person who receives the regulated product from 
a producer
	(i)	to deduct from the money payable to the producer any 
service charges payable by the producer to the 
Commission, and
	(ii)	to forward the amount deducted to the Commission;
	(g)	providing for the use of any class of service charges or other 
money payable to or received by the Commission for the 
purpose of paying its expenses and administering the Plan 
and the regulations made by the Commission.
Expiry
3   For the purpose of ensuring that this Regulation is reviewed for 
ongoing relevancy and necessity, with the option that it may be 
repassed in its present or an amended form following a review, this 
Regulation expires on July 31, 2014.


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Alberta Regulation 213/2009
Apprenticeship and Industry Training Act
COMMUNICATION TECHNICIAN TRADE AMENDMENT REGULATION
Filed: July 21, 2009
For information only:   Made by the Alberta Apprenticeship and Industry Training 
Board on June 19, 2009 pursuant to section 33(2) of the Apprenticeship and Industry 
Training Act and approved by the Minister of Advanced Education and Technology 
on July 14, 2009 pursuant to section 33(2) of the Apprenticeship and Industry 
Training Act 
1   The Communication Technician Trade Regulation 
(AR 312/2002) is amended by this Regulation.

2   Section 9 is amended by striking out "March 31, 2010" and 
substituting "March 31, 2014".



Alberta Regulation 214/2009
Apprenticeship and Industry Training Act
GAS UTILITY OPERATOR OCCUPATION AMENDMENT REGULATION
Filed: July 21, 2009
For information only:   Made by the Alberta Apprenticeship and Industry Training 
Board on June 19, 2009 pursuant to section 37(2) of the Apprenticeship and Industry 
Training Act and approved by the Minister of Advanced Education and Technology 
on July 14, 2009 pursuant to section 37(2) of the Apprenticeship and Industry 
Training Act 
1   The Gas Utility Operator Occupation Regulation 
(AR 278/2000) is amended by this Regulation.

2   Section 5 is amended by striking out "March 31, 2010" and 
substituting "March 31, 2015".


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Alberta Regulation 215/2009
Apprenticeship and Industry Training Act
MILLWRIGHT TRADE AMENDMENT REGULATION
Filed: July 21, 2009
For information only:   Made by the Alberta Apprenticeship and Industry Training 
Board on June 19, 2009 pursuant to section 33(2) of the Apprenticeship and Industry 
Training Act and approved by the Minister of Advanced Education and Technology 
on July 14, 2009 pursuant to section 33(2) of the Apprenticeship and Industry 
Training Act 
1   The Millwright Trade Regulation (AR 290/2000) is 
amended by this Regulation.

2   Section 1(c) is amended
	(a)	by striking out "includes:" and substituting "includes";
	(b)	by adding the following after subclause (xvi):
	(xvii)	power generators;

3   Section 3 is amended
	(a)	in clause (c) by striking out "correcting" and 
substituting "connecting";
	(b)	in clause (f) by striking out "within a decimal place of a 
millimetre tolerance when assembling and fitting" and 
substituting "measure, assemble and fit".


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Alberta Regulation 216/2009
Teachers' Pension Plans Act
TEACHERS' AND PRIVATE SCHOOL TEACHERS' PENSION 
PLAN (PRE-1992 UNFUNDED LIABILITY, 2009) 
AMENDMENT REGULATION
Filed: July 22, 2009
For information only:   Made by the Lieutenant Governor in Council (O.C. 411/2009) 
on July 21, 2009 pursuant to section 14 of the Teachers' Pension Plans Act.
1   The Teachers' and Private School Teachers' Pension 
Plans (AR 203/95) are amended by this Regulation.

2   Section 4 is repealed.

3   Schedule 1 is amended by sections 4 to 6.

4   Section 1(1) is amended
	(a)	in clause (f) by adding "as that section existed prior to 
September 1, 2009" after "Act";
	(b)	in clause (m) by striking out ", including additional 
contributions,";
	(c)	in clause (q)(iii) by striking out "paid under section 12".

5   Section 14 is amended by striking out ", 11 and 12" and 
substituting "and 11".

6   Section 1 of Subschedule 2 is amended
	(a)	in clause (d) by striking out ", contributions under 
section 11 of this Schedule and additional contributions made 
by the member" and substituting "and contributions under 
section 11 of this Schedule";
	(b)	in clause (g) by striking out "B 14045" and 
substituting "V 122515".

7   Schedule 2 is amended by sections 8 to 11.

8   Section 1(1) is amended
	(a)	by repealing clause (a);
	(b)	in clause (c) by striking out "1(1)(q)(ii) and (iii)" and 
substituting "1(1)(q)(iii)";
	(c)	in clause (f)(ii) by striking out "School Grants 
Regulation (Alta. Reg. 72/95)" and substituting 
"Education Grants Regulation (AR 120/2008)".

9   Section 7.1 is amended
	(a)	in subsection (3) by striking out "first day of the month 
following that in which the application is made" and 
substituting "beginning of the fiscal year following that in 
which the application is made provided that the applicant 
school has given at least one month's notice prior to that time 
and, if not, from the beginning of the next following fiscal 
year";
	(b)	in subsection (5) by striking out "month following that 
in which the notice is given" and substituting "fiscal year 
in which the notice is given provided that the school gave at 
least 2 weeks' notice prior to that time and, if not, from the 
end of the next following fiscal year".

10   Section 14 is amended by striking out "except that the 
reference to "sections 10, 11 and 12" are to be treated as reading 
"section 10"".

11   Subschedule 2 is amended by striking out ", contributions 
under section 11 of this Schedule and additional contributions made by 
the member" and substituting "and contributions under section 11 
of this Schedule".

12(1)   Subject to subsection (2), this Regulation comes into 
force on September 1, 2009.
(2)   Sections 6(a) and 11 come into force on September 1, 
2010.


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Alberta Regulation 217/2009
Builders' Lien Act
BUILDERS' LIEN FORMS AMENDMENT REGULATION
Filed: July 22, 2009
For information only:   Made by the Lieutenant Governor in Council (O.C. 413/2009) 
on July 21, 2009 pursuant to section 70 of the Builders' Lien Act. 
1   The Builders' Lien Forms Regulation (AR 51/2002) is 
amended by this Regulation.

2   Section 9 is amended by striking out "August 31, 2009" 
and substituting "August 31, 2012".


--------------------------------
Alberta Regulation 218/2009
Adult Guardianship and Trusteeship Act 
Public Trustee Act
TRANSITIONAL (APPLICATIONS MADE IN CONFORMITY WITH 
THE DEPENDENT ADULTS ACT; CERTIFICATIONS  
OF INCAPACITY) REGULATION
Filed: July 22, 2009
For information only:   Made by the Lieutenant Governor in Council (O.C. 419/2009) 
on July 21, 2009 pursuant to section 117 of the Adult Guardianship and Trusteeship 
Act and section 47 of the Public Trustee Act. 
Table of Contents
	1	Definition
Applications Made in Conformity with the  
Dependent Adults Act
	2	Application for order
	3	Applications under the former Act
Certificates of Incapacity Continued under  
the Public Trustee Act
	4	Prescribed period and date
	5	Review of certificates of incapacity
	6	Manner in which Public Trustee is to account
	7	Application of Acts
	8	Repeal
	9	Expiry
	10	Coming into force
Definition
1   In this Regulation, "former Act" means the Dependent Adults Act 
(RSA 2000 cD-11).
Applications Made in Conformity with  
the Dependent Adults Act
Application for order
2(1)  A person may apply under this section 
	(a)	for the appointment of a guardian or trustee for an adult,
	(b)	for a review of a guardianship or trusteeship order granted 
under the former Act, or
	(c)	to pass the accounts of a trustee under an order granted under 
the former Act.
(2)  Subject to subsections (3) and (4), an application under this section 
shall be made and determined in conformity with the requirements, 
regulations, forms, practices and procedures that applied to 
applications under the former Act.
(3)  A guardianship or trusteeship order that is granted or continued on 
an application under this section shall specify a date within the 6-year 
period immediately after the coming into force of the Adult 
Guardianship and Trusteeship Act by which the order must be 
reviewed under the Adult Guardianship and Trusteeship Act. 
(4)  A guardianship order that is granted or continued on an application 
under this section shall not give the guardian power or authority with 
respect to a matter referred to in section 10(3)(f) or (i) of the former 
Act.
(5)  Section 117(2) and (4) of the Adult Guardianship and Trusteeship 
Act applies to a guardianship or trusteeship order granted or continued 
under this section as if the order had been made under the former Act 
before the coming into force of the Adult Guardianship and 
Trusteeship Act.
(6)  An application under this section that is not completed within the 
one-year period immediately after the coming into force of the Adult 
Guardianship and Trusteeship Act shall be continued and determined 
in conformity with the requirements, regulations, forms, practices and 
procedures that apply to applications under the Adult Guardianship 
and Trusteeship Act.
(7)  An application may be started under this section only within the 
3-month period immediately after the coming into force of the Adult 
Guardianship and Trusteeship Act.
Applications under the former Act
3(1)  An application under the former Act for the appointment of a 
guardian or trustee, the review of a guardianship or trusteeship order or 
the passing of the accounts of a trustee that was started before the 
coming into force of the Adult Guardianship and Trusteeship Act shall 
be continued and determined in conformity with the requirements, 
regulations, forms, practices and procedures that applied to 
applications under the former Act.
(2)  Section 2(2) to (6) applies, with any necessary modifications,  to 
an application referred to in subsection (1).
Certificates of Incapacity Continued  
Under the Public Trustee Act
Prescribed period and date
4(1)  For the purposes of section 47(4)(b)(ii) of the Public Trustee Act, 
the prescribed period is one year after receiving the request. 
(2)  The date prescribed for the purposes of section 47(4)(c) of the 
Public Trustee Act is September 30, 2021. 
Review of certificates of incapacity
5(1)  Subject to subsection (2), Part 2 of the Adult Guardianship and 
Trusteeship Regulation, as it relates to applications for review of 
trusteeship orders, applies, with any necessary modifications, to 
applications to the Court respecting reviews of certificates of 
incapacity.
(2)  On an application for review of a certificate of incapacity, the 
Public Trustee is not required to give notice of the application to any 
relative of the adult with whom the Public Trustee has not had contact 
within the 6-year period immediately preceding the date on which the 
application is started.
Manner in which Public Trustee is to account
6(1)  On an application for review of a certificate of incapacity under 
section 47(4) of the Public Trustee Act the Public Trustee may also 
apply for examination and approval of the Public Trustee's accounts 
respecting administration of the incapacitated person's property under 
the certificate of incapacity.
(2)  If the Public Trustee's accounts respecting administration of the 
incapacitated person's property under the certificate of incapacity are 
not examined and approved by the Court when the certificate of 
incapacity is reviewed under section 47(4) of the Public Trustee Act, 
the Public Trustee may subsequently apply to the Court to have the 
Public Trustee's accounts examined and approved.
(3)  The Public Trustee shall apply to have the Public Trustee's 
accounts respecting administration of the incapacitated person's 
property under the certificate of incapacity examined and approved if 
directed to do so by the Court under section 63(3), (4) or (6) of the 
Adult Guardianship and Trusteeship Act.
(4)  Subject to subsection (5), Part 2 of the Adult Guardianship and 
Trusteeship Regulation, as it relates to applications for examination 
and approval of the Public Trustee's accounts as trustee under a 
trusteeship order, applies, with any necessary modifications, to an 
application to the Court to examine and approve the Public Trustee's 
accounts under a certificate of incapacity.
(5)  On an application for examination and approval of the Public 
Trustee's accounts respecting administration of the incapacitated 
person's property under a certificate of incapacity,
	(a)	the Public Trustee must submit the following accounting 
information:
	(i)	a current inventory of assets and liabilities, and
	(ii)	a statement of receipts and disbursements since the date 
of the Public Trustee's appointment,
	(b)	the accounting documents to be served on or sent to any 
person who is required to be notified of the application are 
the documents referred to in clause (a), and
	(c)	the Public Trustee is not required to give notice of the 
application to any relative of the adult with whom the Public 
Trustee has not had contact within the 6-year period 
immediately preceding the date on which the application is 
started.
Application of Acts
7(1)  Sections 74 and 75 of the former Act apply in respect of a 
certificate of incapacity and to the Public Trustee as trustee for the 
incapacitated person.
(2)  Sections 57, 61, 62, 63(3) to (6) and (9), 67 to 69 and 70(1) of the 
Adult Guardianship and Trusteeship Act apply in respect of a 
certificate of incapacity and to the Public Trustee as trustee for the 
incapacitated person.
Repeal
8   In accordance with section 117(11) of the Adult Guardianship and 
Trusteeship Act, sections 1 to 3 are repealed on the earliest of the 
following:
	(a)	the coming into force of an amendment that adds the subject 
matter of sections 1 to 3 to the Adult Guardianship and 
Trusteeship Act or another Act,
	(b) 	the coming into force of a regulation that repeals sections 1 
to 3, and
	(c)	3 years after sections 1 to 3 come into force.
Expiry
9   For the purpose of ensuring that this Regulation is reviewed for 
ongoing relevancy and necessity, with the option that it may be 
repassed in its present or an amended form following a review, this 
Regulation expires on September 30, 2019.
Coming into force
10   This Regulation comes into force on the coming into force of the 
Adult Guardianship and Trusteeship Act.


Alberta Regulation 219/2009
Adult Guardianship and Trusteeship Act
ADULT GUARDIANSHIP AND TRUSTEESHIP REGULATION
Filed: July 22, 2009
For information only:   Made by the Lieutenant Governor in Council (O.C. 420/2009) 
on July 21, 2009 pursuant to section 116 of the Adult Guardianship and Trusteeship 
Act.
Table of Contents
Interpretation
	1	Definitions
	2	Designation of health professions (health care providers)
Part 1 
General
Capacity Assessment
	3	Capacity assessment
	4	Conduct of capacity assessments
	5	Capacity assessment report
	6	Designation of health professions
	7	Designation of capacity assessors
	8	Training and continuing competence
	9	Fees
	10	Payment of fees by Crown
Co-decision-making, Guardianship and Trusteeship
	11	Evidence of death or incapacity of guardian or trustee
	12	Property not subject to trusteeship order
	13	Authority of trustee
	14	Limits on authority to make gifts
	15	Trustee's accounts
	16	Trustee fee schedule
	17	Results of investigation
Specific Decisions
	18	Right to refuse assessment
	19	Assessment
	20	Communication and assistance
	21	Duty to provide information
	22	Authorization by Public Guardian
	23	Limits on decisions
	24	Scope of decisions
	25	Records
	26	Section 96 capacity assessment
Registry
	27	Registry information
	28	Disclosure
	29	Updates and corrections
	30	Accuracy of information
	31	Limit on duties of review officer
	32	Additional duties of Public Guardian
Part 2 
Court Applications
	33	Interpretation
Division 1 
Co-decision-making, Guardianship or Trusteeship
Application for Order Started by Desk Application
	34	Application 
	35	Service and notice
	36	Duty of review officer 
	37	Request for hearing
	38	Review officer's report
	39	Filing of application 
	40	Powers of Court
	41	Procedure where hearing required
	42	Application by interested person
Application for Order Started by Notice of application and 
hearing
	43	Application
	44	Service and notice
	45	Duty of review officer 
	46	Review officer's report
Review of Co-decision-making, Guardianship or Trusteeship
Application by Co-decision-maker, Guardian or 
Trustee Order Started by Desk Application
	47	Application
	48	Service and notice
	49	Duty of review officer
	50	Request for hearing
	51	Review officer's report
	52	Filing of application 
	53	Powers of Court
	54	Procedure where hearing required
Application by Co-decision-maker, Guardian or Trustee Order 
Started by Notice of application and hearing
	55	Application
	56	Service and notice
	57	Duty of review officer 
	58	Review officer's report
Application for Review of Co-decision-making, Guardianship 
or Trusteeship Order by Other Person
	59	Application
	60	Service and notice
Application for Examination and Approval  
of Trustee's Accounts 
	61	Financial statements
Desk Application
	62	Application
	63	Service and notice
	64	Request for financial statements
	65	Request for hearing
	66	Report by review officer
	67	Filing of application
	68	Powers of Court
	69	Procedure where hearing required
Application Started by Notice of application and hearing
	70	Application
	71	Service and notice
	72	Request for documents
	73	Appointment of Public Trustee to assist
Division 2 
Other Court of Applications
	74	Opinion, advice or direction of Court
	75	Urgent guardianship or trusteeship order 
	76	Order respecting appointment of Public Guardian or Public Trustee
	77	Order to give effect to guardian's decision
	78	Approval of amendment of  trusteeship plan
	79	Order directing trustee to submit accounts
	80	Order authorizing sale of property that is the subject of a bequest
	81	Determination that adult lacks capacity without  
appointment of trustee
	82	Resealing of foreign orders
	83	Temporary protection order
	84	Order to aid investigation
	85	Review respecting specific decision making
	86	Access to financial information
	87	Order directing capacity assessment
Appeal to Court of Appeal
	88	Notice of appeal
Division 3 
General
	89	Withdrawal of consent
	90	Applicant's duty to obtain information
	91	Date of capacity assessment report
	92	General provisions regarding service
	93	Service in respect of person who has not attained age of majority
	94	Service on review officer
	95	Duplicate service not required
	96	Service or sending of orders
	97	Validity of forms and documents
	98	Additional consents
	99	Protection of sensitive information
	100	Costs paid by Crown
	101	Powers of Court
Part 6 
Expiry and Coming into Force
	102	Expiry
	103	Coming into force 
 
Schedules
Interpretation
Definitions
1(1)  In this Regulation,
	(a)	"Act" means the Adult Guardianship and Trusteeship Act;
	(b)	"college" means a college as defined in the Health 
Professions Act;
	(c)	"director", in respect of a residential facility, means the 
person in charge of the facility;
	(d)	"regulated member" means a regulated member as defined in 
the Health Professions Act.
(2)  For the purposes of the Act,
	(a)	"gift" includes a charitable donation;
	(b)	"health profession" means
	(i)	the profession of medical practitioners under the 
Medical Profession Act, and
	(ii)	a profession that is regulated by the Health Professions 
Act;
	(c)	"residential facility" means 
	(i)	a nursing home as defined in the Nursing Homes Act,
	(ii)	a place of care for adults who are aged or infirm or who 
require special care that is licensed under the Social 
Care Facilities Licensing Act,
	(iii)	an approved hospital or auxiliary hospital as defined in 
the Hospitals Act, and
	(iv)	a premises, other than a private residence, in which 4 or 
more adults who are not related to the operator of the 
premises are provided with living accommodation, care 
and supervision;
	(d)	"significantly impaired", in respect of an adult's capacity to 
make decisions, means that the adult's cognitive and adaptive 
abilities
	(i)	are substantially limited as the result of an impairment, 
including, without limitation, a developmental 
disability, an organic, degenerative or neurological 
disease or disorder, an acquired brain injury or a chronic 
mental illness, and
	(ii)	are not so substantially limited that the adult would not 
have the capacity to make decisions with appropriate 
guidance and support;
	(e)	"temporary admission", in respect of admission to a 
residential facility, means admission for a period not 
exceeding 6 months (beginning on the day that a specific 
decision maker consents to the admission).
(3)  For the purposes of section 85 of the Act, "disposition that has 
testamentary effect" includes a designation of a beneficiary that is 
intended to take effect on the death of the represented adult.
(4)  References to an "adult" in the Act and the regulations include a 
person referred to in section 11(1), 24(1), 43(2) of the Act where the 
context requires.
Designation of health professions (health care providers)
2(1)  The following members of health professions are designated for 
the purposes of the definition "health care provider" in section 1(s) of 
the Act in respect of Part 3, Division 1 of the Act:
	(a)	a person who is registered as a medical practitioner under the 
Medical Profession Act;
	(b)	a nurse practitioner who is a regulated member of the Alberta 
College and Association of Registered Nurses;
	(c)	subject to subsection (2), a dentist who is a regulated member 
of the Alberta Dental Association and College.
(2)  The designation of a dentist who is a regulated member of the 
Alberta Dental Association and College is only applicable with respect 
to health care decisions.
(3)  The following members of health professions are designated for 
the purposes of the definition "health care provider" in section 1(s) of 
the Act in respect of Part 3, Division 2 of the Act:
	(a)	a person who is registered as a medical practitioner under the 
Medical Profession Act;
	(b)	a nurse practitioner who is a regulated member of the Alberta 
College and Association of Registered Nurses;
	(c)	a registered nurse who is a regulated member of the Alberta 
College and Association of Registered Nurses.
Part 1 
General
Capacity Assessment
Capacity assessment
3(1)  The following apply to capacity assessments:
	(a)	a capacity assessment may be conducted only if the need for 
the capacity assessment has been established;
	(b)	an adult has the right to refuse to undergo or to continue with 
a capacity assessment;
	(c)	subject to subsection (4), an adult has the right to have a 
person present to assist the adult in feeling comfortable and 
relaxed when undergoing a capacity assessment;
	(d)	an adult has the right to have the assistance of an interpreter 
or the use of a device to assist the adult to communicate in 
order for the adult to be able to fully demonstrate his or her 
capacity during the capacity assessment;
	(e)	an adult shall be given the opportunity to undergo a capacity 
assessment at a time when and under circumstances in which 
the adult will be likely to be able to demonstrate the adult's 
full capacity;
	(f)	a capacity assessor shall make reasonable efforts to obtain 
any information that is relevant to the assessment of the 
adult's capacity.
(2)  The Minister may establish guidelines for the conduct of capacity 
assessments.
(3)  In establishing guidelines for the conduct of capacity assessments, 
the Minister shall consult with the colleges of the health professions 
whose members are or may be designated as capacity assessors under 
section 7.
(4)  A person who is present at a capacity assessment for the purpose 
of assisting the adult to communicate or to feel comfortable and 
relaxed
	(a)	shall comply with any directions of the capacity assessor, and
	(b)	may be asked to leave by the capacity assessor if the person 
does not comply with a direction under clause (a).
Conduct of capacity assessments
4(1)  A capacity assessment relating to co-decision-making, 
guardianship or trusteeship must be conducted in accordance with this 
section, section 3 and any guidelines established by the Minister under 
section 3.
(2)  Before conducting a capacity assessment, a capacity assessor shall
	(a)	ensure that he or she has been advised of the reasons why the 
capacity assessment has been requested and has been 
provided with a description of any event that gave rise to the 
request for a capacity assessment,
	(b)	obtain confirmation that a medical evaluation of the adult 
was conducted within the 3-month period preceding the 
capacity assessment and that the results of the evaluation did 
not indicate that the adult was suffering from a reversible 
temporary medical condition that appeared likely to have a 
significant impact on the adult's capacity to make a decision 
about personal matters or financial matters,
	(c)	make reasonable efforts to
	(i)	meet with the adult in person, and
	(ii)	unless the level of consciousness of the adult is 
non-responsive, explain to the adult
	(A)	the purpose and nature of the capacity assessment,
	(B)	that the adult has the right to refuse to 
	(I)	undergo the capacity assessment, or
	(II)	continue with the capacity assessment at any 
point during the capacity assessment,
	(C)	that the adult has the right to have a person present 
to assist the adult in feeling comfortable and 
relaxed when undergoing the capacity assessment,
	(D)	that the adult has the right to have the assistance of 
an interpreter or the use of a device to assist the 
adult to communicate in order to be able to fully 
demonstrate the adult's capacity during the 
capacity assessment,
	(E)	the significance and effect of a finding that the 
adult does not have the capacity to make a decision 
respecting personal matters or financial matters,
	(iii)	unless the level of consciousness of the adult is 
non-responsive, ask the adult if there have been any 
significant changes recently in his or her beliefs and 
values related to making decisions about the matters 
being assessed,
	(iv)	determine whether it is necessary for the adult to have 
or whether the adult is requesting the assistance of a 
person or the use of any device to undergo the capacity 
assessment, including, without limitation, 
	(A)	the assistance of an interpreter or device to 
communicate, or
	(B)	the assistance of a person to be comfortable and 
relaxed.
(3)  A capacity assessor may conduct a capacity assessment only if the 
adult has not refused to undergo or continue with the capacity 
assessment and,
	(a)	in the opinion of the capacity assessor, the adult
	(i)	understands the purpose of the capacity assessment and 
that the adult has a right to refuse to undergo or 
continue with the capacity assessment,
	(ii)	appears to be capable of consenting to the capacity 
assessment, and
	(iii)	has consented to the capacity assessment,
		or
	(b)	in the opinion of the capacity assessor,
	(i)	the adult appears not be capable of consenting to the 
capacity assessment, and
	(ii)	it is in the best interests of the adult to conduct the 
capacity assessment.
(4)  If an adult refuses to undergo a capacity assessment or refuses to 
continue with a capacity assessment at any point during a capacity 
assessment, the capacity assessor
	(a)	shall forthwith leave the adult's residence if the capacity 
assessor has attended at the adult's residence to conduct the 
capacity assessment,
	(b)	shall not take any further steps with respect to the capacity 
assessment other than to note on the capacity assessment 
report that the adult has refused to undergo or to continue 
with the capacity assessment, and
	(c)	shall notify the person who has requested the capacity 
assessment that the adult refused to undergo or continue with 
the capacity assessment.
(5)  A capacity assessor may conduct a capacity assessment of an 
adult's capacity to make decisions with respect to a matter only if the 
capacity assessor is satisfied that a capacity assessment with respect to 
that matter is warranted.
(6)  When conducting an assessment of an adult's capacity to make 
decisions about personal matters or financial matters, the capacity 
assessor shall meet with the adult and shall 
	(a)	consider the ability of the adult to
	(i)	understand the information that is relevant to a decision, 
and
	(ii)	appreciate the reasonably foreseeable consequences of
	(A)	a decision, and
	(B)	a failure to make a decision, and
	(b)	form an opinion about whether the adult has the capacity to 
make decisions about personal matters or financial matters
(7)  In forming an opinion under subsection (6), the capacity assessor 
shall take into account 
	(a)	whether the adult has the ability to retain the information that 
is relevant to making decisions, and
	(b)	any other factors the capacity assessor considers appropriate.
(8)  If the capacity assessment is being conducted in respect of an 
application for a guardianship order or trusteeship order, on meeting 
with the adult under subsection (6), the capacity assessor shall also 
form an opinion as to whether service of an application for a 
guardianship order or trusteeship order is likely to cause serious 
emotional or physical harm to the adult.
(9)  If the capacity assessor is of the opinion that the adult does not 
have the ability to do the things referred to in subsection (6), the 
capacity assessor shall 
	(a)	consider whether the adult is likely to regain some or all of 
the adult's capacity to make decisions about personal matters 
or financial matters and, if so, the time in which the adult is 
likely to regain capacity, and 
	(b)	if the capacity assessor believes that the adult is likely to 
regain some or all of the adult's capacity to make decisions 
about personal matters or financial matters, include in the 
capacity assessment report a recommendation that a further 
capacity assessment of the adult be conducted, including the 
period within which it should be conducted.
(10)  Subsections (1) to (7) and (9) apply, with any necessary 
modifications, to a capacity assessment that is conducted for the 
purposes of section 96 of the Act.
Capacity assessment report
5   A capacity assessment report must be in the form prescribed by the 
Minister and must contain the information required in the form.
Designation of health professions
6   The following health professions are designated as health 
professions whose members may be designated as capacity assessors:
	(a)	profession of medical practitioners under the Medical 
Profession Act;
	(b)	profession of psychologists under the Health Professions Act;
	(c)	profession of registered nurses under the Health Professions 
Act;
	(d)	profession of registered psychiatric and mental deficiency 
nurses under the Health Professions Act;
	(e)	profession of occupational therapists under the Health 
Professions Act;
	(f)	profession of social workers under the Health Professions 
Act.
Designation of capacity assessors
7(1)  The following persons are designated as capacity assessors:
	(a)	a person who is registered as a medical practitioner under the 
Medical Profession Act;
	(b)	a psychologist who is a regulated member of the College of 
Alberta Psychologists under the Health Professions Act.
(2)  The Minister may designate a person as a capacity assessor if the 
person
	(a)	is a regulated member of a college of a health profession 
listed in section 6(c) to (f),
	(b)	has successfully completed a course for capacity assessors 
referred to in section 8, and
	(c)	meets any other requirements set by the Minister.
(3)  The Minister may revoke the designation of a person who is 
designated as a capacity assessor under subsection (2)
	(a)	if the Minister is satisfied that the person is no longer 
conducting capacity assessments,
	(b)	if the Minister is satisfied that the person is not conducting 
capacity assessments in accordance with the Act and the 
regulations, or
	(c)	for any other reason that the Minister considers warrants the 
revocation of the person's designation as a capacity assessor.
(4)  The Minister shall maintain a list of persons who are designated as 
capacity assessors under subsection (2) and may make the list available 
to the public.
Training and continuing competence
8   The Minister may
	(a)	establish or approve a training course for capacity assessors, 
and
	(b)	establish or approve a continuing competence program for 
capacity assessors.
Fees
9(1)  Subject to subsections (2) and (3), a capacity assessor may 
charge a fee for a capacity assessment including the capacity 
assessment report up to a maximum of 
	(a)	$500, if the capacity assessment relates exclusively to the 
adult's capacity to make decisions about either
	(i)	personal matters, or 
	(ii)	financial matters,
		or
	(b)	$700, if the capacity assessment relates to the adult's 
capacity to make decisions about personal matters and 
financial matters.
(2)  Except where the fee for a capacity assessment is paid by the 
Minister under section 10, the Court may, on application, allow a 
higher fee for a capacity assessment on the basis of the complexity of 
the capacity assessment.
(3)  For greater certainty, subsection (1)(a)(i) also applies to a capacity 
assessment conducted under section 96 of the Act.
Payment of fees by Crown
10(1)  A person who is applying for a co-decision-making, 
guardianship or trusteeship order or for a review of an order may 
request the Crown to pay the fees for a capacity assessment of the adult 
in respect of whom the application is being made by submitting a 
request to the Public Guardian.
(2)  On receiving a request under subsection (1), the Public Guardian 
shall review the financial situation of the person making the request 
and the adult in respect of whom the application is being made, to 
determine whether it would be a financial hardship for the person 
making the request or the adult to pay the fees. 
(3)  If the Public Guardian is satisfied that it would be a financial 
hardship for the applicant and the adult in respect of whom the 
application is being made to pay the fees for a capacity assessment of 
the adult, the Public Guardian may recommend to the Minister that the 
Crown pay the fees.
(4)  The Minister may, on the recommendation of the Public Guardian, 
pay the fees provided for under section 9(1)(a) and (b) for the capacity 
assessment of the adult in respect of whom the application is being 
made.
(5)  The Minister may pay the fees for only one capacity assessment of 
an adult in a calendar year. 
Co-decision-making, Guardianship 
and Trusteeship
Evidence of guardian's or trustee's death or incapacity
11   The evidence to be provided to the clerk of the Court under 
section 32(5), 36(2) or 53(5) of the Act is
	(a)	in the case of the death of the previous guardian or previous 
trustee, a copy of the death certificate or funeral director's 
certificate respecting the previous guardian or previous 
trustee,
	(b)	in the case of the appointment of a guardian or trustee for the 
previous guardian or previous trustee, a copy of the 
guardianship or trusteeship order, or
	(c)	in the case of the coming into effect, because of the previous 
guardian's or previous trustee's incapacity, of
	(i)	a personal directive made by the previous guardian or 
previous trustee, a copy of the declaration of incapacity 
under the Personal Directives Act respecting the 
previous guardian or previous trustee, or
	(ii)	an enduring power of attorney made by the previous 
guardian or previous trustee, a copy of the enduring 
power of attorney and the declaration of contingency 
under the Powers of Attorney Act respecting the 
previous guardian or previous trustee.
Property not subject to trusteeship order
12   A trusteeship order does not apply to real and personal property 
that the represented adult holds in trust or in any fiduciary capacity.
Authority of trustee
13(1)  Unless the trusteeship order or another order of the Court 
provides otherwise, a trustee may carry on a legal proceeding that 
relates to a financial matter of the represented adult and may receive 
and give a discharge for any money or property to which the 
represented adult is entitled under any judgment rendered in or 
settlement of the legal proceeding.
(2)  A trustee may not consent to the disposition of the homestead, as 
defined in the Dower Act, of the represented adult's spouse unless the 
trusteeship order specifically authorizes the trustee to consent to the 
disposition of the homestead.
(3)  A trustee may grant a lease of the real property of the represented 
adult for a term not exceeding 3 years.
Limits on authority to make gifts
14(1)  The total value of gifts made by a trustee in a year out of the 
represented adult's property under section 60(2) of the Act shall not 
exceed 5% of the represented adult's taxable income for the previous 
year.
(2)  A trustee shall not make a gift to himself or herself out of the 
represented adult's property under section 60(2) of the Act unless the 
proposed gift is disclosed in the trusteeship plan approved by the 
Court.
(3)  In deciding whether to make a gift out of the represented adult's 
property under section 60(2) of the Act, a trustee shall consider any 
current wishes expressed by the represented adult.
(4)  A trustee appointed by a trusteeship order to which section 117(4) 
of the Act applies shall not make a gift under section 60(2) of the Act 
until after the trusteeship order is reviewed under section 70 of the Act.
Trustee's accounts 
15(1)  A trustee shall maintain at least the following accounting 
information for the purposes of section 63(1) of the Act:
	(a)	an inventory of the represented adult's assets, liabilities, 
income and expenditures as of the date of the trustee's 
appointment;
	(b)	an ongoing and complete record of transactions affecting the 
property administered by the trustee, which must include all 
of the following information that applies to each transaction:
	(i)	the date of the transaction;
	(ii)	the name of the other party to the transaction;
	(iii)	if money is received or paid in the transaction,
	(A)	the amount, 
	(B)	a description of the transaction, and
	(C)	the account into which the money is deposited or 
from which the money is paid or advanced;
	(iv)	if money is transferred between accounts in the 
transaction, the amount transferred and the accounts 
affected;
	(v)	a brief description of any items, services or property 
acquired in, disposed of or lent in the transaction;
	(vi)	if the transaction is a gift, including a charitable 
donation, made by the trustee on behalf of the 
represented adult
	(A)	a statement to that effect, and
	(B)	the estimated fair market value of the gifted 
property, if the property is not money;
	(vii)	receipts or invoices for all transactions involving the 
payment of $300 or more.
(2)  In this section, "transaction" includes
	(a)	receiving, paying, gifting or lending money on behalf of a 
represented adult,
	(b)	acquiring, disposing of or lending property other than money 
on behalf of a represented adult,
	(c)	transferring money between different accounts maintained by 
a trustee on behalf of a represented adult,
	(d)	incurring or discharging a liability on behalf of a represented 
adult, and
	(e)	entering into a contract on behalf of a represented adult.
Trustee fee schedule
16(1)  The fee schedule prescribed for the purposes of section 66(2) of 
the Act is set out in Schedule 1.
(2)  A trustee may elect to be compensated in accordance with the fee 
schedule by making the election in the trusteeship plan.
Results of investigation
17   An investigator shall notify the following persons as to whether 
the investigator concluded that a complaint under section 75 of the Act 
was founded or not founded and whether or not action was taken under 
section 77 of the Act:
	(a)	the assisted adult or represented adult;
	(b)	the complainant;
	(c)	the co-decision-maker, guardian or trustee who is the subject 
of the complaint;
	(d)	any other co-decision-maker, guardian or trustee appointed in 
the co-decision-making, guardianship or trusteeship order;
	(e)	subject to clause (g), the Public Guardian in the case of a 
complaint about a co-decision-maker or guardian;
	(f)	subject to clause (h), the Public Trustee in the case of a 
complaint about a trustee;
	(g)	the Minister in the case of a complaint about the Public 
Guardian;
	(h)	the Minister of Justice and Attorney General, in the case of a 
complaint about the Public Trustee;
	(i)	any other person the investigator considers appropriate.
Specific Decisions
Right to refuse assessment
18   Before assessing an adult's capacity to make a decision respecting 
the adult's health care or temporary admission to or discharge from a 
residential facility, a health care provider shall inform the adult that 
	(a)	the adult has the right to refuse to 
	(i)	undergo the assessment, or
	(ii)	continue with the assessment,
		and
	(b)	the likely effect that a refusal would have on the ability of the 
health care provider to provide the health care to the adult or 
temporarily admit the adult to or discharge the adult from a 
residential facility, as the case may be.
Assessment 
19(1)  When assessing an adult's capacity to make a decision 
respecting the adult's health care, a health care provider shall meet 
with the adult in person and provide to the adult the information that a 
reasonable person would require to understand the proposed health 
care and to make a decision, including the following information:
	(a)	the condition for which the health care is being proposed;
	(b)	the nature of the proposed health care;
	(c)	the material risks and expected benefits to the adult of the 
proposed health care;
	(d)	any likely side effects of the proposed health care;
	(e)	alternative forms of health care for the condition;
	(f)	the reasonably foreseeable consequences if the adult is not 
provided with the health care.
(2)  When assessing an adult's capacity to make a decision respecting 
the adult's temporary admission to or discharge from a residential 
facility, a health care provider shall meet with the adult in person and 
provide to the adult the information that a reasonable person would 
require to understand the proposed temporary admission or discharge 
and to make a decision, including the following information:
	(a)	the reasons for the proposed admission or discharge;
	(b)	the location and type of residential facility to which it is 
proposed that the adult would be temporarily admitted, in the 
case of an admission;
	(c)	the material risks and expected benefits to the adult of the 
proposed admission or discharge;
	(d)	the alternatives available to the adult if the adult is not 
temporarily admitted to or discharged from the residential 
facility;
	(e)	the reasonably foreseeable consequences if the adult is not 
temporarily admitted to or discharged from the residential 
facility.
(3)  A health care provider shall determine if the adult has the capacity 
to make a decision to consent or refuse to consent to the health care or 
to be temporarily admitted to or discharged from a residential facility, 
as the case may be, based on whether or not the adult
	(a)	understands the information given to the adult by the health 
care provider under subsection (1) or (2), and
	(b)	appreciates the reasonably foreseeable consequences of 
	(i)	a decision, and
	(ii)	a failure to make a decision.
(4)  A health care provider shall complete Form 6 or 7, prescribed in 
the Adult Guardianship and Trusteeship (Ministerial) Regulation, in 
respect of an assessment of capacity conducted under this section.
Communication and assistance
20   When assessing an adult's capacity to make a decision respecting 
the adult's health care or temporary admission to or discharge from a 
residential facility, a health care provider
	(a)	shall communicate with the adult in a manner that is 
appropriate to the adult's skills and abilities, and
	(b)	may allow the adult's spouse, relatives or friends, who 
accompany the adult and offer their assistance, to help the 
adult to understand or to demonstrate an understanding of the 
matters referred to in section 19(1) or (2).
Duty to provide information
21   If a health care provider determines that an adult does not have the 
capacity to make a decision to consent to or to refuse to consent to the 
proposed health care of the proposed temporary admission to or 
discharge from a residential facility, the health care provider shall 
inform the adult of the following:
	(a)	that a specific decision maker may be selected to make the 
decision for the adult;
	(b)	that the adult has the right under section 96 of the Act to 
request a capacity assessor to conduct a capacity assessment;
	(c)		that the adult has the right under section 97 of the Act to 
apply to the Court for a review of the assessment of the 
adult's capacity.
Authorization by Public Guardian
22(1)  The Public Guardian may authorize a person to be a specific 
decision maker for an adult if the person
	(a)	is a relative of the adult listed in the definition of "nearest 
relative" in section 1(x) of the Act, and
	(b)	meets the criteria set out in section 89(1)(a) to (f) of the Act.
(2)  For greater certainty, the Public Guardian may authorize a person 
who is not the nearest relative of an adult to be the specific decision 
maker for the adult.
(3)  The Public Guardian may not authorize the person that the health 
care provider had selected and whose selection was disputed to be the 
specific decision maker.
Limit on authority
23   The following types of health care are prescribed for the purposes 
of section 88(2)(e) of the Act,
	(a)	any type of health care that is the subject of a treatment 
decision for an adult who is a formal patient as defined in the 
Mental Health Act, or  
	(b)	any type of health care where a decision respecting the 
provision of or withdrawal or withholding of the health care 
would be likely to result in the imminent death of the adult.
Scope of decisions
24(1)  A specific decision maker may, in making a decision respecting 
an adult's health care that the specific decision maker is authorized to 
make, make a decision to consent to or refuse to consent to the 
provision of or withdrawal or withholding of the health care to the 
adult.
(2)  A specific decision maker may, in making a decision respecting 
the adult's temporary admission to or discharge from a residential 
facility that the specific decision maker is authorized to make, make a 
decision to consent to or refuse to consent to the adult's temporary 
admission to or discharge from the residential facility.
(3)  Subject to subsection (4), if a specific decision maker has made a 
decision to consent to an adult's temporary admission to a residential 
facility on a transitional basis, the specific decision maker may make a 
further decision with respect to the adult's temporary admission to 
another residential facility.
(4)  Subsection (3) does not apply if 
	(a)	more than 6 months have passed since the day on which the 
specific decision maker consented to the adult's temporary 
admission to the residential facility on a transitional basis, or
	(b)	the adult's health care provider or specific decision maker 
has reason to believe that there has been a significant 
improvement in the capacity of the adult to make a decision 
with respect to the adult's temporary admission to a 
residential facility.
Records
25   In addition to the records required to be kept under section 91 of 
the Act, the health care provider who selects a specific decision maker 
to make a decision for an adult shall keep a copy of the assessment of 
the capacity of the adult referred to in section 19(4).
Section 96 capacity assessment
26   The period prescribed for the purposes of section 98(3) of the Act 
within which arrangements must be made for a capacity assessment is 
7 days.
Registry
Registry information
27(1)  In addition to the documents referred to in section 106 of the 
Act, the Minister shall deposit the following information into the 
registry:
	(a)	information respecting the date by which a 
co-decision-making, guardianship or trusteeship order is 
required to be reviewed;
	(b)	contact information for each assisted adult or represented 
adult as set out in the co-decision-making, guardianship or 
trusteeship order or as provided by the assisted adult, 
represented adult, co-decision-maker, guardian or trustee;
	(c)	contact information for each co-decision-maker, guardian, 
alternate guardian, trustee and alternate trustee appointed 
under the Act as set out in the co-decision-making, 
guardianship or trusteeship order or as provided by the 
co-decision-maker, guardian, alternate guardian, trustee or 
alternate trustee.
(2)  The Minister may deposit the following information and 
documents into the registry:
	(a)	information related to applications or orders under the Act 
that would limit the authority of the Public Guardian or 
Public Trustee to disclose information from the registry;
	(b)	a copy of any order made under the Dependent Adults Act;
	(c)	a copy of or information respecting any certificate of 
incapacity issued under the Dependent Adults Act.
Disclosure
28(1)  Subject to subsection (2) and any express provisions to the 
contrary in a co-decision-making, guardianship or trusteeship order, 
the Public Guardian or the Public Trustee may disclose information, 
including personal information, from the registry to the following 
persons or bodies:
	(a)	the Provincial Court, Court of Queen's Bench or Court of 
Appeal;
	(b)	a government institution as defined in the Privacy Act 
(Canada);
	(c)	a bank to which the Personal Information Protection and 
Electronic Documents Act (Canada) applies;
	(d)	a public body as defined in the Freedom of Information and 
Protection of Privacy Act;
	(e)	a custodian or an affiliate as defined in the Health 
Information Act;
	(f)	an organization as defined in the Personal Information 
Protection Act;
	(g)	the individual that the information is about or the individual's 
co-decision-maker, guardian or trustee;
	(h)	a relative of
	(i)	an assisted adult,
	(ii)	a represented adult, or
	(iii)	an adult who is the subject of a certificate of incapacity;
	(i)	a lawyer representing a person or body referred to in clause 
(a) to (h).
(2)  The Public Guardian or Public Trustee may disclose information to 
a person or body referred to in subsection (1) only if
	(a)	the person or body has requested the information in a manner 
that is acceptable to the Public Guardian or Public Trustee 
and has
	(i)	identified the adult that the person or body believes is or 
may be the subject of a co-decision-making, 
guardianship, trusteeship order or certificate of 
incapacity,
	(ii)	identified the information that the person or body is 
requesting, and
	(iii)	set out the person's or body's reasons for requesting the 
information,
		and
	(b)	the Public Guardian or Public Trustee is satisfied that the 
person or body has a legitimate interest 
	(i)	in determining whether an adult is the subject of a 
co-decision-making, guardianship or trusteeship order 
or certificate of incapacity,
	(ii)	in being advised of the terms of 
	(A)	an order or certificate referred to in subclause (i), 
or
	(B)	an order made on a review of an order referred to 
in subclause (i),
			or
	(iii)	in being provided with contact information for a 
co-decision-maker, guardian or trustee of an assisted 
adult or represented adult.
(3)  A person or body who does not fall into a category set out in 
subsection (1) may request the Public Guardian or the Public Trustee 
to provide the person's or body's contact information to a 
co-decision-maker, guardian or trustee.
Updates and corrections
29   The Minister may update or correct any information contained in 
the registry.
Accuracy of information
30   The Minister, the Public Guardian and the Public Trustee are not 
responsible for the accuracy of information that is disclosed from the 
Registry.
Limit on duties of review officer
31   A review officer has no duties or functions except the duties and 
functions expressly provided for in the Act and the regulations.
Additional duties of Public Guardian
32   The Minister may designate the Public Guardian as a review 
officer, complaints officer or investigator.
Part 2 
Court Applications
Interpretation 
33(1)  In this Part, 
	(a)	"band" means band within the meaning of the Indian Act 
(Canada);
	(b)	"council of the band" means council of the band within the 
meaning of the Indian Act (Canada);
	(c)	"date for submitting the request for hearing" means the date 
set out by a review officer in a request for hearing by which 
the  completed request for hearing is to be submitted to the 
review officer;
	(d)	"desk application" means an application for an order under 
section 13, 21, 26, 40, 46, 63 or 70 of the Act that the 
applicant proposes be considered and determined by the 
Court in accordance with section 111 of the Act;
	(e)	"Indian" means an Indian as defined in the Indian Act 
(Canada);
	(f)	"reserve" means reserve within the meaning of the Indian Act 
(Canada).
(2)  When counting to or from a date in months, time is calculated 
from the date on which the event or activity occurs in the month to
	(a)	the same-numbered day in a subsequent or previous month 
(the target month), as the case may be, or
	(b)	if there is no same-numbered date in the target month, the 
last day of the target month.
(3)  The forms for the purposes of this Part are set out in Schedule 2.
Division 1 
Co-decision-making, Guardianship  
or Trusteeship
Application for Order Started by  
Desk Application
Application
34(1)  An interested person may start an application for a 
co-decision-making order under section 13 of the Act, a guardianship 
order under section 26 of the Act or a trusteeship order under section 
46 of the Act by desk application by submitting the documents referred 
to in subsection (2), (3) or (4) to a review officer.
(2)  In the case of a desk application for a co-decision-making order 
under section 13 of the Act, the applicant shall submit the following:
	(a)	an application, in Form 1;
	(b)	the affidavit of the applicant, in Form 2;
	(c)	a capacity assessment report in the form prescribed by the 
Adult Guardianship and Trusteeship (Ministerial) 
Regulation;
	(d)	the consent of
	(i)	each proposed co-decision-maker, in Form 12, 
	(A)	to act as co-decision-maker, and
	(B)	to the review officer or a person acting on behalf 
of the review officer obtaining a criminal records 
check respecting the proposed co-decision-maker, 
			and
	(ii)	the proposed assisted adult to the appointment of the 
proposed co-decision-maker, in Form 11;
	(e)	2 personal references for each proposed co-decision-maker, 
in Form 30;
	(f)	a draft co-decision-making order, in Form 5, to which the 
proposed assisted adult has consented;
	(g)	the Court filing fee.
(3)  In the case of a desk application for a guardianship order under 
section 26 of the Act, the applicant shall submit the following:
	(a)	an application, in Form 14;
	(b)	the affidavit of the applicant, in Form 15;
	(c)	a capacity assessment report in the form prescribed by the 
Adult Guardianship and Trusteeship (Ministerial) 
Regulation;
	(d)	a guardianship plan, in Form 32;
	(e)	the consent of each proposed guardian, in Form 24 or 25, and 
each alternate guardian, in Form 26,
	(i)	to act as guardian or alternate guardian, and
	(ii)	in the case of a proposed guardian or alternate guardian, 
to the review officer or a person acting on behalf of the 
review officer obtaining a criminal records check 
respecting the proposed guardian or alternate guardian;
	(f)	2 personal references for each proposed guardian or alternate 
guardian, in Form 30;
	(g)	the Court filing fee.
(4)  In the case of a desk application for a trusteeship order under 
section 46 of the Act, the applicant shall submit the following:
	(a)	an application, in Form 14;
	(b)	the affidavit of the applicant, in Form 15;
	(c)	a capacity assessment report in the form prescribed by the 
Adult Guardianship and Trusteeship (Ministerial) 
Regulation;
	(d)	a trusteeship plan, in Form 34 or 35;
	(e)	either
	(i)	an inventory, in Form 37, or
	(ii)	the proposed trustee's undertaking to file an inventory 
with the Court within 6 months of the effective date of 
the proposed trustee's appointment as trustee, unless the 
Court dispenses with the filing of the inventory;
	(f)	the consent of each proposed trustee, in Form 27 or 28, and 
alternate trustee, in Form 29,
	(i)	to act as trustee or alternate trustee, and
	(ii)	in the case of a trustee who is an individual, to the 
review officer or a person acting on behalf of the review 
officer obtaining a credit report and a criminal records 
check respecting the proposed trustee or alternate 
trustee;
	(g)	2 personal references for each proposed trustee or alternate 
trustee who is an individual, in Form 30;
	(h)	the Court filing fee.
(5)  If the applicant has not submitted all of the documents required 
under subsection (2), (3) or (4), the review officer shall advise the 
applicant that the documents are not complete and may return some or 
all of the documents to the applicant.
(6)  In addition to the documents referred to in subsections (3) and (4), 
an applicant for a guardianship or trusteeship order may also submit to 
the review officer a draft order, which may be in Form 18.
Service and notice
35(1)  If all of the documents required under section 34(2), (3) or 
(4) have been submitted to the review officer, the review officer shall
	(a)	prepare a notice of application, solely on the basis of the 
information set out in the application submitted to the review 
officer under section 34(2), (3) or (4),
	(i)	in Form 3, in the case of an application for a 
co-decision-making order, or
	(ii)	in Form 16, in the case of an application for a 
guardianship or trusteeship order, 
		and
	(b)	serve and send the notice of application and other documents 
with respect of the application in accordance with 
subsections (2) to (7).
(2)  Subject to subsection (3), the review officer shall serve the 
following documents on the adult who is the subject of the application:
	(a)	all of the documents in respect of the application that were 
submitted to the review officer under section 34, except the 
personal references;
	(b)	the notice of application;
	(c)	a request for hearing, in Form 31.
(3)  The review officer shall not serve the adult who is the subject of an 
application for a guardianship or trusteeship order if
	(a)	the capacity assessor has included an express statement in the 
capacity assessment report indicating that, in the opinion of 
the capacity assessor, service of notice of the application on 
the adult is likely to cause serious physical or emotional harm 
to the adult, or
	(b)	the applicant has, in the application, requested the Court to 
dispense with service on the adult.
(4)  Subject to subsection (5), the review officer shall send the notice 
of application and a request for hearing, in Form 31, to the following 
persons by ordinary mail:
	(a)	each of the following relatives of the adult who is the subject 
of the application whose name and address appears in the 
application and who resides in Canada:
	(i)	spouse or adult interdependent partner;
	(ii)	parent;
	(iii)	child who is 18 years of age or older;
	(iv)	sister or brother who is 18 years of age or older;
	(b)	each supporter, co-decision-maker, guardian, alternate 
guardian, trustee, alternate trustee, agent or attorney of the 
adult who is the subject of the application;
	(c)	each proposed co-decision-maker, guardian, alternate 
guardian, trustee or alternate trustee;
	(d)	if the adult who is the subject of the application resides in a 
residential facility, the director of the residential facility;
	(e)	if the adult who is the subject of the application is an Indian 
who is a member of a band and is ordinarily resident on a 
reserve, the Chief of the council of the band;
(5)  The review officer shall not send documents to a person referred to 
in subsection (4) if the applicant has, in the application, requested the 
Court to dispense with notice to the person. 
(6)  If the review officer is of the opinion that it would be in the best 
interests of the adult who is the subject of the application for any other 
person to be given notice of the application, the review officer may 
send the notice of application and a request for hearing, in Form 31, to 
the person.
(7)  Documents must be served under subsection (2) and sent under 
subsections (4) and (6) at least 20 days before the date for submitting 
the request for hearing.
(8)  A person referred to in subsection (4) or (6) may request the 
review officer to provide a copy of any document submitted by the 
applicant in support of the application except
	(a)	the capacity assessment report, or
	(b)	the personal references.
(9)  A request under subsection (8) must be
	(a)	in writing, and
	(b)	submitted before the date for submitting the request for 
hearing.
(10)  On receiving a request made by a person in accordance with 
subsections (8) and (9), the review officer shall provide a copy of the 
document to the person.
Duty of review officer 
36   Where an adult who is the subject of a desk application for a 
co-decision-making, guardianship or trusteeship order is served under 
section 35(2), a review officer shall make reasonable efforts to 
	(a)	meet with the adult in person,
	(b)	explain to the adult
	(i)	the nature and purpose of the application, and
	(ii)	that the adult has the right to request a hearing of the 
application and to attend and make representations at 
the hearing,
		and
	(c)	ascertain the views and wishes of the adult respecting the 
application.
Request for hearing
37(1)  The following persons are entitled to request a hearing:
	(a)	the adult who is the subject of the application;
	(b)	the review officer;
	(c)	any person to whom a notice of application and request for 
hearing was sent under section 35(4) or (6); 
	(d)	any interested person.
(2)  The adult who is the subject of an application may request a 
hearing by completing the request for hearing and submitting it to the 
review officer on or before the date for submitting the request for 
hearing.
(3)  A review officer may request a hearing in the review officer's 
report.
(4)  A person referred to in subsection (1)(c) may request a hearing by 
completing the request for hearing and submitting it to the review 
officer on or before the date for submitting the request for hearing.
(5)  An interested person referred to in subsection (1)(d) may request a 
hearing by completing a request for hearing, in Form 31, and 
submitting it to the review officer before the review officer files the 
application with the Court.
Review officer's report
38(1)  Before filing the application with the Court, the review officer 
shall complete the review officer's report in accordance with this 
section.
(2)  The review officer's report must be in a form approved by the 
Minister and include the following:
	(a)	a summary of the views and wishes of the adult who is the 
subject of the application respecting the application or a 
statement indicating the reasons why it was not possible for 
the review officer to ascertain the adult's views and wishes;
	(b)	a summary of any information of which the review officer is 
aware that relates to the suitability of a proposed 
co-decision-maker, guardian, alternate guardian, trustee or 
alternate trustee;
	(c)	a statement that
	(i)	the documents referred to in section 35(2) were 
personally served on the adult who is the subject of the 
application, or 
	(ii)	if the documents referred to in section 35(2) were not 
personally served on the adult, sets out the reasons why 
personal service was not effected; 
	(d)	a statement identifying the persons to whom the review 
officer sent a notice of application and a request for hearing 
under section 35(4) and (6);
	(e)	a statement identifying any persons referred to in section 
35(4) to whom the review officer did not send a notice of 
application and a request for hearing;
	(f)	a statement indicating whether a document referred to in 
clause (d) was returned undelivered;
	(g)	a statement indicating whether a request for hearing was 
submitted to the review officer;
	(h)	a statement as to whether the review officer is requesting a 
hearing.
(3)  The review officer may include in the review officer's report the 
review officer's comments on any other matter that the review officer 
considers relevant to the application.
(4)  If a proposed trustee or alternate trustee is a trust corporation, a 
statement that the proposed trustee or alternate trustee is registered as a 
trust corporation under the Loan and Trust Corporations Act is 
sufficient for the purposes of subsection (2)(b).
(5)  If the review officer's report indicates that a request for hearing 
was submitted to the review officer, the request for hearing must be 
attached to the report.
(6)  The review officer shall send the applicant a copy of the review 
officer's report, including any attachments, by ordinary mail.
Filing of application
39(1)  The review officer shall, as soon as practicable after the latest 
date for submitting the request for hearing set out in a request for 
hearing that was served or sent in accordance with section 35, file with 
or submit to the Court
	(a)	subject to section 99, the documents submitted to the review 
officer under section 34(2), (3) or (4), 
	(b)	the review officer's report,
	(c)	the draft order submitted to the review officer by the 
applicant, if applicable, and
	(d)	in the case of an application for a guardianship or trusteeship 
order, if the applicant did not submit a draft order and the 
review officer is not requesting a hearing and has not 
received a request for hearing, a draft order, in Form 18, 
prepared by the review officer solely on the basis of the 
information set out in the application submitted to the review 
officer under section 34(3)(a) or (4)(a),
	(e)	the Court filing fee.
(2)  The review officer shall file the application in the judicial centre 
that the review officer considers appropriate, having regard to the 
circumstances of the matter.
Powers of Court
40(1)  If the review officer's report in respect of an application 
indicates that no person has submitted a request for hearing to the 
review officer and that the review officer is not requesting a hearing, 
the Court may
	(a)	consider and determine the application in the absence of the 
applicant and any other persons in accordance with section 
111 of the Act, or 
	(b)	direct that a hearing be held in respect of the application.
(2)  The Court may consider and determine an application under 
subsection (1)(a) despite evidence that a person to whom a notice of 
application and request for hearing was sent under section 35(4) or (6) 
did not receive the notice of application or request for hearing. 
(3)  Subject to subsection (4), if the Court considers and determines the 
application in the absence of the applicant and any other persons in 
accordance with section 111 of the Act and makes a 
co-decision-making, guardianship or trusteeship order, the clerk of the 
Court shall send a copy of the order by ordinary mail to
	(a)	the assisted adult or represented adult,
	(b)	the applicant,
	(c)	the review officer, and
	(d)	each person to whom the review officer sent notice of the 
application.
(4)  The Court may direct that another form of notice of a 
co-decision-making, guardianship or trusteeship order be given to an 
assisted adult, represented adult or other person referred to in 
subsection (3) in addition to or in substitution for the notice provided 
for in subsection (3).
Procedure where hearing required
41(1)  Where a person has requested a hearing in accordance with 
section 37 or the Court has directed that a hearing be held under 
section 40(1)(b), the applicant may, after the review officer has filed 
the application with the Court, proceed with the application by filing a 
notice of application and hearing, in Form 39, with the Court.
(2)  Unless the Court directs otherwise, the applicant shall, at least 20 
days before the hearing date, serve 
	(a)	on the review officer the notice of application and hearing, 
and
	(b)	on the adult who is the subject of the application, each 
proposed co-decision-maker, guardian, alternate guardian, 
trustee or alternate trustee for the adult and any person who 
submitted a request for hearing
	(i)	the notice of application and hearing,
	(ii)	the documents submitted by the applicant to the review 
officer, except any personal references,
	(iii)	the review officer's report, and
	(iv)	any other documents on which the applicant intends to 
rely in support of the application.
(3)  The review officer has no duties or functions in respect of an 
application that proceeds under this section.
Application by interested person 
42(1)  If the applicant referred to in section 41 does not file a notice of 
application and hearing under section 41 within 3 months after the 
review officer files the application under section 39, an interested 
person may, in the same proceeding, start an application for a 
co-decision-making, guardianship or trusteeship order, by filing, 
subject to subsection (3)(b), the documents referred to in section 43(2), 
(3) or (4) with the Court.
(2)  Subject to subsection (3), sections 43 to 46 apply with any 
necessary modifications to an application started under subsection (1).
(3)  An interested person who starts an application under subsection (1)
	(a)	is not required to pay a Court filing fee,
	(b)	may adopt the capacity assessment report that was filed in 
support of the application started by the applicant referred to 
in section 41(1) if
	(i)	the capacity assessment report is dated not more than 6 
months before the date on which the notice of 
application and hearing is filed, or
	(ii)	the Court otherwise directs that the capacity assessment 
report may be adopted,
		and
	(c)	shall serve the notice of application and hearing on the 
applicant referred to in section 41(1).
Application for Order Started by 
Notice of Application and Hearing
Application
43(1)  An interested person may start an application for a 
co-decision-making order under section 13 of the Act, a guardianship 
order under section 26 of the Act or a trusteeship order under section 
46 of the Act by filing with or submitting to the Court the documents 
referred to in subsection (2), (3) or (4).
(2)  In the case of an application for a co-decision-making order under 
section 13 of the Act, the applicant shall file or submit the following:
	(a)	an application, in Form 1;
	(b)	the affidavit of the applicant, in Form 2;
	(c)	a capacity assessment report in the form prescribed by the 
Adult Guardianship and Trustee (Ministerial) Regulation;
	(d)	the consent of 
	(i)	each proposed co-decision-maker, in Form 12,
	(A)	to act as co-decision-maker, and
	(B)	to the review officer or a person acting on behalf 
of the review officer obtaining a criminal records 
check respecting the proposed co-decision-maker, 
			and
	(ii)	the proposed assisted adult to the appointment of the 
proposed co-decision-maker, in Form 11;
	(e)	a draft co-decision-making order in Form 5 to which the 
proposed assisted adult has consented;
	(f)	a notice of application and hearing, in Form 4;
(3)  In the case of an application for a guardianship order under section 
26 of the Act, the applicant shall file or submit the following:
	(a)	an application, in Form 14;
	(b)	the affidavit of the applicant, in Form 15;
	(c)	a capacity assessment report in the form prescribed by the 
Adult Guardianship and Trustee (Ministerial) Regulation;
	(d)	a guardianship plan, in Form 32;
	(e)	the consent of each proposed guardian, in Form 24 or 25, and 
alternate guardian, in Form 26,
	(i)	to act as guardian or alternate guardian, and
	(ii)	in the case of a proposed guardian or alternate guardian, 
to the review officer or a person acting on behalf of the 
review officer obtaining a criminal records check 
respecting the proposed guardian or alternate guardian;
	(f)	a notice of application and hearing, in Form 17;
(4)  In the case of an application for a trusteeship order under section 
46 of the Act, the applicant shall file or submit the following:
	(a)	an application, in Form 14;
	(b)	the affidavit of the applicant, in Form 15;
	(c)	a capacity assessment report in the form prescribed in the 
Adult Guardianship and Trusteeship (Ministerial) 
Regulation;
	(d)	a trusteeship plan, in Form 34 or 35;
	(e)	either
	(i)	an inventory, in Form 37, or
	(ii)	the proposed trustee's undertaking to file an inventory 
with the Court within 6 months of the effective date of 
the proposed trustee's appointment as trustee, unless the 
Court dispenses with the filing of the inventory;
	(f)	the consent of each proposed trustee, in Form 27 or 28, and 
alternate trustee, in Form 29, 
	(i)	to act as trustee or alternate trustee, and
	(ii)	in the case of a proposed trustee or alternate trustee who 
is an individual, to the review officer or a person acting 
on behalf of the review officer obtaining a credit report 
and a criminal records check respecting the proposed 
trustee or alternate trustee;
	(g)	a notice of application and hearing, in Form 17.
(5)  The application must be made in a judicial centre that is 
appropriate in the circumstances, having regard in particular to the 
location of the adult's residence.
Service and notice
44(1)  The applicant shall serve the documents filed under section 43 
on the adult.
(2)  The applicant shall serve on the review officer 
	(a)	the documents filed under section 43, and
	(b)	2 personal references, in Form 30, for each proposed 
	(i)	co-decision-maker,
	(ii)	guardian or alternate guardian, or
	(iii)	trustee or alternate trustee who is an individual.
(3)  The applicant shall serve the notice of application and hearing on
	(a)	each supporter, co-decision-maker, guardian, alternate 
guardian, trustee, alternate trustee, agent or attorney of the 
adult who is the subject of the application, and
	(b)	each proposed co-decision-maker, guardian, alternate 
guardian, trustee or alternate trustee.
(4)  The applicant shall send the notice of application and hearing to 
the following persons by ordinary mail:
	(a)	each of the following relatives of the adult who is the subject 
of the application who resides in Canada;
	(i)	spouse or adult interdependent partner;
	(ii)	parent;
	(iii)	child who is 18 years of age or older;
	(iv)	sister or brother who is 18 years of age or older;
	(b)	if the adult who is the subject of the application resides in a 
residential facility, the director of the residential facility, and
	(c)	if the adult who is the subject of the application is an Indian 
who is a member of a band and is ordinarily resident on a 
reserve, the Chief of the Band Council.
(5)  The applicant is not required to send the notice of application and 
hearing to any person referred to in subsection (4)(a) whose address 
cannot be ascertained by the use of ordinary diligence.
(6)  Documents must be served under subsections (1) to (3) and sent 
under subsection (4) at least one month before the hearing date.
(7)  A person referred to in subsection (3) or (4) may request the 
applicant to provide a copy of any document filed with the Court by 
the applicant.
(8)  A request under subsection (7) must be in writing.
(9)  Unless the Court approves a shorter period, on receiving a request 
made by a person in accordance with subsections (7) and (8), the 
applicant shall provide the documents to the person making the request 
at least 5 days before the hearing date.
Duty of review officer
45   Except where the applicant is seeking an order under section 26(5) 
or 46(4) of the Act dispensing with service on the adult who is the 
subject of the application, the review officer shall make reasonable 
efforts to 
	(a)	meet with the adult in person,
	(b)	explain to the adult
	(i)	the nature and purpose of the application, and
	(ii)	that the adult has the right to attend and make 
representations at the hearing,
		and
	(c)	ascertain the views and wishes of the adult respecting the 
application.
Review officer's report
46(1)  On receiving a notice of application and hearing under section 
44(2), the review officer shall complete the review officer's report in 
accordance with this section.
(2)  The review officer's report must be in a form approved by the 
Minister and must include the following:
	(a)	a summary of the views and wishes of the adult who is the 
subject of the application respecting the application or a 
statement indicating the reasons why it was not possible for 
the review officer to ascertain the adult's views and wishes;
	(b)	a summary of any information of which the review officer is 
aware that relates to the suitability of a proposed 
co-decision-maker, guardian, alternate guardian, trustee or 
alternate trustee.
(3)  The review officer may include in the review officer's report the 
review officer's comments on any other matter that the review officer 
considers relevant to the application.
(4)  If a proposed trustee or alternate trustee is a trust corporation, a 
statement that the proposed trustee or alternate trustee is registered as a 
trust corporation under the Loan and Trust Corporations Act is 
sufficient for the purposes of subsection (2)(b).
(5)  The review officer shall
	(a)	file the review officer's report with the Court, and
	(b)	provide a copy of the review officer's report to the applicant 
at least 2 days before the hearing date.
Review of Co-decision-making, Guardianship 
or Trusteeship Order
Application by Co-decision-maker,  
Guardian or Trustee Started 
by Desk Application
Application
47(1)  A co-decision-maker, guardian or trustee may start an 
application for a review of a co-decision-making order under section 
21 of the Act, a review of a guardianship order under section 40 of the 
Act or a review of a trusteeship order under section 70 of the Act by 
desk application by submitting the documents referred to in subsection 
(2), (3) or (4) to a review officer.
(2)  In the case of a desk application for a review of a 
co-decision-making order under section 21 of the Act, the applicant 
shall submit the following:
	(a)	an application, in Form 6;
	(b)	the affidavit of the applicant, in Form 7;
	(c)	a capacity assessment report in the form prescribed in the 
Adult Guardianship and Trusteeship (Ministerial) Regulation 
if
	(i)	the application for a review is made in accordance with 
a requirement in the co-decision-making order, unless 
the order provides that a capacity assessment is not 
required,
	(ii)	the capacity of the assisted person is in issue in the 
proceedings,
	(iii)	the applicant is requesting the termination of the 
co-decision-making order, or
	(iv)	the applicant has reason to believe that there has been a 
significant change in the capacity of the assisted person;
	(d)	if the applicant is requesting the continuation, amendment or 
replacement of the co-decision-making order,
	(i)	the consent of
	(A)	each proposed co-decision-maker, in Form 12, to 
act as co-decision-maker, 
	(B)	each proposed new co-decision-maker, in Form 12, 
to act as a co-decision-maker and to the review 
officer or a person acting on behalf of the review 
officer obtaining a criminal records check 
respecting the proposed new co-decision-maker, 
and
	(C)	the assisted person, in Form 11, to the appointment 
of the proposed co-decision-maker;
	(ii)	2 personal references for each proposed new 
co-decision-maker, if any, in Form 30;
	(iii)	a draft order to which the assisted person has consented.
(3)  In the case of a desk application for a review of a guardianship 
order under section 40 of the Act, the applicant shall submit the 
following:
	(a)	an application, in Form 19;
	(b)	the affidavit of the applicant, in Form 20;
	(c)	a capacity assessment report in the form prescribed in the 
Adult Guardianship and Trusteeship (Ministerial) Regulation 
if, 
	(i)	the application for a review is made in accordance with 
a requirement in the guardianship order, unless the order 
provides that a capacity assessment is not required,
	(ii)	the capacity of the represented person is in issue in the 
proceedings,
	(iii)	the applicant is requesting the termination of the 
guardianship order, or
	(iv)	the applicant has reason to believe that there has been a 
significant change in the capacity of the represented 
person;
	(d)	if the applicant is requesting the continuation, amendment or 
replacement of the guardianship order,
	(i)	a guardianship plan, in Form 32;
	(ii)	a record of decisions for each guardian, in Form 33;
	(iii)	the consent of
	(A)	each proposed guardian, in Form 24 or 25, and 
alternate guardian, in Form 26, to act as guardian 
or alternate guardian, and
	(B)	each proposed new guardian, in Form 24 or 25, 
and alternate guardian, in Form 26, to act as a 
guardian or alternate guardian and to the review 
officer or a person acting on behalf of the review 
officer obtaining a criminal records check 
respecting the proposed new guardian or alternate 
guardian;
	(iv)	2 personal references for each proposed new guardian 
or alternate guardian, if any, in Form 30.
(4)  In the case of a desk application for a review of a trusteeship order 
under section 70 of the Act, the applicant shall submit the following:
	(a)	an application, in Form 19;
	(b)	the affidavit of the applicant, in Form 20;
	(c)	a capacity assessment report in the form prescribed in the 
Adult Guardianship and Trusteeship (Ministerial) Regulation 
if, 
	(i)	the application for a review is made in accordance with 
a requirement in the trusteeship order, unless the order 
provides that a capacity assessment is not required,
	(ii)	the capacity of the represented person is in issue in the 
proceedings,
	(iii)	the applicant is requesting the termination of the 
trusteeship order, or
	(iv)	the applicant has reason to believe that there has been a 
significant change in the capacity of the represented 
person;
	(d)	if the applicant is requesting the continuation, amendment or 
replacement of the trusteeship order,
	(i)	a trusteeship plan, in Form 34 or 35,
	(ii)	the consent of
	(A)	each proposed trustee, in Form 27 or 28, and 
alternate trustee, in Form 29, to act as trustee or 
alternate trustee, and
	(B)	each proposed new trustee, in Form 27 or 28, and 
alternate trustee, in Form 29, who is an individual, 
to act as trustee or alternate trustee and to the 
review officer or a person acting on behalf of the 
review officer obtaining a credit report and a 
criminal records check respecting the proposed 
new trustee or alternate trustee,
	(iii)	2 personal references for each proposed new trustee or 
alternate trustee who is an individual, if any, in Form 
30.
(5)  If the applicant has not submitted all of the documents required 
under subsection (2), (3) or (4), the review officer shall advise the 
applicant that the documents are not complete and may return some or 
all of the documents to the applicant.
(6)  In addition to the documents referred to in subsections (3) and (4), 
an applicant for a review of a guardianship or trusteeship order may 
also submit to the review officer a draft order which may be in Form 
23.
Service and notice
48(1)  If all of the documents required under section 47(2), (3) or (4) 
have been submitted to the review officer, the review officer shall
	(a)	prepare a notice of application
	(i)	in Form 8, in the case of an application for a review of a 
co-decision-making order, or
	(ii)	in Form 21, in the case of an application for a review of 
a guardianship or trusteeship order, and
	(b)	serve and send the documents in support of the application in 
accordance with subsections (2) to (7).
(2)  Subject to subsection (3), the review officer shall serve the 
following documents on the assisted person or represented person:
	(a)	all of the documents in respect of the application that were 
submitted to the review officer under section 46, except the 
personal references;
	(b)	the notice of application;
	(c)	a request for hearing, in Form 31.
(3)  The review officer shall not serve the represented person if
	(a)	the capacity assessor has included an express statement in the 
capacity assessment report indicating that, in the opinion of 
the capacity assessor, service of notice of the application on 
the represented person would be likely to cause serious 
physical or emotional harm to the represented person, or
	(b)	the applicant has, in the application, requested the Court to 
dispense with service on the represented person.
(4)  Subject to subsection (5), the review officer shall send a copy of 
the notice of application and a request for hearing, in Form 31, to the 
following persons by ordinary mail:
	(a)	each of the following relatives of the assisted person or 
represented person whose name and address appears in the 
application and who resides in Canada:
	(i)	spouse or adult interdependent partner;
	(ii)	parent;
	(iii)	child who is 18 years of age or older;
	(iv)	sister or brother who is 18 years of age or older;
	(b)	each co-decision-maker, guardian, alternate guardian, trustee, 
alternate trustee, agent or attorney of the assisted person or 
represented person;
	(c)	each proposed co-decision-maker, guardian, alternate 
guardian, trustee or alternate trustee;
	(d)	if the assisted person or represented person resides in a 
residential facility, the director of the residential facility;
	(e)	if the assisted person or represented  person is an Indian who 
is a member of a band and is ordinarily resident on a reserve, 
the Chief of the council of the band.
(5)  The review officer shall not send documents to a person referred to 
in subsection (4) if the applicant has, in the application, requested the 
Court to dispense with notice to the person.  
(6)  If the review officer is of the opinion that it would be in the best 
interests of the assisted person or represented person for any other 
person to be given notice of the application, the review officer may 
send the notice of application and a request for hearing, in Form 31, to 
the person.
(7)  Documents must be served under subsection (2) and sent under 
subsections (4) and (6) at least 20 days before the date for submitting 
the request for hearing.
(8)  A person referred to in subsection (4) or (6) may request the 
review officer to provide a copy of any document submitted by the 
applicant in support of the application except
	(a)	the capacity assessment report, or
	(b)	the personal references.
(9)  A request under subsection (8) must be
	(a)	in writing, and
	(b)	submitted before the date for submitting the request for 
hearing.
(10)  On receiving a request made by a person in accordance with 
subsections (8) and (9), the review officer shall provide a copy of the 
document to the person.
Duty of review officer
49   Where an assisted person or represented person is served under 
section 48(2), the review officer shall make reasonable efforts to
	(a)	meet with the assisted person or represented person in 
person,
	(b)	explain to the assisted person or represented person
	(i)	the nature and purpose of the application, and
	(ii)	that the assisted person or represented person has the 
right to request a hearing of the application and to 
attend and make representations at the hearing,
		and
	(c)	ascertain the views and wishes of the assisted person or 
represented person respecting the application.
Request for hearing
50(1)  The following persons are entitled to request a hearing in 
respect of an application under section 21, 40, or 70 of the Act:
	(a)	the  assisted person or represented person;
	(b)	the review officer;
	(c)	any person to whom a notice of application and hearing was 
sent under section 48(4) or (6); 
	(d)	any interested person.
(2)  The assisted  person or represented person may request a hearing 
by completing the request for hearing and submitting it to the review 
officer on or before the date for submitting the request for hearing.
(3)  A review officer may request a hearing in the review officer's 
report.
(4)  A person referred to in subsection (1)(c) may request a hearing by 
completing the request for hearing and submitting it to the review 
officer on or before the date for submitting the request for hearing.
(5)  An interested person referred to in subsection (1)(d) may request a 
hearing by completing a request for hearing, in Form 31, and 
submitting it to the review officer before the review officer files the 
application with the Court.
Review officer's report
51(1)  Before filing the application with the Court, the review officer 
shall complete the review officer's report in accordance with this 
section.
(2)  The review officer's report must be in a form approved by the 
Minister and include the following:
	(a)	a summary of the views and wishes of the assisted person or 
represented person respecting the application or a statement 
indicating the reasons why it was not possible for the review 
officer to ascertain the assisted person's or represented 
person's views and wishes;
	(b)	a summary of any information of which the review officer is 
aware that relates to the suitability of a proposed 
co-decision-maker, guardian, alternate guardian, trustee or 
alternate trustee;
	(c)	a statement that
	(i)	the documents referred to in section 48(2) were 
personally served on the assisted person or represented 
person, or
	(ii)	if the documents referred to in section 48(2) were not 
personally served on the assisted person or represented 
person, sets out the reasons why personal service was 
not effected;
	(d)	a statement identifying the persons to whom the review 
officer sent a notice of application and a request for hearing 
under section 48(4) and (6);
	(e)	a statement identifying any persons referred to in section 
48(4) to whom the review office did not send a notice of the 
application and a request for hearing;
	(f)	a statement indicating whether a document referred to in 
clause (d) was returned undelivered;
	(g)	a statement indicating whether a request for hearing was 
submitted to the review officer;
	(h)	a statement as to whether the review officer is requesting a 
hearing.
(3)  The review officer may include in the review officer's report the 
review officer's comments on any other matter that the review officer 
considers relevant to the application.
(4)  If a proposed trustee or alternate trustee is a trust corporation, a 
statement that the proposed trustee or alternate trustee is registered as a 
trust corporation under the Loan and Trust Corporations Act is 
sufficient for the purposes of subsection (2)(b).
(5)  If the review officer's report indicates that a request for hearing 
was submitted to the review officer, the request for hearing must be 
attached to the report.
(6)  The review officer shall send the applicant a copy of the review 
officer's report, including any attachments, by ordinary mail.
Filing of application
52   The review officer shall, as soon as practicable after the latest date 
for submitting the request for hearing set out in a request for hearing 
that was served or sent in accordance with section 48, file with or 
submit to the Court
	(a)	subject to section 99, the documents submitted to the review 
officer under section 47(2), (3) or (4), and
	(b)	the review officer's report,
	(c)	the draft order submitted to the review officer by the 
applicant, if applicable, and
	(d)	in the case of an application for review of a guardianship or 
trusteeship order, if the applicant did not submit a draft order 
and if the review officer is not requesting a hearing and has 
not received a request for hearing, a draft order, in Form 23, 
prepared by the review officer solely on the basis of the 
information set out in the application submitted to the review 
officer under section 47(3)(a) or (4)(a).
Powers of Court
53(1)  If the review officer's report in respect of an application 
indicates that no person has submitted a request for hearing to the 
review officer and that the review officer is not requesting a hearing, 
the Court may 
	(a)	consider and determine the application in the absence of the 
applicant and any other persons in accordance with section 
111 of the Act, or 
	(b)	direct that a hearing be held in respect of the application.
(2)  The Court may consider and determine an application under 
subsection (1)(a) despite evidence that a person to whom a notice of 
application and request for hearing was sent under section 48(4) or (6) 
did not receive the notice of application or request for hearing. 
(3)  Subject to subsection (4), if the Court considers and determines the 
application in the absence of the applicant and any other persons in 
accordance with section 111 of the Act and makes an order, the clerk 
of the Court shall send a copy of the order by ordinary mail to 
	(a)	the assisted person or represented person,
	(b)	the applicant,
	(c)	the review officer, and
	(d)	each person to whom the review officer sent notice of 
application.
(4)  The Court may direct that another form of notice of an order be 
given to an assisted person, represented person or other person referred 
to in subsection (3) in addition to or in substitution for the notice 
provided for in subsection (3).
Procedure where hearing required
54(1)  Where a person has requested a hearing in accordance with 
section 50 or the Court has directed that a hearing be held under 
section 53(1)(b), the applicant may, after the review officer has filed 
the application with the Court, proceed with the application by filing 
with the Court a notice of application and hearing, in Form 39.
(2)  Unless the Court directs otherwise, the applicant shall, at least 20 
days before the hearing, serve 
	(a)	on the review officer the notice of application and hearing, 
and
	(b)	on the assisted person or represented person, each proposed 
co-decision-maker, guardian, alternate guardian, trustee, 
alternate trustee and any person who submitted a request for 
hearing
	(i)	the notice of application and hearing,
	(ii)	the documents submitted by the applicant to the review 
officer, except any personal references,
	(iii)	the review officer's report, and
	(iv)	any other documents on which the applicant intends to 
rely in support of the application.
(3)  The review officer has no duties or functions in respect of an 
application that proceeds under this section.
Application by Co-decision-maker, 
Guardian or Trustee Started by  
Notice of Application and Hearing
Application
55(1)  A co-decision-maker, guardian or trustee may start an 
application for a review of a co-decision-making order under section 
21 of the Act, a guardianship order under section 40 of the Act or a 
trusteeship order under section 70 of the Act by filing with or 
submitting to the Court the documents set out in subsection (2), (3) or 
(4).
(2)  In the case of an application for a review of a co-decision-making 
order under section 21 of the Act, the applicant shall file or submit the 
following documents:
	(a)	an application, in Form 6;
	(b)	the affidavit of the applicant, in Form 7;
	(c)	a capacity assessment report in the form prescribed in the 
Adult Guardianship and Trusteeship (Ministerial) Regulation 
if
	(i)	the application for a review is made in accordance with 
a requirement in the co-decision-making order, unless 
the order provides that a capacity assessment report is 
not required,
	(ii)	the capacity of the assisted person is in issue in the 
proceedings,
	(iii)	the applicant is requesting a termination of the 
co-decision-making order, or
	(iv)	the applicant has reason to believe there has been a 
significant change in the capacity of the assisted person;
	(d)	if the applicant is requesting the continuation, amendment or 
replacement of the co-decision-making order, the consent of
	(i)	each proposed co-decision-maker, in Form 12, to act as 
a co-decision-maker;
	(ii)	each proposed new co-decision-maker, in Form 12, to 
act as a co-decision-maker and to the review officer or a 
person acting on behalf of the review officer obtaining a 
criminal records check respecting the proposed new 
co-decision-maker;
	(ii)	the proposed assisted person to the appointment of the 
proposed co-decision-maker, in Form 11;
	(e)	a draft order, in Form 5, to which the assisted person has 
consented;
	(f)	a notice of application and hearing, in Form 9.
(3)  In the case of an application for a review of a guardianship order 
under section 40 of the Act, the applicant shall file or submit the 
following documents:
	(a)	an application, in Form 19;
	(b)	the affidavit of the applicant, in Form 20;
	(c)	a capacity assessment report in the form prescribed in the 
Adult Guardianship and Trusteeship (Ministerial) Regulation 
if
	(i)	the application for a review is made in accordance with 
a requirement in the guardianship order unless the order 
provides that a capacity assessment report is not 
required, 
	(ii)	the capacity of the represented person is in issue in the 
proceedings,
	(iii)	the applicant is requesting a termination of the 
guardianship order, or
	(iv)	the applicant has reason to believe there has been a 
significant change in the capacity of the represented 
person;
	(d)	if the applicant is requesting the continuation, amendment or 
replacement of the guardianship order,
	(i)	a guardianship plan, in Form 32,
	(ii)	a record of decisions for each guardian, in Form 33,
	(iii)	the consent of 
	(A)	each proposed guardian, in Form 24 or 25, and 
alternate guardian, if any, in Form 26, to act as 
guardian or alternate guardian, and
	(B)	each proposed new guardian, in Form 24 or 25, 
and alternate guardian, if any, in Form 26, to act as 
a guardian or alternate guardian and to the review 
officer or a person acting on behalf of the review 
officer obtaining a criminal records check 
respecting the proposed new guardian or alternate 
guardian;
	(e)	a notice of application and hearing, in Form 22.
(4)  In the case of an application for a review of a trusteeship order 
under section 70 of the Act, the applicant shall file or submit the 
following documents:
	(a)	an application, in Form 19;
	(b)	the affidavit of the applicant, in Form 20;
	(c)	a capacity assessment report in the form prescribed in the 
Adult Guardianship and Trusteeship (Ministerial) Regulation 
if,
	(i)	the application for a review is made in accordance with 
a requirement in the trusteeship order unless the order 
provides that a capacity assessment report is not 
required,
	(ii)	the capacity of the represented person is in issue in the 
proceedings,
	(iii)	the applicant is requesting a termination of the 
guardianship order, or
	(iv)	the applicant has reason to believe there has been a 
significant change in the capacity of the represented 
person;
	(d)	if the applicant is requesting the continuation, amendment or 
replacement of the trusteeship order,
	(i)	a trusteeship plan, in Form 34 or 35,
	(ii)	the consent of 
	(A)	each proposed trustee, in Form 27 or 28, and 
alternate trustee, in Form 29, to act as trustee or 
alternate trustee, and
	(B)	each proposed new trustee, in Form 27 or 28, and 
alternate guardian, in Form 29, to act as trustee or 
alternate trustee and to the review officer or a 
person acting on behalf of the review officer 
obtaining a credit report and a criminal records 
check in respect of the proposed new trustee or 
alternate trustee;
	(e)	a notice of application and hearing, in Form 22.
Service and notice
56(1)  The applicant shall serve the documents filed under section 57 
on the assisted person or represented person.
(2)  The applicant shall serve on the review officer
	(a)	the documents filed under section 57, and
	(b)	2 personal references, in Form 30, for each proposed new
	(i)	co-decision-maker,
	(ii)	guardian or alternate guardian, or
	(iii)	trustee or alternate trustee who is an individual.
(3)  The applicant shall serve the notice of application and hearing on
	(a)	each co-decision-maker, guardian, alternate guardian, trustee, 
alternate trustee, agent or attorney of the assisted person or 
represented person, and
	(b)	each proposed co-decision-maker, guardian, alternate 
guardian, trustee or alternate trustee.
(4)  The applicant shall send the notice of application and hearing to 
the following persons by ordinary mail:
	(a)	each of the following relatives of the assisted person or 
represented person who resides in Canada:
	(i)	spouse or adult interdependent partner;
	(ii)	parent;
	(iii)	child who is 18 years of age or older;
	(iv)	sister and brother who is 18 years of age or older;
	(b)	if the assisted person or represented person resides in a 
residential facility, the director of the residential facility;
	(c)	if the assisted person or represented person is an Indian who 
is a member of a band and is ordinarily resident on a reserve, 
the Chief of the council of the band.
(5)  The applicant is not required to send the notice of application and 
hearing to any person referred to in subsection (4)(a) whose address 
cannot be ascertained by the use of ordinary diligence.
(6)  Documents must be served under subsection (1) to (3) and sent 
under subsection (4) at least one month before the hearing date.
(7)  A person referred to in subsection (3) or (4) may request the 
applicant to provide a copy of any document filed with the Court by 
the applicant.
(8)  A request under subsection (7) must be in writing.
(9)  Unless the Court approves a shorter period, on receiving a request 
made by a person in accordance with subsections (7) and (8) the 
applicant shall provide the documents to the person making the request 
at least 5 days before the hearing date.
Duty of review officer
57   Except where the applicant is seeking an order dispensing with 
service on the assisted person or represented person, the review officer 
shall make reasonable efforts to 
	(a)	meet with the assisted person or represented person in 
person,
	(b)	explain to the assisted person or represented person
	(i)	the nature and purpose of the application, and
	(ii)	that the assisted person or represented person has the 
right to attend and make representations at the hearing,
		and
	(c)	ascertain the views and wishes of the assisted person or 
represented person respecting the application.
Review officer's report
58(1)  On receiving a notice of application and hearing under section 
58(2), the review officer shall complete the review officer's report in 
accordance with this section.
(2)  The review officer's report must be in a form approved by the 
Minister and must include the following:
	(a)	a summary of the views and wishes of the assisted person or 
represented person respecting the application or a statement 
indicating the reasons why it was not possible for the review 
officer to ascertain the assisted person's or represented 
person's views and wishes;
	(b)	a summary of any information of which the review officer is 
aware that relates to the suitability of any proposed new 
co-decision-maker, guardian, alternate guardian, trustee or 
alternate trustee.
(3)  The review officer may include in the review officer's report the 
review officer's comments on any other matter that the review officer 
considers relevant to the application.
(4)  If a proposed trustee or alternate trustee is a trust corporation, a 
statement that the proposed trustee or alternate trustee is registered as a 
trust corporation under the Loan and Trust Corporations Act is 
sufficient for the purposes of subsection (2)(b).
(5)  The review officer shall
	(a)	file the review officer's report with the Court, and
	(b)	provide a copy of the review officer's report to the applicant 
at least 2 days before the hearing date.
Application for Review of Co-decision-making, 
Guardianship or Trusteeship Order 
by Other Person
Application
59   A person other than a co-decision-maker, guardian or trustee may 
start an application for a review of a co-decision-making order under 
section 21 of the Act, a guardianship order under section 40 of the Act 
or a trusteeship order under section 70 of the Act by filing with the 
Court
	(a)	a notice of application and hearing, in Form 39, 
	(b)	any other documents the applicant intends to rely on in 
support of the application, and
	(c)	if the capacity of the assisted person or represented person is 
in issue on the application, a capacity assessment report 
respecting the assisted person or represented person in the 
form prescribed in the Adult Guardianship and Trusteeship 
(Ministerial) Regulation.
Service and notice
60(1)  The applicant shall serve the documents filed under section 59 
on 
	(a)	the assisted person or represented person,
	(b)	each co-decision-maker, guardian, trustee, agent or attorney 
of the assisted person or represented person, and
	(c)	if the applicant is requesting the appointment of a new or 
additional co-decision-maker, guardian or trustee, the review 
officer.
(2)  The applicant shall send the documents filed under section 59 to 
the following persons by ordinary mail:
	(a)	each of the following relatives of the assisted person or 
represented person who resides in Canada:
	(i)	spouse or adult interdependent partner;
	(ii)	parent;
	(iii)	child who is 18 years of age or older;
	(iv)	sister or brother who is 18 years of age or older;
	(b)	if the assisted person or represented person resides in a 
residential facility, the director of the residential facility;
	(c)	if the assisted person or represented person is an Indian who 
is a member of a band and is ordinarily resident on a reserve, 
the Chief of the council of the band.
(3)  Documents must be served under subsection (1) or (2) or sent 
under subsection (2) at least one month before the hearing date.
(4)  The applicant is not required to send documents under subsection 
(2)(a) to a person whose address cannot be ascertained by the use of 
ordinary diligence.
Application for Examination and  
Approval of Trustee's Accounts 
Financial statements
61   Financial statements submitted or filed on an application for 
examination and approval of a trustee's accounts under section 62 or 
70 must
	(a)	be verified by the affidavit of the trustee, and
	(b)	include
	(i)	an inventory, in Form 37, to which is attached
	(A)	a current copy of the certificate of title for any land 
identified in the inventory, and
	(B)	a copy of the most recent statement of account for 
any bank account or investment account identified 
in the inventory,
	(ii)	a statement of transactions, which may be in Form 36, 
that contains the information referred to in section 
15(1)(b)(i) to (vi) for each transaction that occurred 
during the period covered by the financial statements, 
and
	(iii)	an overview of trusteeship accounts, in Form 38.
Desk Application
Application
62(1)  A trustee may start a desk application for an examination and 
approval of the trustee's accounts under section 63(10) of the Act by 
submitting the following documents to the review officer:
	(a)	an application, in Form 19;
	(b)	the affidavit of the applicant, in Form 20;
	(c)	the financial statements.
(2)  In addition to the documents referred to in subsection (1), the 
applicant may submit to the review officer a draft form of order, which 
may be in Form 23.
(3)  If the applicant has not submitted all of the documents required 
under subsection (1), the review officer shall advise the applicant that 
the documents are not complete and may return some or all of the 
documents that were submitted to the applicant.
Service and notice
63(1)  If the desk application for examination and approval of the 
trustee's accounts is being made at the same time as a desk application 
for a review of the trusteeship order, the review officer shall serve the 
overview of trusteeship accounts on the represented adult in addition to 
the documents that are served under section 48(2).
(2)  If the desk application for examination and approval of trustee's 
accounts is not being made at the same time as a desk application for a 
review of the trusteeship order, the review officer shall send the 
following documents to the represented adult by ordinary mail:
	(a)	the application;
	(b)	the affidavit of the applicant;
	(c)	the overview of trusteeship accounts;
	(d)	a notice of application, in Form 21;
	(e)	a request for hearing, in Form 31.
(3)  Subject to subsection (4), the review officer shall send the notice 
of application, the overview of trusteeship accounts and a request for 
hearing, in Form 31, to the following persons by ordinary mail:
	(a)	each of the following relatives of the represented adult who is 
the subject of the application whose name and address 
appears in the application and who resides in Canada:
	(i)	spouse or adult interdependent partner;
	(ii)	parent;
	(iii)	child who is 18 years of age or older;
	(iv)	sister or brother who is 18 years of age or older;
	(b)	any guardian, alternate guardian, trustee, alternate trustee or 
agent of the represented adult;
	(c)	if the application is combined with an application for a 
review of the trusteeship order, each proposed guardian, 
alternate guardian, trustee or alternate trustee;
	(d)	if the represented adult resides in a residential facility, the 
director of the residential facility.
(4)  The review officer shall not send documents to a person referred to 
in subsection (3) if the applicant has, in the application, requested the 
Court to dispense with notice to the person. 
(5)  If the review officer is of the opinion that it would be in the best 
interests of the represented adult for any other person to be given 
notice of the application, the review officer may send a notice of 
application, the overview of trusteeship accounts and a request for 
hearing to the person.
(6)  Documents must be served under subsection (1) and sent under 
subsections (2), (3) and (5) at least 20 days before the date for 
submitting the request for hearing.
Request for financial statements
64(1)  The represented adult or a person to whom the review officer 
has sent a notice of the application under section 63 may request the 
review officer to provide a copy of the financial statements submitted 
by the applicant in support of the application.
(2)  A request under subsection (1) must be
	(a)	in writing, and
	(b)	submitted to the review officer before the date for submitting 
the request for hearing.
(3)  On receiving a request made by a person in accordance with 
subsections (1) and (2), the review officer shall provide a copy of the 
financial statements to the person.
Request for hearing
65(1)  The following persons are entitled to request a hearing in 
respect of an application referred to in section 62(1):
	(a)	the represented adult;
	(b)	any person to whom a notice of application was sent under 
section 63; 
	(c)	any interested person.
(2)  The represented adult may request a hearing by completing the 
request for hearing and submitting it to the review officer on or before 
the date for submitting the request for hearing.
(3)  A person referred to in subsection (1)(b) may request a hearing by 
completing the request for hearing and submitting it to the review 
officer on or before the date for submitting the request for hearing.
(4)  An interested person referred to in subsection (1)(c) may request a 
hearing by completing a request for hearing, in Form 31, and 
submitting it to the review officer before the review officer files the 
application with the Court.
Review officer's report
66(1)  Before filing the application with the Court, the review officer 
shall complete the review officer's report in accordance with this 
section.
(2)  If the desk application for examination and approval of the 
trustee's accounts is combined with a desk application for a review of 
the trusteeship order, the review officer's report shall, in addition to the 
information required by section 51(2), include the following:
	(a)	information relating to the serving and sending of the 
overview of trusteeship accounts, and
	(b)	a statement that the review officer has not reviewed the 
financial statements.
(3)  If the desk application for examination and approval of the 
trustee's accounts is not combined with a desk application for review 
of the trusteeship order the review officer shall complete the review 
officer's report in accordance with subsections (4) to (6).
(4)  The review officer's report must be in a form approved by the 
Minister and include the following:
	(a)	a statement that the documents referred to in section 63(2) 
were sent to the represented adult by ordinary mail;
	(b)	a statement identifying the persons to whom the review 
officer sent the notice of application, the overview of 
trusteeship accounts and a request for hearing under section 
63(3) and (5);
	(c)	a statement identifying any persons referred to in section 
63(3) to whom the review officer did not send the notice of 
application, the overview of trusteeship accounts and a 
request for hearing;
	(d)	a statement indicating whether a document referred to in 
clause (a) or (b) was returned undelivered;
	(e)	a statement indicating whether a request for hearing was 
submitted to the review officer;
	(f)	a statement that the review officer has not reviewed the 
financial statements.
(5)  If the review officer's report indicates that a request for hearing 
was submitted to the review officer, the request for hearing must be 
attached to the report.
(6)  The review officer shall not 
	(a)	review the financial statements, or
	(b)	comment on the substance of the financial statements in the 
review officer's report.
(7)  The review officer shall send the applicant a copy of the review 
officer's report, including any attachments, by ordinary mail.
Filing of application 
67(1)  Where the desk application for examination and approval of the 
trustee's accounts is combined with a desk application for a review of 
the trusteeship order, the review officer shall file the financial 
statements with the Court at the same time the review officer files or 
submits the documents referred to in section 52.
(2)  Where the desk application for examination and approval of  the 
trustee's accounts is not combined with a desk application for review 
of the trusteeship order, the review officer shall, as soon as practicable 
after the latest date for submitting the request for hearing set out in a 
request for hearing that was served or sent in accordance with section 
63, file with or submit to the Court
	(a)	the documents submitted to the review officer under section 
62, 
	(b)	the review officer's report, 
	(c)	the draft order that was submitted to the review officer by the 
applicant, if any, and
	(d)	if the applicant did not submit a draft order and the review 
officer has not received a request for hearing, a draft order, in 
Form 23, prepared by the review officer solely on the basis of 
the information set out in the application submitted to the 
review officer.
Powers of Court
68(1)  If the review officer's report in respect of a desk application for 
examination and approval of a trustee's accounts indicates that no 
person has submitted a request for hearing to the review officer, the 
Court may
	(a)	consider and determine the application in the absence of the 
applicant and any other persons in accordance with section 
111 of the Act, or 
	(b)	direct that a hearing be held in respect of the application.
(2)  The Court may consider and determine an application under 
subsection (1)(a) despite evidence that a person to whom a notice of 
application, overview of trusteeship accounts and request for hearing 
was sent under section 63 did not receive the notice of application, 
overview of trusteeship accounts or request for hearing. 
(3)  Subject to subsection (4), if the Court considers and determines the 
application in the absence of the applicant and any other persons in 
accordance with section 111 of the Act and makes an order, the clerk 
of the Court shall send a copy of the order by ordinary mail to
	(a)	the represented adult,
	(b)	the applicant,
	(c)	the review officer, and
	(d)	each person to whom the review officer sent notice of the 
application.
(4)  The Court may direct that another form of notice of an order be 
given to a represented adult or other person referred to in subsection 
(3) in addition to or in substitution for the notice provided for in 
subsection (3).
Procedure where hearing required
69(1)  Where a person has requested a hearing in accordance with 
section 65 or the Court has directed a hearing to be held under section 
68, the applicant may, after the review officer has filed the application 
with the Court, proceed with the application by filing a notice of 
application and hearing, in Form 39.
(2)  Unless the Court directs otherwise, the applicant shall, at least 20 
days before the hearing date,
	(a)	serve on the review officer the notice of application and 
hearing;
	(b)	serve on the represented adult and on any person who 
submitted a request for hearing
	(i)	the notice of application and hearing;
	(ii)	the documents submitted to the review officer under 
section 62;
	(iii)	any other documents on which the applicant intends to 
rely in support of the application.
(3)  The review officer has no duties or functions in respect of a 
hearing that proceeds under this section.
Application Started by Notice of  
application and hearing
Application
70   A trustee may start an application for examination and approval of 
the trustee's accounts under section 63(10) of the Act by filing the 
following documents with the Court:
	(a)	an application, in Form 19;
	(b)	the affidavit of the applicant, in Form 20;
	(c)	the financial statements;
	(d)	a notice of application and hearing, in Form 22.
Service and notice
71(1)  The applicant shall serve the documents referred to in section 
70(a), (b) and (d) and the overview of trusteeship accounts on the 
represented adult.
(2)  The applicant shall serve the notice of application and hearing and 
the overview of trusteeship accounts on
	(a)	each guardian, alternate guardian, trustee or alternate trustee 
or agent of the represented adult, and
	(b)	if the application for examination and approval of the 
trustee's accounts is combined with an application for a 
review of the trusteeship order, each proposed guardian, 
alternate guardian, trustee or alternate trustee.
(3)  The applicant shall send the notice of application and hearing and 
the overview of trusteeship accounts to the following persons by 
ordinary mail:
	(a)	each of the following relatives of the represented adult who 
resides in Canada:
	(i)	spouse or adult interdependent partner;
	(ii)	parent;
	(iii)	child who is 18 years of age or older;
	(iv)	sister or brother who is 18 years of age or older;
	(b)	if the represented adult resides in a residential facility, the 
director of the residential facility.
(4)  The applicant is not required to send documents to a person 
referred to in subsection (3)(a) whose address cannot be ascertained by 
the use of ordinary diligence.
(5)  Documents must be served under subsections (1) and (2) and sent 
under subsection (3) at least one month before the hearing date.
Request for documents
72(1)  A person referred to in section 71(2) or (3) may request the 
applicant to provide a copy of any document that was filed with the 
Court by the applicant and that was not served on or sent to the 
applicant under section 71(2) or (3).
(2)  A request under subsection (1) must be in writing.
(3)  Unless the Court approves a shorter period, on receiving a request 
made by a person in accordance with subsections (1) and (2), the 
applicant shall provide the document to the person 5 days before the 
hearing date.
Appointment of Public Trustee to assist
73(1)  When considering an application for examination and approval 
of a trustee's accounts, the Court may, with the consent of the Public 
Trustee, appoint the Public Trustee 
	(a)	to examine any entry or entries in the financial statements 
and provide a report to the Court, or 
	(b)	to retain a chartered accountant, certified general accountant, 
or certified management accountant to examine any entry or 
entries in the financial statements and provide a report to the 
Court.
(2)  In an appointment under subsection (1), the Court 
	(a)	shall specify the nature, scope, and extent of the examination, 
and
	(b)	may give any direction the Court considers appropriate.
(3)  Fees and disbursements of the Public Trustee or an accountant 
retained by the Public Trustee in carrying out duties under subsection 
(1) are payable directly out of the property of the represented adult 
unless otherwise ordered by the Court.
(4)  A trustee and any other person having knowledge or possession of 
records relating to the trusteeship shall
	(a)	make all relevant records available to the Public Trustee and 
an accountant retained by the Public Trustee, and 
	(b)	co-operate fully with the Public Trustee and an accountant 
retained by the Public Trustee.
(5)  After completing the examination referred to in subsection (1), the 
Public Trustee or accountant shall file a written report with the Court 
and send a copy of the report by ordinary mail to the trustee and to any 
other person directed by the Court.
Division 2 
Other Court Applications
Opinion, advice or direction of Court
74(1)  An assisted adult, co-decision-maker, guardian or trustee may 
start application for the opinion, advice or direction of the Court under 
section 20, 39 or 68 of the Act by filing with the Court
	(a)	a notice of application and hearing, in Form 39, and
	(b)	any other documents the assisted adult, co-decision-maker, 
guardian or trustee intends to rely on in support of the 
application.
(2)  The applicant shall serve the  documents referred to in subsection 
(1) on
	(a)	the assisted adult,
	(b)	any guardian, alternate guardian, trustee, alternate trustee, 
agent or attorney of the adult, and
	(c)	any other person who is likely to be directly affected by the 
order.
Urgent guardianship or trusteeship order 
75(1)  Except as otherwise directed or approved by the Court, an 
interested person may start an application for an order under section 27 
or 48 of the Act by filing with the Court
	(a)	a notice of application and hearing, in Form 39, and
	(b)	any other documents the interested person intends to rely on 
in support of the application.
(2)  Except as otherwise directed or approved by the Court, the 
applicant shall serve the documents referred to in subsection (1) at 
least 2 days before the hearing date on
	(a)	the adult who is the subject of the application, and
	(b)	any supporter, co-decision-maker, guardian, alternate 
guardian, trustee, alternate trustee, agent or attorney of the 
adult.
Order respecting appointment of 
Public Guardian or Public Trustee
76(1)  The Public Guardian or the Public Trustee may start an 
application for an order under section 29(2) or 50(2) of the Act by 
filing with the Court
	(a)	a notice of application and hearing, in Form 39, and
	(b)	any other documents that the Public Guardian or Public 
Trustee intends to rely on in support of the application. 
(2)  The applicant shall 
	(a)	serve the documents referred to in subsection (1) on
	(i)	the represented adult, and
	(ii)	any guardian, alternate guardian, trustee, alternate 
trustee, agent or attorney of the represented adult,
		and
	(b)	send the documents referred to in subsection (1) by ordinary 
mail to 
	(i)	each of the following relatives of the represented adult 
who resides in Canada:
	(A)	spouse or adult interdependent partner;
	(B)	parent;
	(C)	child who is 18 years of age or older;
	(D)	sister or brother who is 18 years of age or older;
	(ii)	if the represented adult resides in a residential facility, 
the director of the residential facility, and
	(iii)	if the represented adult is a member of an Indian who is 
a member of a band and is ordinarily resident on a 
reserve, the Chief of the council of the band.
Order to give effect to guardian's decision
77(1)  A guardian may start an application for an order under section 
38 of the Act by filing with the Court 
	(a)	a notice of application and hearing, in Form 39, and
	(b)	any other documents the guardian intends to rely on in 
support of the application.
(2)  The applicant shall serve the documents referred to in subsection 
(1) at least 5 days before the hearing date on
	(a)	the represented adult,
	(b)	any guardian, alternate guardian, trustee, alternate trustee, 
agent or attorney of the adult, and
	(c)	any other person who is likely to be directly affected by the 
order.
Approval of amendment of trusteeship plan
78(1)  A trustee may start an application for an order under section 
54(2) of the Act by filing with the Court
	(a)	a notice of application and hearing, in Form 39, and
	(b)	any other documents the trustee intends to rely on in support 
of the application.
(2)  The applicant shall serve the documents referred to in subsection 
(1) on
	(a)	the represented adult,
	(b)	any guardian or agent of the represented adult, and
	(c)	any other person who is likely to be directly affected by the 
order.
Order directing trustee to submit accounts
79(1)  A represented adult or an interested person may start an 
application for an order under section 63(3), (6) or (8) of the Act by 
filing with the Court 
	(a)	a notice of application and hearing, in Form 39, and
	(b)	any other documents the represented adult or interested 
person intends to rely on in support of the application.
(2)  If the application is for an order under
	(a)	section 63(3) of the Act, the applicant shall serve the 
documents referred to in subsection (1) on
	(i)	the trustee, and
	(ii)	if the represented adult is not the applicant, the 
represented adult;
	(b)	section 63(6) of the Act the applicant shall serve the 
documents referred to in subsection (1) on the trustee;  
	(c)	section 63(8) of the Act the applicant shall serve the 
documents referred to in subsection (1) on 
	(i)	the represented adult, and
	(ii)	the personal representative, attorney or trustee of the 
deceased or incapacitated trustee.
Order authorizing sale of property that is the 
subject of a bequest
80(1)  A trustee may start an application for an order under section 67 
of the Act by filing with the Court
	(a)	a notice of application and hearing, in Form 39, and
	(b)	any other documents the trustee intends to rely on in support 
of the application.
(2)  The applicant shall serve the documents referred to in subsection 
(1) on
	(a)	the represented adult,
	(b)	any guardian or agent of the represented adult, and
	(c)	any other person who is likely to be directly affected by the 
order.
Determination that adult lacks capacity without  
appointment of trustee
81(1)  The Indian Act (Canada) is prescribed for the purposes of 
section 71 of the Act.
(2)  An application under section 71 of the Act may be made only in 
respect of an adult to whom section 51(1) of the Indian Act (Canada) 
would apply if the adult were determined to lack capacity in relation to 
financial matters.
(3)  The following persons may make an application under section 71 
of the Act
	(a)	a person who is concerned for the welfare of an adult referred 
to in subsection (2);
	(b)	a person acting under the authority of the federal Minister 
responsible for the Indian Act (Canada), or
	(c)	the Public Trustee.
(4)  An applicant may start an application for an order under section 71 
of the Act by filing with the Court
	(a)	a notice of application and hearing, in Form 39,
	(b)	a capacity assessment report, and
	(c)	 any other documents the applicant intends to rely on in 
support of the application.
(5)  The applicant shall serve
	(a)	the documents referred to in subsection (4) on 
	(i)	the adult who is the subject of the application, and
	(ii)	the federal Minister responsible for the Indian Act 
(Canada), and
	(b)	the notice of application and hearing on each supporter, 
co-decision-maker, guardian, alternate guardian, trustee, 
alternate trustee, agent or attorney of the adult who is the 
subject of the application.
(6)  The applicant shall send the notice of application and hearing to 
the following persons by ordinary mail:
	(a)	each of the following relatives of the adult who is the subject 
of the application who resides in Canada:
	(i)	spouse or adult interdependent partner,
	(ii)	parent,
	(iii)	child who is 18 years of age or older,
	(iv)	sister or brother who is 18 years of age or older;
	(b)	if the adult who is the subject of the application resides in a 
residential facility, the director of the residential facility;
	(c)	the Chief of the council of the band.
(7)  The applicant is not required to send the notice of application and 
hearing to any person referred to in subsection (6)(a) whose address 
cannot be ascertained by the use of ordinary diligence.
(8)  Documents must be served under subsection (4) and sent under 
subsection (5) at least one month before the hearing date.
(9)  A person referred to in subsection (5) or (6) may request the 
applicant to provide a copy of any document filed with the Court by 
the applicant.
(10)  A request under subsection (9) must be in writing.
(11)  Unless the Court approves a shorter period, on receiving a request 
made by a person in accordance with subsections (9) and (10), the 
applicant shall provide the document to the person making the request 
at least 5 days before the hearing date.
Resealing of foreign orders
82(1)  A person may start an application for an order under section 73 
of the Act by filing with the Court
	(a)	a notice of application and hearing, in Form 39, and
	(b)	any other documents the person intends to rely on in support 
of the application.
(2)  The applicant shall serve the documents filed under subsection (1) 
on
	(a)	the adult who is the subject of the application,
	(b)	the review officer,
	(c)	each co-decision-maker, guardian, alternate guardian, trustee, 
alternate trustee, agent or attorney of the adult who is the 
subject of the application, and
	(d)	each proposed co-decision-maker, guardian, alternate 
guardian, trustee or alternate trustee.
(3)  The applicant shall send the notice of application and hearing to 
the following persons by ordinary mail:
	(a)	each of the following relatives of the adult who is the subject 
of the application who resides in Canada:
	(i)	spouse or adult interdependent partner,
	(ii)	parent,
	(iii)	child who is 18 years of age or older,
	(iv)	sister or brother who is 18 years of age or older;
	(b)	if the adult who is the subject of the application resides in a 
residential facility, the director of the residential facility;
	(c)	if the adult who is the subject of the application is an Indian 
who is a member of a band and is ordinarily resident on a 
reserve, the Chief of the council of the band.
(4)  The applicant is not required to send the notice of application and 
hearing to any person referred to in subsection (3)(a) whose address 
cannot be ascertained by the use of ordinary diligence.
(5)  Documents must be served under subsection (2) and sent under 
subsection (3) at least 20 days before the hearing date
(6)  A person referred to in subsection (3) may request the applicant to 
provide copy of any document filed with the Court by the applicant.
(7)  A request under subsection (6) must be in writing.
(8)  Unless the Court approves a shorter period, on receiving a request 
made by a person in accordance with subsections (6) and (7), the 
applicant shall provide the document to the person making the request 
at least 5 days before the hearing date.
Temporary protection order
83(1)  The Public Guardian may start an application under section 74 
of the Act by filing with the Court
	(a)	a notice of application and hearing, and
	(b)	any other documents the Public Guardian intends to rely on 
in support of the application.
(2)  Subject to subsection (3), the applicant shall serve the documents 
referred to in subsection (1) on the following persons at least 2 days 
before the hearing date:
	(a)	the adult who is the subject of the application;
	(b)	any guardian, trustee, agent or attorney of the adult;
	(c)	any other person who is likely to be directly affected by the 
order.
(3)  The applicant is not required to serve a person referred to in 
subsection (2)(b) or (c) if the Court permits the application to be made 
ex parte or makes an order dispensing with service on the person. 
Order to aid investigation
84(1)  An investigator may make application under section 76(6) of 
the Act by filing with the Court 
	(a)	a notice of application and hearing, in Form 39, and
	(b)	any other documents that the investigator intends to rely on 
in support of the application.
(2)  An application under subsection (1) must be made
	(a)	on 2 days' notice to the person in charge of the premises, or
	(b)	on notice to another person as directed or approved by the 
Court.
Review respecting specific decision making
85(1)  A person referred to in section 97(1) of the Act may make an 
application under that section by filing with the Court
	(a)	a notice of application and hearing, in Form 39, and
	(b)	any other documents the person intends to rely on in support 
of the application.
(2)  The applicant shall serve the documents referred to in subsection 
(1) at least 7 days before the hearing date on the following persons:
	(a)	the adult, for whom a specific decision maker may be or has 
been selected;
	(b)	if a specific decision maker has been selected, the specific 
decision maker;
	(c)	the 
	(i)	nearest relative of the adult other than the specific 
decision maker or applicant, or 
	(ii)	the Public Guardian if there is no nearest relative 
referred to in subclause (i);
	(d)	the Public Guardian if the specific decision maker was 
authorized by the Public Guardian to be the specific decision 
maker.
Access to financial information
86(1)  A capacity assessor may make an application under section 
103(3) of the Act by filing with the Court
	(a)	a notice of application and hearing, in Form 39, and
	(b)	any other documents that the capacity assessor intends to rely 
on in support of the application.
(2)  The applicant shall serve the documents referred to in subsection 
(1) at least one month before the hearing date on the following 
persons:
	(a)	the adult whose capacity is being assessed,
	(b)	any supporter, co-decision-maker, guardian, trustee, agent or 
attorney of the adult whose capacity is being assessed, and
	(c)	any other person who is likely to be directly affected by the 
order, including, without limitation,
	(i)	the person holding the financial information, and 
	(ii)	any person with an interest in property to which the 
information relates.
Order directing capacity assessment
87(1)  The Court may make an order under section 104 of the Act
	(a)	on its own motion, or
	(b)	on the application of
	(i)	the applicant in the proceeding, or
	(ii)	a person who is required under this Part to be served 
with or sent the notice of the application by which the 
proceeding was started.
(2)  A person referred to in subsection (1)(b) may apply for an order 
under section 104 of the Act by filing with the Court
	(a)	a notice of application and hearing, in Form 39,
	(b)	an affidavit of the applicant setting out the reasons why the 
applicant believes it would be in the best interests of the adult 
who is the subject of the proceeding for the Court to make 
the order including the reasons why the applicant believes
	(i)	the adult may not have capacity, and
	(ii)	the adult is at risk of suffering serious harm or financial 
loss if the order is not made, and
	(c)	any other documents that the applicant intends to rely on in 
support of the application. 
(3)  An applicant shall serve the documents referred to in subsection 
(2) on
	(a)	the adult who is the subject of the application, and
	(b)	any other persons as the court may direct or approve.
Appeal to Court of Appeal
Notice of appeal
88   A person appealing an order under the Act to the Court of Appeal 
shall serve the notice of appeal on
	(a)	the adult who is the subject of the order,
	(b)	any supporter, co-decision-maker, guardian or trustee for the 
adult who is the subject of the order,
	(c)	any attorney under an enduring power of attorney given by 
the adult who is the subject of the order,
	(d)	if the adult who is the subject of the order has made a 
personal directive, the agent, if any, designated in the 
personal directive,
	(e)	if the adult who is the subject of the order resides in a 
residential facility, the director of the residential facility, and
	(f)	any other persons a judge of the Court of Appeal may direct,
within the time prescribed by the Alberta Rules of Court for service of 
a notice of appeal in an appeal to the Court of Appeal.
Division 3 
General
Withdrawal of consent
89   The form for a withdrawal of the consent of an assisted person to 
a co-decision-making order is set out in Form 13.
Applicant's duty to obtain information
90   An applicant shall make reasonable efforts to obtain any 
information that is to be provided in an application to the Court under 
this Part.
Date of capacity assessment report
91   Unless an application contains a request for the Court to accept a 
capacity assessment report that was conducted earlier, a capacity 
assessment report submitted in respect of an application under this Part 
must be dated not more than 6 months before the date the application is 
started.
General provisions regarding service
92(1)  If a time is not specified for serving or sending a document 
under this Part, the document must be served or sent 10 days before the 
hearing date for the application in respect of which the document is 
served or sent.
(2)  An affidavit of service may be in Form 40.
Service in respect of person who has not attained age of majority
93   If the person who is the subject of an application for a 
co-decision-making, guardianship or trusteeship order or a review of 
any of those orders has not attained the age of majority, the documents 
that are required to be served on the person must also be served on the 
following:
	(a)	any person who is a guardian or trustee for the person under 
the Family Law Act, the Child, Youth and Family 
Enhancement Act or the Minors' Property Act;
	(b)	an agent under the Personal Directives Act who has been 
given authority as agent for the temporary care and education 
of the person.
Service on review officer
94   Where a document is to be served on a review officer under this 
Regulation, service may be effected by
	(a)	sending the document by recorded mail to the address 
designated by the Minister for the purposes of this section,
	(b)	leaving the document at an office designated by the Minister 
for the purposes of this section, or
	(c)	another method approved by the Minister.
Duplicate service not required
95   Nothing in this Regulation requires 
	(a)	an applicant, a review officer or other person to 
	(i)	serve a document on a person on whom the document 
has been served in another capacity, or
	(ii)	send a document to a person on whom the document has 
been served or to whom the document has been sent in 
another capacity;
	(b)	a review officer or other person to serve on or send to an 
applicant a document originated by the applicant.
Service or sending of orders
96   Except as otherwise specifically provided in this Regulation or as 
otherwise directed or approved by the Court, the applicant for an order 
under the Act shall,
	(a)	serve any order granted on the application on
	(i)	the adult who is the subject of the application, and
	(ii)	any other person who was served with notice of the 
application, 
		and
	(b)	send any order granted on the application to any person who 
was sent notice of the application in the same manner as the 
notice was sent.
Validity of forms and documents
97   A prescribed form or a document prepared in place of a prescribed 
form is not invalidated nor is there any contravention of this 
Regulation if there is a deviation from or an addition to or omission 
from the form or document that
	(a)	does not adversely affect the substance of the information 
required to be provided or that the Court requires to be 
provided, and
	(b)	is not intended to mislead.
Additional consents
98   Notwithstanding any other provision of this Regulation, a review 
officer may require a proposed co-decision-maker, guardian, alternate 
guardian, trustee or alternate trustee to sign any form of consent or 
authorization that is reasonably required to enable the review officer or 
a person acting on behalf of the review officer to obtain a credit report 
or criminal records check required under this Part.
Protection of sensitive information
99(1)  If a review officer is of the opinion that a personal reference, 
credit report or criminal records check contains information that should 
be brought to the attention of the Court, the review officer shall include 
a statement to that effect in the review officer's report and ask the 
Court for directions.
(2)  Where a review officer requests directions under subsection (1), 
the review officer shall recommend that the Court consider making an 
order under section 113(2)(c) of the Act in the event that the Court 
directs the review officer to file the personal references, credit report 
or criminal records check with the Court.
(3)  Except as may be directed by the Court under this section, the 
review officer shall not file with the Court a personal reference, credit 
report or criminal records check in respect of a proposed 
co-decision-maker, guardian, alternate guardian, trustee or alternate 
trustee that was provided to or obtained by the review officer.
Costs paid by Crown
100(1)   The Court of Queen's Bench or the Court of Appeal may 
order the costs of an application made under the Act to be paid by the 
Crown in right of Alberta only if
	(a)	the application specifically indicates that costs against the 
Crown will be sought, and
	(b)	the Court is satisfied that it would be a hardship to order the 
costs to be paid by the person making the application, the 
person in respect of whom the application is made or the 
estate of the person in respect of whom the application is 
made.
(2)  An order for costs of an application under the Act paid by the 
Crown in right of Alberta must not exceed the following amounts:
	(a)	$425 plus reasonable disbursements for
	(i)	an application for an order appointing a co-decision-
maker, guardian or trustee in respect of which a hearing 
is not held, or
	(ii)	an application for a review of an order referred to in 
subclause (i), in respect of which a hearing is not held;
	(b)	for an application other than an application referred to in 
clause (a), $500 plus reasonable disbursements.
Powers of Court
101(1)  In any matter not provided for in the Act or this Regulation, 
the Court may follow the Alberta Rules of Court and the procedures of 
the Court of Queen's Bench.
(2)   Subject to the Act and subsection (3) the Court may, on any 
application made under the Act,
	(a)	shorten the time for service of any document on any person,
	(b)	direct the manner of service, or approve the manner of 
service, of any document on any person,
	(c)	dispense with service on or the sending of any document to 
any person other than a review officer, or
	(d)	direct that any document be served on or sent to any person.
(3)  On an application for a review of a guardianship or trusteeship 
order, the Court may dispense with service on the represented person 
only if the Court is satisfied that notification of the application would 
be harmful to the represented person.
Part 3 
Expiry and Coming into Force
Expiry
102   For the purpose of ensuring that this Regulation is reviewed for 
ongoing relevancy and necessity, with the option that it may be 
repassed in its present or an amended form following a review, this 
Regulation expires on September 30, 2019.
Coming into force
103   This Regulation comes into force on the coming into force of the 
Adult Guardianship and Trusteeship Act.
Schedule 1
1   The compensation that is payable to a trustee or trustees under 
section 66(2) of the Act for a period is determined by the following 
formula:
A+B = C 
 
where
	A  	is 2.5% of the money received by the trustee or trustees on 
behalf of the represented adult during the period;
	B 	is 2.5% of the payments made by the trustee or trustees on 
behalf of the represented adult during the period;
	C  	is the compensation payable to the trustee or trustees.
2(1)  The amount determined in accordance with item 1 is the total 
compensation payable to the trustee or trustees.
(2)  If there is more than one trustee, the amount determined under 
item 1 shall be divided among the trustees
	(a)	equally,
	(b)	as agreed by the trustees, or
	(c)	as determined by the Court.
Form 1 
 
Application for Appointment of 
Co-decision-maker
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Application
Applicant Name


APPLICANT'S ADDRESS FOR SERVICE (Omit lawyer information if inapplicable)



Law Firm Name
Responsible Lawyer's Name
Lawyer's File Number



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail

1   Information About the Application and Applicant
1.1   This is an application to appoint a co-decision-maker for


Name of Adult

1.2   Are you proposing that your application proceed as a desk application or by 
hearing?
?
 
Desk 
You submit the application documents to a review officer. The 
review officer will serve or send notice of the application to 
everyone who is required to be served or notified and will file the 
application documents with the Court. A court hearing before a 
judge will be required only if someone requests a hearing or a 
judge directs a hearing.
?
 
Hearing
You begin by filing the application documents with the clerk of 
the Court and setting a date for a hearing before a judge. You must 
then serve or send notice of the application and hearing to the 
adult, the review officer, and various other persons. You will then 
need to complete and file affidavits of service and attend the 
hearing, either in person or by legal counsel.

1.3   Are you applying on your own behalf to appoint a co-decision-maker for 
yourself?
? 
Yes
Please skip Question 1.4.
? 
No

1.4   What is your relationship to the adult? I am the adult's:

? 
Parent
? 
Spouse
? 
Adult interdependent partner

? 
Child
? 
Brother/Sister
? 
Other (describe):


1.5   Provide your usual address and 
contact information, if different than your 
address for service
? 
Same as Address for Service 
OR



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail

2   Information About the Adult
2.1   What is the adult's name, date of birth and marital status?




Last Name
First Name
Middle Name
Other (maiden / nickname)



Marital 
Status
? 
Single
? 
Married
? 
Adult  Interdependent 
Partnership
? 
Separated
? 
Divorced
? 
Widowed

YYYY
MM
DD


Date of Birth



2.2   What is the adult's permanent address?



Name of Residential Facility 
(if any)
Street Address
Suite




City
Province
Postal Code
Telephone No.

2.3   What is the adult's present address, if different from 
permanent address?
? 
Same address



Name of Residential 
Facility (if any)
Street Address
Suite




City
Province
Postal Code
Telephone No.
3   Information About Current Decision-making Arrangements for the Adult
3.1   Does the adult already 
have a supporter under a 
supported decision-making 
authorization or a 
co-decision-maker, guardian, 
or trustee?
?  
No 
Review Date

?  
Supporter
YYYY
MM
DD

?  
Co-decision-maker




?  
Guardian




? 
Trustee




3.2   Provide the following information for each current supporter, 
co-decision-maker, guardian, alternate guardian, trustee, or alternate trustee:



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Person is a:
? 
Supporter
?
 
Guardian
?
 
Trustee

? 
Co-decision-maker
?
 
Alternate Guardian
?
 
Alternate Trustee



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Person is a:
? 
Supporter
?
 
Guardian
?
 
Trustee

? 
Co-decision-maker
?
 
Alternate Guardian
?
 
Alternate Trustee

3.3   Has the adult signed an enduring power of 
attorney? If yes, provide the following information for 
each attorney: 
? 
Yes
? 
No



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code

3.4   Does the adult have a personal directive?
? 
Yes
? 
No
If yes, has an agent been named under the personal 
directive?
? 
Yes
? 
No
If yes, provide the following information for the agent.



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Areas of agent's authority that may impact the application




Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Areas of agent's authority that may impact the application

4   Information About Family Members and Other Interested Persons
4.1   Provide the following information for each living family member of the adult 
who fits into any of the following categories and lives in Canada:
? Spouse 
? Parents
? Children 18 years of age or older
? Adult interdependent partner
? Brothers and sisters 18 years of age or 
older



Last Name
First Name
Family Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / 
Station)




City
Province
Postal Code




Last Name
First Name
Family Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / 
Station)




City
Province
Postal Code

4.2   If the adult is an Indian who is a member of a band and is ordinarily resident 
on a reserve, provide the following information: 
Name of Band




Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone
City
Province
Postal Code
Fax


E-mail
4.3   If there are any other interested persons who are 18 years age or older who 
you think should be given notice of this application, please provide their contact 
information and their relationship to the adult.



Last Name
First Name
Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / Station)




City
Province
Postal Code

5   Information about Proposed Co-decision-maker(s)
5.1   Provide the following information for each proposed co-decision-maker:



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code

6.1   For which of the following personal matters are you proposing that the adult 
be required to make decisions with a co-decision-maker? [Check all that are 
applicable]
?  
the adult's health care
? 
where, with whom and under what conditions the adult is to live, either 
permanently or temporarily
? 
the persons with whom the adult may associate
? 
the adult's participation in social activities
? 
the adult's participation in any educational, vocational or other training
? 
the adult's employment
? 
the carrying on of any legal proceeding that does not relate primarily to the 
financial matters of the adult
? 
any other personal matter the Court considers necessary, specifically:



6.2   If you are proposing the appointment of two or more decision-makers, 
indicate whether you are requesting the Court to authorize the co-decision-makers 
to act jointly, separately, or successively.
?   Jointly
?   Separately (describe below):
?   Successively (describe below):



6.3   Are you requesting the Court to specify in the co-decision-making order that a 
contract respecting a personal matter is voidable unless it is in writing and signed 
by the adult and the co-decision-maker?
?   Yes
?   No

6.4   Does the capacity assessment report indicate that the adult's capacity to make 
decisions in personal matters is likely to improve?
? 
Yes
? 
No
If yes, you must propose a review date below. If no, 
you may propose  a review date or request the Court not 
to require a review within a certain period.*
? 
I propose* that the Court require the order to be 
reviewed within

years.
? 
I propose* that the Court  not require the order to be reviewed within a 
certain period.
* Your affidavit must state why you believe your proposal regarding review of the 
order is in the best interest of the adult.
7   Other Documents Submitted with Application
7.1   Along with this application form, I am submitting the following application 
documents to be filed with the clerk of the Court (check all that apply):
? 
Affidavit of applicant
? 
Capacity assessment report dated *
? 
Consent of adult to appointment of co-decision-maker
? 
Consent to act of each proposed co-decision-maker
? 
Notice of Application and Hearing (if not proposing that application proceed 
as desk application)
*The capacity assessment report must be dated not more than 6 months before you 
start the application unless you are specifically requesting the Court to accept an 
older report. (You may make a request by completing 9.2 below.)

7.2   I am submitting or will submit the following documents to a review officer. I 
understand these documents will not be filed with the Court unless the Court 
subsequently directs the review officer to do so:
? 
2 personal references for each co-decision-maker
8   Request to Dispense with Service or Notice
8.1   Are you requesting the Court to dispense with the requirement to give notice 
of this application to a person (other than the adult) to whom notice must otherwise 
be given?
? 
No

? 
Yes
Give the following information for each person for whom you are 
asking the Court to dispense with notice. Your affidavit must state 
why you are requesting the Court to dispense with the requirement to 
give notice to the person.
Name of Person 
Person's Relationship to Adult


NOTE:   On a desk application the review officer will NOT send notice of the 
application to a person to whom you request the Court to dispense with notice. If you 
make such a request but the Court decides not to dispense with notice, a decision on 
your application will be delayed until the person is notified and given an opportunity to 
respond.
9   Costs and Other Matters
9.1   How or by whom do you request all or part of the costs (i.e. legal fees, if 
applicable, and disbursements) of the application to be paid?
? 
I am asking the Court to order that my lawyer's fees for this application
? 
in the amount of
$

? 
in an amount to be taxed
 
plus reasonable disbursements, be paid by or from the property of the adult.
? 
I am asking the Court to order that the reasonable disbursements only be 
paid by or from the property of the adult.
? 
I am asking the Court to order that the costs be paid by the Crown and have 
provided supporting information in my affidavit.
? 
I am not asking the Court to make an order regarding costs. I will pay the 
costs myself.
? 
Other:


9.2   Are you requesting the Court to give any direction, approval or dispensation 
not already described in this application?
?  
No

? 
Yes
Describe the requested direction, approval or dispensation.

Form 2 
 
Affidavit of Applicant 
Application to Appoint Co-decision-maker
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Affidavit of Applicant

The contents of this affidavit must be adjusted as necessary to ensure that your 
affidavit accurately reflects the circumstances of your application.

I, 

of

,

Name

Address
having personal knowledge of the facts and matters referred to in this affidavit 
except where stated to be based on information and belief, swear or affirm as 
follows:
1   I make this affidavit in support of my application to appoint a co-decision-maker 
for  < name of adult > who is referred to in this affidavit as "the adult".
2   I have personally completed or carefully read the application form and all other 
forms and documents set out in item 7 of the application form, and to the best of my 
knowledge the information in them is accurate and complete.
3   I believe the adult's capacity to make decisions about the personal matters for 
which I am requesting the Court to appoint a co-decision-making order is 
significantly impaired, but that the adult would have the capacity to make such 
decisions if provided with appropriate guidance and support. This belief is based on 
my review of the capacity assessment report.
4   The following alternative measures that are less intrusive and less restrictive than 
co-decision-making have been implemented and have not been effective in meeting 
the adult's needs for the following reason(s): 

5   The following alternative measures that are less intrusive and less restrictive than 
co-decision-making have been considered and are not likely to be effective to meet 
the needs of the adult for the following reasons: 


Note: To make a co-decision-making order the court must be satisfied either that 
alternative measures have been implemented and have not been effective or have 
been considered and are unlikely to be effective.>
6   In addition to information set out elsewhere in this affidavit, I have the following 
reasons for believing it would be in the adult's best interests for the Court to make the 
co-decision-making order requested in my application:

7   I believe that each proposed co-decision-maker will act in the best interests of the 
adult and is suitable as a co-decision-maker for the adult. This belief is based on the 
following information:

8   I believe that my proposal with respect to periodic review of the 
co-decision-making order by the Court, as set out in item 6.3 of the application form 
is in the best interests of the adult for the following reasons:
 for the following reason:


NOTE: The remaining paragraphs should only be completed if you are requesting 
that the Crown in right of Alberta pay the costs of the application.
10   To the best of my information and belief, the adult's financial resources and 
obligations are as follows:
Estimated monthly income from all sources
$
Estimated value of cash and liquid assets, including bank accounts, 
GICs, investments and all assets that can readily be converted into 
cash
$
Estimated value of real estate and personal property not mentioned 
above
$
Estimated total debts
$
11   It would be a hardship for me, as applicant, to pay the costs of this application 
personally.
12   It would be a hardship for the adult to pay the costs of this application or for the 
costs of the application to be paid out of the adult's property.
Sworn or affirmed before me at

)

Alberta, on

)


)

A Commissioner for Oaths in the Province of Alberta
)
SIGNATURE

)

PRINT NAME AND EXPIRY/LAWYER/ STUDENT-AT-LAW
)
NAME
Form 3 
 
Notice of Application - 
Appointment of Co-decision-maker
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Notice of Application and Hearing
Applicant 


1   An application has been commenced by

to appoint one or 
more persons as co-decision-maker for 

("adult") on the
grounds that the adult's capacity to make decisions about personal matters is 
significantly impaired, and the  adult would have the capacity to make decisions if 
provided with appropriate guidance and support.

2   The application requests the Court to appoint the following person(s) 
co-decision-maker for the adult:

Name of Proposed Co-decision-maker
Relationship to Adult









3   The application requests that the Court make a co-decision-making order that 
would require the adult to make decisions regarding the following matters with a 
co-decision-maker:
? 
the adult's health care
? 
where, with whom and under what conditions the adult is to live, either 
permanently or temporarily
? 
the persons with whom the adult may associate
? 
the adult's participation in social activities
? 
the adult's participation in any educational, vocational or other training
? 
the adult's employment
? 
the carrying on of any legal proceeding that does not relate primarily to the 
financial matters of the adult
? 
any other personal matter the Court considers necessary, specifically:





4   The adult has consented to the Court making the co-decision-making order.

5   The Court may consider the application and grant an order without holding a 
hearing unless an interested person requests a hearing in accordance with the 
regulations.

6   You have received a Request for Hearing form along with this notice. You 
may request the Court to hold a hearing regarding the application by completing 
the Request for Hearing and 
submitting it to a review officer on or before this date:




7   The following documents have been submitted in support of this application:
? 
Application form
? 
Consent to act 
? 
Affidavit of applicant
? 
Capacity assessment report

To make enquiries about the application, you may contact the review officer by 
telephone at

The review officer's file number is



Phone Number

File Number

Form 4 
 
Notice of Application and Hearing 
Appointment of Co-decision-maker
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Notice of Application and Hearing
Applicant 


1   An application has been commenced by

to appoint one or 
more persons as co-decision-maker for 

("adult") on the
grounds that the adult's capacity to make decisions about personal matters is 
significantly impaired, and the  adult would have the capacity to make decisions if 
provided with appropriate guidance and support.

2   The application will be heard by a judge of the Court of Queen's Bench of 
Alberta as follows:
Date:


Time:


Place:


3   The application requests the Court to appoint the following person(s) 
co-decision-maker for the adult:
    Name of Proposed Co-decision-maker
Relationship to Adult









4   The application requests that the Court make a co-decision-making order that 
would require the adult to make decisions regarding the following matters with a 
co-decision-maker:
? 
the adult's health care
? 
where, with whom and under what conditions the adult is to live, either 
permanently or temporarily
? 
the persons with whom the adult may associate
? 
the adult's participation in social activities
? 
the adult's participation in any educational, vocational or other training
? 
the adult's employment
? 
the carrying on of any legal proceeding that does not relate primarily to the 
financial matters of the adult
? 
any other personal matter the Court considers necessary, specifically:





5   The adult has consented to the Court making the co-decision-making order.
6   You may obtain any or all of the following documents filed in support of the 
application by requesting them from the applicant as soon as possible after you 
receive this notice.
? 
Application form
? 
Consent to act as co-decision-maker
? 
Affidavit of applicant
? 
Capacity assessment report
? 
Guardianship plan
? 

7   If you consent to or do not oppose the application, you may:
?  Do nothing further; or
?  Attend at the hearing and indicate your position to the court.
If you oppose any part of the application, you should come to the hearing and tell 
the judge what part of the application you are opposed to, and why you are 
opposed. If you do not attend either in person or by your lawyer before the Court at 
the time and place shown above, the Court may give the applicant(s) what they 
want in your absence.

APPLICANT'S ADDRESS FOR SERVICE (Omit lawyer information if inapplicable)



Law Firm Name
Responsible Lawyer's Name
Lawyer's File Number



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail

Form 5 
 
Order 
Appointment of Co-decision-maker
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Order
Applicant 

I consent to the following order:	_______(signature of adult)______
Considered by the Honourable Justice 

on

ORDER

Include only those provisions that are appropriate to the application presented to 
the Court. Standard provisions should be modified as appropriate to the context.
The Court:
	?	has reviewed the consent of the adult and other written material filed in this 
application;
	?	has considered the application in the absence of the applicant and any other 
person, being satisfied that
	?	no person entitled to do so has requested a hearing in accordance with the 
regulations, and
	?	it is unnecessary to hold a hearing,
	?	has determined that
	?	the adult is 18 years of age or older;
	?	the adult will attain the age of 18 within 12 months of the date of the 
application;
	?	the conditions for appointment of a co-decision-maker are satisfied, 
namely,
	?	the adult's capacity to make decisions about the personal matters 
referred to in this order is significantly impaired;
	?	the adult would have the capacity to make decisions about the personal 
matters referred to in this order if provided with appropriate guidance 
and support;
	?	less intrusive and less restrictive alternative measures than a 
co-decision-making order, including a supported decision-making 
authorization, have been considered or have been implemented and 
would not likely be or have not been effective to meet the needs of the 
adult;
	?	it is in the adult's best interests for a co-decision-maker to be appointed.
And the Court Orders:
1   Appointment of Co-decision-maker
[Include in all cases]
1.1 

is (are) appointed  
co-decision-makers of   
< Name of adult >
[Include in all cases]
1.2   The adult is required to make decisions with respect to the following personal 
matters with the co-decision-maker:
? 
the adult's health care;
? 
where, with whom and under what conditions the adult is to live, either 
permanently or temporarily;
? 
with whom the adult may associate;
? 
the adult's participation in social activities;
? 
the adult's participation in any educational, vocational or other training;
? 
the adult's employment;
? 
the carrying on of any legal proceeding that does not relate primarily to the 
financial matters of the adult;
? 
the following personal matter(s) of the adult that the Court considers 
necessary, namely:


[Include only if requested in application]
1.3   A contract made by the adult after the date of this order with respect to the 
above personal matters is voidable unless it is in writing and signed by the adult and 
the co-decision-maker.
[Include only if requested in application]
1.4   The co-decision-makers must act jointly with respect to the following 
personal matters of the adult: 


[Include only if requested in application]
1.5   The co-decision-makers must act successively in the following manner 

with respect to the following personal matters of the adult:


[Include in all cases]
1.6   This order is subject to the following conditions, limits, or requirements:

< reserved for conditions, limits or requirements considered 
appropriate by Court >


[Include if the adult is subject to a guardianship order that is to be terminated]
1.7   The guardianship order dated

is terminated.
[Include in all cases]
1.8        must apply for a review of this 
co-decision-making order 

? 
within

years of the date of this order, OR

? 
as circumstances require (no fixed review date).
AND in any event

? if there has been a significant change in the needs, circumstances or capacity 
of the adult that the co-decision-maker considers would make a variation or 
termination of the order in the adult's best interests, OR
? if there has been a change in circumstances that affects the 
co-decision-maker's ability to exercise the authority or carry out the duties and 
responsibilities of a co-decision-maker or suitability to be a co-decision-maker 
for the adult.
2   Costs of Application
2.1   The following order is made regarding costs (legal fees and disbursements) of 
this application:
? 
Legal fees for this application

? 
in the amount of 
$


? 
to be taxed

plus reasonable disbursements shall be 
paid by

? 
Reasonable disbursements only shall be 
paid by 

? 
No order is made regarding payment of legal fees or disbursements.
3   Other Matters
3.1   All requirements of the Act and regulations regarding service or sending of 
notice of this application are deemed to have been satisfied including requirements 
as to:

? the persons to be notified of this application;
? the documents to be served or sent to such persons; 
? the manner of and time for serving or sending documents
? 
Notice of this application to the following person is dispensed with:

NAME
RELATIONSHIP







3.2   The following direction is given regarding service of this order:

? 
Except as otherwise provided below, a copy of this order must be sent by 
ordinary mail to the adult, the review officer, and every other person who 
was notified of this application.

? 
A copy of this order must be served on


by the following method of service:


Justice of the Court of Queen's Bench of  Alberta

Entered at

, Alberta

Filed by

City / Town / Municipality



on





Date


Address



Clerk of the Court of Queen's Bench of Alberta


Phone Number

Form 6  
 
Application  
Review of Co-decision-making Order
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Application
Applicant 


APPLICANT'S ADDRESS FOR SERVICE (Omit lawyer information if inapplicable)



Law Firm Name
Responsible Lawyer's Name
Lawyer's File Number



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail

1   Information About the Application
1.1   This application is for review of a co-decision-making order granted on

and most recently reviewed (if ever) on




Date of Prior Review (if any)


1.2   Are you proposing that your application proceed as a desk application or by 
hearing?

? 
Desk
You submit the application documents to a review officer. The 
review officer will serve or send notice of the application to 
everyone who is required to be served or notified and will file the 
application documents with the Court. A court hearing before a 
judge will be required only if someone requests a hearing or a 
judge directs a hearing.
? 
Hearing
You begin by filing the application documents with the clerk of 
the Court and setting a date for a hearing before a judge. You 
must then serve or send notice of the application and hearing to 
the adult, the review officer, and various other persons. You will 
then need to complete and file affidavits of service and attend the 
hearing, either in person or by legal counsel.

2.1   What is the adult's name, date of birth and marital status?




Last Name
First Name
Middle Name
Other (maiden / nickname)



Marital 
Status
? 
Single
? 
Married
? 
Adult  Interdependent 
Partnership
? 
Separated
? 
Divorced
? 
Widowed

YYYY
MM
DD


Date of Birth



2.2   What is the adult's permanent address?



Name of Residential Facility 
(if any)
Street Address
Suite




City
Province
Postal Code
Telephone No.

2.3   What is the adult's present address, if different from 
permanent address?
? 
Same address



Name of Residential 
Facility (if any)
Street Address
Suite




City
Province
Postal Code
Telephone No.
3   Information About Co-decision-makers and Agents
3.1   Provide the following information for each person who is CURRENTLY a 
co-decision-maker of the adult or who is PROPOSED for any of these positions. 
Indicate both the current and proposed position, if any, for each person.



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Who is
? 
currently a co-decision-maker  and / or

? 
proposed as a co-decision-maker



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Who is
? 
currently a co-decision-maker  and / or

? 
proposed as a co-decision-maker

3.4   Does the adult have a personal directive?
? 
Yes
? 
No
If yes, has an agent been named under the personal directive?
? 
Yes
? 
No
If yes, provide the following information for the agent



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Areas of agent's authority that may impact the application




Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Areas of agent's authority that may impact the application

4   Information About Family Members and Other Interested Persons
4.1   Provide the following information for each living family member of the adult 
who fits into any of the following categories and lives in Canada:
? Spouse 
? Parents
? Children 18 years of age or older
? Adult interdependent partner
? Brothers and sisters 18 years of age or 
older



Last Name
First Name
Family Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / Station)




City
Province
Postal Code




Last Name
First Name
Family Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / Station)




City
Province
Postal Code


4.2   If the adult is an Indian who is a member of a band and is ordinarily resident on 
a reserve, provide the following information:

Name of First Nation Band




Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone
City
Province
Postal Code
Fax


E-mail

4.3   If there are any other interested persons 18 years of age or older who you 
think should be given notice of this application, please provide their contact 
information and their relationship to the adult.




Last Name
First Name
Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / Station)




City
Province
Postal Code

5   Information About Order Requested on Review
5.1   What are you requesting the Court to do (check all that apply)?
? 
Continue the co-decision-making order

? 
as is without any amendment (except for the required review date, if 
any)

? 
with amendments as requested
? 
Terminate the co-decision-making order 
? 
Replace the co-decision-making order*
? 
Discharge the following person(s) as 
co-decision-maker





5.2   Unless you are requesting the Court to terminate the co-decision-making 
order, indicate the personal matters for which the co-decision-maker 
CURRENTLY must make decisions with a co-decision-maker and the personal 
matters for which you are PROPOSING the adult be required to make decisions 
with a co-decision-maker?    [Check all that are applicable]
Now
Proposed

? 
? 
the adult's health care
? 
? 
where, with whom and under what conditions the adult is to 
live, either permanently or temporarily
? 
? 
the persons with whom the adult may associate
? 
? 
the adult's participation in social activities
? 
? 
the adult's participation in any educational, vocational or other 
training
? 
? 
the adult's employment
? 
? 
the carrying on of any legal proceeding that does not relate 
primarily to the financial matters of the adult
? 
? 
any other personal matter the Court considers necessary, 
specifically:





5.3   If you are proposing the appointment of two or more decision-makers, 
indicate whether you are requesting the Court to authorize the co-decision-makers 
to act jointly, separately, or successively.
?   Jointly
?   Separately (describe below):
?   Successively (describe below):



5.4   Are you requesting the Court to specify in the co-decision-making order that a 
contract respecting a personal matter is voidable unless it is in writing and signed 
by the adult and the co-decision-maker?
?   Yes
?   No

5.5   Does the capacity assessment report indicate that the adult's capacity to make 
decisions in personal matters is likely to improve?
? 
Yes
? 
No
If yes, you must propose a review date below. If no, 
you may propose  a review date or request the Court not 
to require a review within a certain period.*
? 
I propose* that the Court require the co-decision-making 
order to be reviewed within 

years.
? 
I propose* that the Court not require the order to be reviewed within a certain 
period.


* Your affidavit must state why you believe your proposal is in the best interest of the adult.
6   Other Documents Submitted with Application
6.1   Along with this application form, I am submitting the following application 
documents to be filed with the clerk of the Court (check all that apply):
? 
Affidavit of applicant
? 
Capacity assessment report dated *
? 
Consent to act of each proposed co-decision-maker
? 
Notice of application and hearing (if not proposing that application proceed 
as desk application)
* The capacity assessment report must be dated within 6 months of when you start 
the application unless you are specifically requesting the Court to accept an older 
report. (You may make a request by completing 8.2 below.)

6.2   I am submitting or will submit the following documents to a review officer for 
each proposed co-decision-maker who is not already a co-decision-maker. I 
understand these documents will not be filed with the Court unless the Court 
subsequently directs the review officer to do so:
? 
2 personal references for each co-decision-maker
7   Request to Dispense with Notice
7.1   Are you requesting the Court to dispense with the requirement to give notice 
of this application to a person (other than the adult) to whom notice must otherwise 
be given?
? 
No

? 
Yes
Give the following information for each person for whom you are 
asking the Court to dispense with notice. Your affidavit must state 
why you are requesting the Court to dispense with the requirement to 
give notice to the person.
Name of Person 
Person's Relationship to Adult





NOTE:   On a desk application the review officer will NOT send notice of the application to a 
person to whom you request the Court to dispense with notice. If you make such a request but the 
Court decides not to dispense with notice, a decision on your application will be delayed until the 
person is notified and given an opportunity to respond.
8   Costs and Other Matters  
8.1   How or by whom do you request all or part of the costs (i.e. legal fees, if 
applicable, and disbursements) of the application to be paid?
? 
I am asking the Court to order that my lawyer's fees for this application
? 
in the amount of
$

? 
in an amount to be taxed
 
plus reasonable disbursements, be paid by or from the property of the adult.
? 
I am asking the Court to order that the reasonable disbursements only be 
paid by or from the property of the adult.
? 
I am asking the Court to order that the costs be paid by the Crown and have 
provided supporting information in my affidavit.
? 
I am not asking the Court to make an order regarding costs. I will pay the 
costs myself.
? 
Other:


8.2   Are you requesting the Court to give any direction, approval or dispensation 
not already described in this application?
?  
No

? 
Yes
Describe the requested direction, approval or dispensation.




Applicant's Signature or Signature of Lawyer on behalf of Applicant
Date
Form 7  
 
Affidavit of Applicant  
Review of Co-decision-making Order
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Affidavit of Applicant

The contents of this affidavit must be adjusted as necessary to ensure that your 
affidavit accurately reflects the circumstances of your application.

I, 

of

,

Name

Address
having personal knowledge of the facts and matters referred to in this affidavit 
except where stated to be based on information and belief, swear or affirm as 
follows:
1   I am a co-decision-maker for  (the "adult").
2   I make this affidavit in support of an application for review of the 
co-decision-making order.
3   I have personally completed or carefully read the application form and all other 
forms and documents submitted in support of my application, as set out in item 6 of 
the application form, and to the best of my knowledge the information in them is 
accurate and complete.
4   I believe the adult's capacity to make decisions about the personal matters for 
which I am requesting the Court to continue the co-decision-making order is 
significantly impaired, but that the adult would have the capacity to make such 
decisions if provided with appropriate guidance and support. This belief is based on 
my review of the capacity assessment report.
5   I believe that less intrusive and less restrictive alternative measures than a 
co-decision-making order would not be effective in meeting the adult's needs, for the 
following reasons:

6   In addition to information set out elsewhere in this affidavit, I have the following 
reasons for believing it would be in the adult's best interests for the Court to continue 
the co-decision-making order with the amendments, if any, requested in my 
application: 

7   I believe that each proposed co-decision-maker will act in the best interests of the 
adult and is suitable as a co-decision-maker for the adult. This belief is based on the 
following information:

8   I believe that my proposal with respect to periodic review of the 
co-decision-making order by the Court, as set out in item 5.5 of the application form, 
is in the best interests of the adult for the following reasons:
 for the following reason:
.

The remaining paragraphs should only be completed if you are requesting that the 
Crown in right of Alberta pay the costs of the application.
10   To the best of my information and belief, the adult's financial resources and 
obligations are as follows:
Estimated monthly income from all sources
$
Estimated value of cash and liquid assets, including bank accounts, 
GICs, investments and all assets that can readily be converted into 
cash
$
Estimated value of real estate and personal property not mentioned 
above
$
Estimated total debts
$
11   It would be a hardship for me, as applicant, to pay the costs of this application 
personally.
12   It would be a hardship for the adult to pay the costs of this application or for the 
costs of the application to be paid out of the adult's property.
Sworn or affirmed before me at

)

Alberta, on

)


)

A Commissioner for Oaths in the Province of Alberta
)
SIGNATURE

)

PRINT NAME AND EXPIRY/LAWYER/ STUDENT-AT-LAW
)
NAME
Form 8  
 
Notice of Application  
Review of Co-decision-making Order
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Notice of Application
Applicant 


1   An application has been commenced by the applicant for review of a 
co-decision-making order for the adult.

2   The application requests the Court to appoint or continue the appointment of  
the following person(s) as a co-decision-maker for the adult:

Name of Proposed Co-decision-maker
Relationship to Adult










3   The application requests the Court to do the following on reviewing the 
co-decision-making order:
? 
Continue the co-decision-making order

? 
as is without any amendment (except for the required review date, if 
any)

? 
with amendments as requested
? 
Replace the current co-decision-making order with a new co-decision-making order
? 
Terminate the co-decision-making order 
? 
Discharge the following person(s) as co-decision-maker


4   The following are the personal matters for which the adult CURRENTLY must 
make decisions with a co-decision-maker and the personal matters for which the 
applicant is PROPOSING the adult be required to make decisions with a 
co-decision-maker after the order is reviewed:
Now
Proposed

? 
? 
the adult's health care
? 
? 
where, with whom and under what conditions the adult is to 
live, either permanently or temporarily
? 
? 
the persons with whom the adult may associate
? 
? 
the adult's participation in social activities
? 
? 
the adult's participation in any educational, vocational or other 
training
? 
? 
the adult's employment
? 
? 
the carrying on of any legal proceeding that does not relate 
primarily to the financial matters of the adult
? 
? 
any other personal matter the Court considers necessary, 
specifically:





5   The Court may consider the application and grant an order without holding a 
hearing unless an interested person requests a hearing in accordance with the 
regulations. 

6   You have received a Request for Hearing form along with this notice. You 
may request the Court to hold a hearing regarding the application by completing 
the Request for Hearing and 
returning it to a review officer on or before 
this date:




7   The following documents have been submitted in support of this application:
? 
Application form
? 
Consent to act as co-decision-maker
? 
Affidavit of applicant
? 
Capacity assessment report
? 
Consent of adult



To make enquiries about the application, you may contact the review officer by telephone at


The review officer's file number is



Phone Number

File Number

Form 9  
 
Notice of Application and Hearing 
Review of Co-decision-making Order
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Notice of Application and Hearing
Applicant 


1   An application has been commenced by the applicant for review of a 
co-decision-making order for the adult.

2   The application will be heard by a judge of the Court of Queen's Bench of 
Alberta as follows:
Date:


Time:


Place:




3   The application requests the Court to appoint or continue the appointment of  
the following person(s) co-decision-maker for the adult:

Name of Proposed Co-decision-maker
Relationship to Adult










4   The application requests the Court to do the following on reviewing the 
co-decision-making order:
? 
Continue the co-decision-making order

? 
as is without any amendment (except for the required review date, if 
any)

? 
with amendments as requested
? 
Replace the current co-decision-making order with a new co-decision-making 
order
? 
Terminate the co-decision-making order 
? 
Discharge the following person(s) as co-decision-maker


5   The following are the personal matters for which the adult CURRENTLY must 
make decisions with a co-decision-maker and the personal matters for which the 
applicant is PROPOSING the adult be required to make decisions with a 
co-decision-maker after the order is reviewed.
Now
Proposed

? 
? 
the adult's health care
? 
? 
where, with whom and under what conditions the adult is to 
live, either permanently or temporarily
? 
? 
the persons with whom the adult may associate
? 
? 
the adult's participation in social activities
? 
? 
the adult's participation in any educational, vocational or other 
training
? 
? 
the adult's employment
? 
? 
the carrying on of any legal proceeding that does not relate 
primarily to the financial matters of the adult
? 
? 
any other personal matter the Court considers necessary, 
specifically:





6   You may obtain any or all of the following documents filed in support of the 
application by requesting them from the applicant as soon as possible after you 
receive this notice:
? 
Application form
? 
Consent to act of co-decision-maker
? 
Affidavit of applicant
? 
Capacity assessment report
? 
Guardianship plan
? 


7   If you consent to or do not oppose the application, you may:
?  Do nothing further, or
?  Attend at the hearing and indicate your position to the court.
If you oppose any part of the application, you should come to the hearing and tell 
the judge what part of the application you are opposed to, and why you are 
opposed. If you do not attend either in person or by your lawyer before the Court at 
the time and place shown above, the Court may give the applicant(s) what they 
want in your absence.

APPLICANT'S ADDRESS FOR SERVICE (Omit lawyer information if inapplicable)



Law Firm Name
Responsible Lawyer's Name
Lawyer's File Number



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail

Form 10 
 
Order 
Review of Co-decision-making Order

Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Order
Name of Applicant(s)


Considered by the Honourable Justice 

on

ORDER

Include only those provisions that are appropriate to the application presented to 
the Court. Standard provisions should be modified as appropriate to the context.
The Court:
	?	has reviewed the consent of the adult and other written material filed in this 
application;
	?	has considered the application in the absence of the applicant and any other 
person, being satisfied that
	?	no person entitled to do so has requested a hearing in accordance with the 
regulations, and
	?	it is unnecessary to hold a hearing;
	?	has determined that
	?	the adult is 18 years of age or over;
	?	the adult will attain the age of 18 within 12 months of the date of this 
application:
	?	the adult's capacity to make decisions about the personal matters referred to 
in this order is significantly impaired;
	?	the adult would have the capacity to make decisions about the personal 
matters referred to in this order if provided with appropriate guidance and 
support;
	?	less intrusive and less restrictive alternative measures than a 
co-decision-making order, including a supported decision-making 
authorization, have been considered or have been implemented and would 
not likely be or have not been effective to meet the needs of the adult;
	?	it is in the adult's best interests for a co-decision-maker to be appointed;
	?	alternative for review of co-decision-making order that is to be terminated: 
the adult's capacity to make decisions about all the matters in respect of 
which the co-decision-making order was made is no longer significantly 
impaired; 
And the Court Orders:
[Include in all cases]
1.1 

is (are) appointed  
co-decision-makers of   
< Name of adult >
[Include in all cases unless application requests termination of co-decision-maker order]
2   The adult is required to make decisions with respect to the following personal 
matters with the co-decision-maker:
? 
the adult's health care;
? 
where, with whom and under what conditions the adult is to live, either 
permanently or temporarily;
? 
with whom the adult may associate;
? 
the adult's participation in social activities;
? 
the adult's participation in any educational, vocational or other training;
? 
the adult's employment;
? 
the carrying on of any legal proceeding that does not relate primarily to the 
financial matters of the adult;
? 
the following personal matter(s) of the adult that the Court considers 
necessary, namely:


[Include only if requested in application]
2.1   The co-decision-making order is terminated. 
[Include only if requested in application]
2.2 < Name of co-decision-maker to be discharged>    
       Is discharged as co-decision-maker of the adult.
[Include only if requested in application]
2.3   A contract made by the adult after the date of this order with respect to the 
above personal matters is voidable unless it is in writing and signed by the adult and 
the co-decision-maker.
[Include only if requested in application]
2.4   The co-decision-makers must act jointly with respect to the following 
personal matters of the adult: 


[Include only if requested in application]
2.5   The co-decision-makers must act successively in the following manner 

with respect to the following personal matters of the adult:


[Include in all cases]
2.6   This order is subject to the following conditions, limits, or requirements:

< reserved for conditions, limits or requirements considered appropriate by Court >



2.7            must apply for a review of this 
co-decision-making order 

? 
within

years of the date of this order, OR

? 
as circumstances require (no fixed review date).

AND in any event

?  if there has been a significant change in the needs, circumstances or 
capacity of the represented person that the co-decision-maker considers would 
make a variation or termination of the order in the adult's best interests, OR
?  if there has been a change in circumstances that affects the 
co-decision-maker's ability to exercise the authority or carry out the duties 
and responsibilities of co-decision-maker or suitability to be a 
co-decision-maker for the adult.
3   Costs of Application
3.1   The following order is made regarding costs (legal fees and disbursements) of 
this application:
? 
Legal fees for this application

? 
in the amount of 
$


? 
to be taxed

plus reasonable disbursements shall be paid 
by

? 
Reasonable disbursements only shall be 
paid by 

? 
No order is made regarding payment of legal fees or disbursements.
4   Other Matters
4.1   All requirements of the Act and regulations regarding service or sending of 
notice of this application are deemed to have been satisfied including requirements 
as to:
  ? the persons to be notified of this application;
  ? the documents to be served or sent to such persons; 
  ? the manner of and time for serving or sending documents.
? 
Notice of this application to the following person is dispensed with:

NAME
RELATIONSHIP







4.2   The following direction is given regarding service of this order:
? 
Except as otherwise provided below, a copy of this order must be sent by 
ordinary mail to the adult, the review officer, and every other person who 
was notified of this application.
? 
A copy of this order must be served on


by the following method of service:


Justice of the Court of Queen's Bench of  Alberta

Entered at

, Alberta

Filed by

City / Town / Municipality



on





Date


Address



Clerk of the Court of Queen's Bench of Alberta


Phone Number
Form 11  
 
Consent of 
Proposed Assisted Adult
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Consent of Proposed Assisted Adult
Applicant 


1   My name is 



2   I understand that an application is to be made to the Court to appoint the 
following person or persons as co-decision-maker(s) for me:




3   I understand that if the Court makes a co-decision-making order, I will have to 
make decisions in the following personal matters with a co-decision-maker. [Check 
all that are applicable, as set out in the application form.]
? 
my health care
? 
where, with whom and under what conditions I am to live, either 
permanently or temporarily
? 
the persons with whom I may associate
? 
my participation in social activities
? 
my participation in any educational, vocational or other training
? 
my employment
? 
the carrying on of any legal proceeding that does not relate primarily to my 
financial matters 
? 
any other personal matter the Court considers necessary, specifically:



4   I consent to the Court making an order appointing the person or persons named 
above as my co-decision-maker(s).

5   I understand that if the Court makes a co-decision-making order, I may 
terminate the order by signing a withdrawal of consent form and filing it with the 
clerk of the Court.



Signature 
Signature of Witness 


Date Signed
Full Name (Printed) of Witness

Form 12  
 
Consent of Proposed 
Co-decision-maker
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Consent of Proposed Co-decision-maker
Applicant Name


1   I,
< name of proposed 
co-decision-maker>,  
consent to act as 
co-decision-maker for
< name of 
adult>
("adult")
.
2   I am 18 years of age or older.
3   I believe that I am a suitable person to be co-decision-maker for the adult.
4
?
 
I am unaware of any conflict of interest that exists or could potentially 
come into existence if I am appointed co-decision-maker
OR

?
 
Details of any potential conflict of interest are set out below, together with 
an explanation of why I believe it will not prevent me from acting in the 
best interests of the adult.


5   I understand that as co-decision-maker I
?	must exercise my authority in the adult's best interests, diligently, and in good faith,
?	must assist the adult to access, collect or obtain from any person the 
information relevant to the personal matters with respect to which the assisted adult 
is required to make decisions with me,
?	must discuss the relevant information with the adult and assist the adult in 
making those decisions, and
?	must not refuse to sign a document respecting a personal matter in respect of 
which the adult is required to make a decision with me if a reasonable person could 
have made the decision and the decision is not likely to result in harm to the 
assisted adult.
6   I authorize a review officer or a person acting on behalf of a review officer to 
obtain a criminal records check if required by the review officer for the purpose of 
preparing a report to the Court regarding my suitability to be co-decision-maker for 
the adult.

Signature of Proposed Co-decision-maker
Signature of Witness 

Date Signed
Full Name (Printed) of Witness
Form 13  
 
Withdrawal of Consent of Assisted Person
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Withdrawal of Consent of Assisted Person
Applicant 


1   My name is 


2   The Court with my consent made a co-decision-making order appointing the 
following person or persons as co-decision-maker(s) for me:




3   I understand that I may withdraw my consent to the co-decision-making order 
by signing this form and filing it with the clerk of the Court of Queen's Bench.
5   I understand that I must serve a filed copy of this withdrawal of consent on each 
co-decision-maker named in the co-decision-making order.
6   I understand that if I withdraw my consent, the co-decision-making order will 
terminate and I will no longer have a co-decision-maker.
5   I understand that if I withdraw my consent, the clerk of the Court must send a 
filed copy of my withdrawal of consent to the Public Guardian.
7   I withdraw my consent to the co-decision-making order.



Signature 
Signature of Witness 


Date Signed
Full Name (Printed) of Witness
Form 14  
 
Application for Appointment of 
Guardian, Trustee or Both
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Application
Applicant Name


APPLICANT'S ADDRESS FOR SERVICE (Omit lawyer information if inapplicable)



Law Firm Name
Responsible Lawyer's Name
Lawyer's File Number



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail

1   Information About the Application and Applicant
1.1   ?    For what type(s) of order are you applying? (check either box or both, as 
applicable)
?
Appointment of guardian(s) for the adult
?
Appointment of trustee(s) for the adult

1.2   Are you proposing that your application proceed as a desk application or by 
hearing?

? 
Desk
You submit the application documents to a review officer. The 
review officer will serve or send notice of the application to 
everyone who is required to be served or notified and will file the 
application documents with the Court. A court hearing before a 
judge will be required only if someone requests a hearing or a 
judge directs a hearing.
? 
Hearing
You begin by filing the application documents with the clerk of 
the Court and setting a date for a hearing before a judge. You 
must then serve or send notice of the application and hearing to 
the adult, the review officer, and various other persons. You will 
then need to complete and file affidavits of service and attend the 
hearing, either in person or by legal counsel.

1.3   What is your relationship to the adult? I am the adult's:

? 
Parent
? 
Spouse
? 
Adult interdependent 
partner

? 
Child
? 
Brother / Sister
? 
Other (describe):


1.4   Provide your usual address and 
contact information, if different than your 
address for service
? 
Same as Address for Service 
OR



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail

2   Information About the Adult
2.1   What is the adult's name, date of birth and marital status?




Last Name
First Name
Middle Name
Other (maiden / nickname)



Marital 
Status
? 
Single
? 
Married
? 
Adult  Interdependent 
Partnership
? 
Separated
? 
Divorced
? 
Widowed

YYYY
MM
DD


Date of Birth



2.2   What is the adult's permanent address?



Name of Residential Facility 
(if any)
Street Address
Suite




City
Province
Postal Code
Telephone No.

2.3   What is the adult's present address, if different from 
permanent address?
? 
Same address



Name of Residential 
Facility (if any)
Street Address
Suite




City
Province
Postal Code
Telephone No.
3   Information About Current Decision-making Arrangements for the Adult
3.1   Does the adult already 
have a supporter under a 
supported decision-making 
authorization or a 
co-decision-maker, guardian, 
or trustee?
?  
No 
Review Date

?  
Supporter
YYYY
MM
DD

?  
Co-decision-maker




?  
Guardian




? 
Trustee




3.2   Provide the following information for each current supporter, 
co-decision-maker, guardian, alternate guardian, trustee, or alternate trustee.



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Person is a:
?
 
Supporter
? 
Guardian
? 
Trustee

?
 
Co-decision-maker
? 
Alternate Guardian
? 
Alternate Trustee



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Person is a:
?
 
Supporter
? 
Guardian
? 
Trustee

?
 
Co-decision-maker
? 
Alternate Guardian
? 
Alternate Trustee

3.3   Has the adult signed an enduring power of attorney? If 
yes, provide the following information for each attorney. 
? 
Yes
? 
No



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code

3.4   Does the adult have a personal directive?
? 
Yes
? 
No
If yes, has an agent been named under the personal directive?
? 
Yes
? 
No
If yes, provide the following information for each agent



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Areas of agent's authority that may impact the application




Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Areas of agent's authority that may impact the application

4   Information About Family Members and Other Interested Persons
4.1   Provide the following information for each living family member of the adult 
who fits into any of the following categories and lives in Canada:
? Spouse 
? Parents
? Children 18 years of age or older
? Adult interdependent partner
? Brothers and sisters 18 years of age or 
older



Last Name
First Name
Family Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / Station)




City
Province
Postal Code




Last Name
First Name
Family Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / Station)




City
Province
Postal Code


4.2   If the adult is an Indian who is a member of a band and is ordinarily resident on 
a reserve, provide the following information:

Name of Band




Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone
City
Province
Postal Code
Fax


E-mail

4.3   If there are any other interested persons who are 18 years of age or older who 
you think should be given notice of this application, please provide their contact 
information and their relationship to the adult.




Last Name
First Name
Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / Station)




City
Province
Postal Code

5   Information about Proposed Guardian(s), Alternate Guardian(s), 
Trustee(s) and Alternate Trustee(s)
5.1   Provide the following information about each proposed guardian, alternate 
guardian, trustee and alternate trustee:



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Proposed as:
?
Guardian
?
Alternate Guardian
?
Trustee
?
Alternate Trustee




Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Proposed as:
?
Guardian
?
Alternate Guardian
?
Trustee
?
Alternate Trustee
6   Information About Proposed Guardianship Order
Complete this item if requesting appointment of a guardian for the adult.

6.1   For which of the following personal matters of the adult are you proposing 
that the guardian have authority to act and make decisions? [Check all that are 
applicable]
?  
the adult's health care
? 
where, with whom and under what conditions the adult is to live, either 
permanently or temporarily
? 
the persons with whom the adult may associate
? 
the adult's participation in social activities
? 
the adult's participation in any educational, vocational or other training
? 
the adult's employment
? 
the carrying on of any legal proceeding that does not relate primarily to the 
financial matters of the adult
? 
any other personal matter the Court considers necessary, specifically:



6.2   Are you requesting the Court to make an order under section 31(2) of the Act 
where there are two or more guardians?
? 
No
? 
Yes
If yes, describe the order you are requesting the Court 
to make: 


6.3   Does the capacity assessment report indicate that the adult's capacity to make 
decisions in personal matters is likely to improve?
? 
Yes
? 
No
If yes, you must propose a review date below. If no, 
you may propose  a review date or request the Court not 
to require a review within a certain period.*
? 
I propose* that the Court require the guardianship order to 
be reviewed within 

years.
? 
I propose* that the Court not require the order to be reviewed within a certain 
period.


* Your affidavit must state why you believe your proposal regarding review of the 
order is in the best interest of the adult.
7   Information About Proposed Trusteeship Order
Complete this item if requesting appointment of a trustee for the adult.

7.1   Are you requesting that the Court give the trustee any special authority or 
direction or impose any special limitation or condition on the trustee's authority?

? 
Yes*
? 
No

*If yes, indicate the special authority or direction you are requesting.

? 
Limit the trustee's  authority to the following property or financial matters of 
the adult (s54(5)(a) of the Act):




? 
Extend the trustee's authority to the following land situated outside of 
Alberta, subject to the laws of the jurisdiction where the land is located 
(s54(5)(b) of the Act):




? 
Authorize the trustee to permit the adult to open or maintain a deposit 
account at a financial institution, subject to any conditions that may be 
imposed by the Court, including (s54(6) of the Act):


Maximum permitted monthly deposit to account:
$

Maximum permitted balance of account:
$

? 
Authorize the trustee to sell, encumber or purchase real property of or for the 
adult, as detailed below (s55(2) of the Act):




? 
Give exclusive 
authority to 

over the following financial 
matters (s52(2)(a) of the Act):


Name of Trustee





? 
Authorize any one of the trustees to act separately in respect of the following 
financial matters of the adult (where there will be two or more trustees - 
s52(2)(b) of the Act):




? 
Approve the following security to be provided by a non-resident trustee 
(s49(5) of the Act): 




? 
Dispense with requirement for a non-resident trustee to provide a bond or 
other security (s49(6) of the Act)

7.2   What is your proposal regarding periodic examination and approval of the 
trustee's accounts by the Court?*
? 
I propose the Court require the trustee to submit accounts for the Court's 
examination and 

approval within 

years.
? 
I propose the trustee not be required to submit accounts for the Court's 
examination and approval within a certain period.
* Your affidavit must state why you believe your proposal regarding periodic 
examination and approval of accounts is in the best interest of the adult.

7.3   Does the capacity assessment report indicate that the adult's capacity to make 
decisions in financial matters is likely to improve?
?
 
yes
? 
no
If yes, you must propose a review date below. If no, you 
may propose  a review date or request the Court not to 
require a review within a certain period.*
?
 
I propose* that the Court require the 
trusteeship order to be reviewed within 

years.
?
 
I propose* that the Court not require the trusteeship order to be reviewed 
within a certain period.
*Your  affidavit must state why you believe your proposal regarding review of the 
order is in the best interest of the adult.
8   Other Documents Submitted with Application
8.1   Along with this application form, I am submitting the following application 
documents to be filed with the clerk of the Court (check all that apply):
? 
Affidavit of applicant
? 
Capacity assessment report dated *
? 
Guardianship plan
? 
Trusteeship plan
? 
Consent to act of each proposed guardian, alternate guardian, trustee, and 
alternate trustee
? 
Notice of Application and Hearing (if not proposing that application proceed 
as desk application)

Documents relating to current decision-making arrangements for adult (if any 
and available):

? 
Supported decision-making authorization

? 
Personal directive

? 
Enduring power of attorney

? 
Co-decision-making order

? 
Trusteeship order

? 
Guardianship order

 
If applying to appoint a 
trustee, either:
? 
inventory of adult's assets and liabilities, 
OR


? 
undertaking of trustee(s) to file inventory 
after appointment
*The capacity assessment report must be dated not more than 6 months before you 
start the application unless you are specifically requesting the Court to accept an 
older report. (You may make a request by completing 10.2 below.)

8.2   I am submitting or will submit the following documents to a review officer. I 
understand these documents will not be filed with the Court unless the Court 
subsequently directs the review officer to do so.
? 
2 personal references for each proposed guardian, alternate guardian, 
trustee, or alternate trustee where required by the Adult Guardianship and 
Trusteeship Regulation.
9   Request to Dispense with Service or Notice
9.1   The Court may dispense with service of the application documents on the 
adult only if the Court is satisfied service would be harmful to the adult. Are you 
requesting the Court to dispense with service of the application documents on the 
adult?
? 
No
? 
Yes
The capacity assessment report must state that service is likely to 
cause harm to the adult or you must provide other evidence to the 
Court that service on the adult should be dispensed with.

9.2   Are you requesting the Court to dispense with the requirement to give notice 
of this application to a person (other than the adult) to whom notice must otherwise 
be given?
? 
No

? 
Yes
Give the following information for each person for whom you are 
asking the Court to dispense with notice. Your affidavit must state 
why you are requesting the Court to dispense with the requirement to 
give notice to the person.
Name of Person 
Person's Relationship to Adult



NOTE:   On a desk application the review officer will NOT send notice of the application to a 
person to whom you request the Court to dispense with notice. If you make such a request but the 
Court decides not to dispense with notice, a decision on your application will be delayed until the 
person is notified and given an opportunity to respond.
10   Costs and Other Matters
10.1   How or by whom do you request all or part of the costs (i.e. legal fees, if 
applicable, and disbursements) of the application to be paid?
? 
I am asking the Court to order that my lawyer's fees for this application
? 
in the amount of
$

? 
in an amount to be taxed

plus reasonable disbursements, be paid by or from the property of the adult.
? 
I am asking the Court to order that the reasonable disbursements only be 
paid by or from the property of the adult.
? 
I am asking the Court to order that the costs be paid by the Crown and have 
provided supporting information in my affidavit.
? 
I am not asking the Court to make an order regarding costs. I will pay the 
costs myself.
? 
Other:


10.2 Are you requesting the Court to give any direction, approval or dispensation 
not already described in this application?
? 
No

? 
Yes
Describe the requested direction, approval or dispensation.




Applicant's Signature or Signature of Lawyer on behalf of Applicant
Date
Form 15 
 
Affidavit of Applicant 
Application to Appoint Guardian, Trustee or Both
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")



Document
Application

The contents of this affidavit must be adjusted as necessary to ensure that your 
affidavit accurately reflects the circumstances of your application.

I, 

of

,

Name

Address
having personal knowledge of the facts and matters referred to in this affidavit 
except where stated to be based on information and belief, swear or affirm as 
follows:
1   Information applicable to all applications
This section of the affidavit must be completed for all applications.
?    I make this affidavit in support of an application to appoint a < e.g. guardian and 
trustee > for  < name of adult > who is referred to in this affidavit as "the adult".
1.2   I have personally completed or carefully read the application form and all other 
forms and documents set out in item 8 of the application form, and to the best of my 
knowledge the information in them is accurate and complete.
2   Information applicable to applications to appoint a guardian
This section of the affidavit must be completed if you are applying for the 
appointment of a guardian (or a guardian and trustee) for the adult. Otherwise, the 
section should be omitted and the following headings and paragraphs renumbered 
accordingly.
2.1   I believe the adult lacks the capacity to make decisions about the personal 
matters for which I am requesting the Court to appoint a guardian. This belief is based 
on my review of the capacity assessment report.
2.2   The following alternative measures that are less intrusive and less restrictive than 
guardianship have been implemented and have not been effective in meeting the 
adult's needs for the following reason(s): 

2.3   The following alternative measures that are less intrusive and less restrictive than 
guardianship have been considered and are not likely to be effective to meet the needs 
of the adult for the following reasons: 


Note:   To make a guardianship order the court must be satisfied either that 
alternative measures have been implemented and have not been effective or have 
been considered and are unlikely to be effective.>

2.4   In addition to information set out elsewhere in this affidavit, I have the following 
reasons for believing it would be in the adult's best interests for the Court to make the 
guardianship order requested in my application:

2.5   I believe that each proposed guardian and each proposed alternate guardian (if 
any) will act in the best interests of the adult and is suitable as a guardian for the 
adult. This belief is based on the following information:
 
2.6   I believe that my proposal with respect to periodic review of the guardianship 
order by the Court, as set out in item 6.3 of the application form is in the best interests 
of the adult for the following reasons:

3   Information applicable to applications to appoint a trustee
This section of the affidavit must be completed if you are applying for the 
appointment of a trustee (or a guardian and trustee) for the adult. Otherwise, the 
section should be omitted and the following sections and paragraphs renumbered 
accordingly.
3.1   I believe the adult lacks the capacity to make decisions about financial matters. 
This belief is based on my review of the capacity assessment report.
3.2   I believe that less intrusive and less restrictive alternative measures than 
trusteeship would not adequately protect the adult's interests in respect of financial 
matters, for the following reasons:

3.3   In addition to information set out elsewhere in this affidavit, I have the following 
reasons for believing it would be in the adult's best interests for the Court to make the 
trusteeship order requested in my application:

3.4   I believe that each proposed trustee and each proposed alternate trustee (if any) 
will act in the best interests of the adult and is suitable as a trustee for the adult. This 
belief is based on the following information:
 
3.5   I believe that my proposal with respect to periodic examination and approval of 
trusteeship accounts by the Court, as set out in item 7.2 of the application form, is in 
the best interests of the adult for the following reasons:

3.6   I believe that my proposal with respect to periodic review of the trusteeship order 
by the Court, as set out in item 7.3 of the application form, is in the best interests of 
the adult for the following reasons:


Add additional paragraphs as necessary to provide information in support of any 
special authority or direction that is being sought in relation to financial matters of 
the adult, such as authority to sell real property, or an order dispensing with the 
requirement for an out-of-province trustee to provide a bond.
4   Request to Dispense with Notice
NOTE:   Include this section only if you are requesting the Court to dispense with 
the requirement to send notice of the application to a particular person. If you are 
requesting the Court to dispense with notice to two or more persons, include a 
separate paragraph for each person.
4.1   I am requesting the Court to dispense with the requirement to send notice of the 
application to  for the following reason:

5   Costs
This section should only be completed if you are requesting the Court to make an 
order that the Crown in right of Alberta pay the costs of the application.
5.1   To the best of my information and belief, the adult's financial resources and 
obligations are as follows:
Estimated monthly income from all sources
$
Estimated value of cash and liquid assets, including bank accounts, 
GICs, investments and all assets that can readily be converted into 
cash
$
Estimated value of real estate and personal property not mentioned 
above
$
Estimated total debts
$
5.2   It would be a hardship for me, as applicant, to pay the costs of this application 
personally.
5.3   It would be a hardship for the adult to pay the costs of this application or for the 
costs of the application to be paid out of the adult's property.
Sworn or affirmed before me at

)

Alberta, on

)


)

A Commissioner for Oaths in the Province of Alberta
)
SIGNATURE

)

PRINT NAME AND EXPIRY/LAWYER/ STUDENT-AT-LAW
)
NAME
Form 16 
 
Notice of Application 
Appointment of Guardian, Trustee or Both
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")



Document
Notice of Application
Applicant


Items that are inapplicable to an application should be omitted.

1   An application has been commenced by

to appoint one or 
more
persons as 
? 
guardian
? 
trustee for 

("adult") on the
ground that the adult lacks capacity to make decisions about personal matters or 
financial matters.

2   The application requests the Court to appoint the following persons to the positions 
indicated:
Name
Relationship to 
Adult
Proposed Position


? 
Guardian
? 
Trustee


? 
Alternate Guardian
? 
Alternate Trustee


? 
Guardian
? 
Trustee


? 
Alternate Guardian
? 
Alternate Trustee

3   The application requests that the Court give the guardian authority to make 
decisions regarding the following personal matters of the adult:
? 
the adult's health care
? 
where, with whom and under what conditions the adult is to live, either 
permanently or temporarily
? 
the persons with whom the adult may associate
? 
the adult's participation in social activities
? 
the adult's participation in any educational, vocational or other training
? 
the adult's employment
? 
the carrying on of any legal proceeding that does not relate primarily to the 
financial matters of the adult
? 
any other personal matter the Court considers necessary, specifically:





4   Subject to certain limitations, a trustee appointed under the Act has authority to 
do anything in relation to the adult's financial affairs that the adult could do if the 
adult had capacity. One limitation is that a trustee other than the Public Trustee 
cannot sell land owned by the adult unless expressly authorized to do so by the 
Court.  The box below will be checked if the application asks the Court to 
authorize a trustee to sell land of the adult.
? 
The application asks the Court to authorize the trustee to sell land owned by 
the adult.

5   The Court may consider the application and grant an order without holding a 
hearing unless the person who is the subject of the application or an interested 
person requests a hearing in accordance with the regulations. 

6   You have received a Request for Hearing form along with this notice. You 
may request the Court to hold a hearing regarding the application by completing 
the Request for Hearing and 
submitting it to a review officer on or before 
this date:




7   The following documents have been submitted in support of this application:
? 
Application form
? 
Consent to act 
? 
Affidavit of applicant
? 
Capacity assessment report
? 
Guardianship plan
? 
Trusteeship plan


To make enquiries about the application, you may contact the review officer by 
telephone at


The review officer's file number is



Phone Number

File Number

Form 17 
 
Notice of Application and Hearing 
Appointment of Guardian, Trustee or Both
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Notice of Application and Hearing
Applicant


Items that are inapplicable to an application should be omitted.

1   An application has been commenced by

to appoint one or more
persons as 
? 
guardian
? 
trustee for 

("adult") on the
ground the adult lacks capacity to make decisions about personal matters and/or 
financial matters.

2   The application will be heard by a judge of the Court of Queen's Bench of 
Alberta as follows:
Date:


Time:


Place:




3   The application requests the Court to appoint the following persons to the positions 
indicated:
Name
Relationship to 
Adult
Proposed Position


? 
Guardian
? 
Trustee


? 
Alternate Guardian
? 
Alternate Trustee


? 
Guardian
? 
Trustee


? 
Alternate Guardian
? 
Alternate Trustee

4   The application requests that the Court give the guardian authority to make 
decisions regarding the following personal matters of the adult:
? 
the adult's health care
? 
where, with whom and under what conditions the adult is to live, either 
permanently or temporarily
? 
the persons with whom the adult may associate
? 
the adult's participation in social activities
? 
the adult's participation in any educational, vocational or other training
? 
the adult's employment
? 
the carrying on of any legal proceeding that does not relate primarily to the 
financial matters of the adult
? 
any other personal matter the Court considers necessary, specifically:





5   Subject to certain limitations, a trustee appointed under the Act has authority to 
do anything in relation to the adult's financial affairs that the adult could do if the 
adult had capacity. One limitation is that a trustee other than the Public Trustee 
cannot sell land owned by the adult unless expressly authorized to do so by the 
Court.  The box below will be checked if the application asks the Court to 
authorize a trustee to sell land of the adult.
? 
The application asks the Court to authorize the trustee to sell land owned by 
the adult.

6   You may obtain any or all of the following documents filed in support of the 
application by requesting them from the applicant as soon as possible after you 
receive this notice.:
? 
Application form
? 
Consent to act 
? 
Affidavit of applicant
? 
Capacity assessment report
? 
Guardianship plan
? 
Trusteeship plan

7   If you consent to or do not oppose the application, you may:
?  Do nothing further, or
?  Attend at the hearing and indicate your position to the court.
If you oppose any part of the application, you should come to the hearing and tell 
the judge what part of the application you are opposed to, and why you are 
opposed. If you do not attend either in person or by your lawyer before the Court at 
the time and place shown above, the Court may give the applicant(s) what they 
want in your absence.

APPLICANT'S ADDRESS FOR SERVICE (Omit lawyer information if inapplicable)



Law Firm Name
Responsible Lawyer's Name
Lawyer's File Number



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail

Form 18 
 
Order 
Appointment of Guardian, Trustee or Both
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Order
Applicant


Considered by the Honourable Justice 

on

ORDER

Include only those provisions that are appropriate to the application presented to 
the Court. Standard provisions should be modified as appropriate to the context 
(e.g. to refer to multiple guardians or trustees).
The Court:
	?	has reviewed the written material filed in this application;
	?	has considered the application in the absence of the applicant and any other 
person, being satisfied that
	?	no person entitled to do so has requested a hearing in accordance with the 
regulations, and
	?	it is unnecessary to hold a hearing;
	?	has determined that
	?	the adult is 18 years of age or over;
	?	the adult will attain the age of 18 within 12 months of the date of the 
application;
	?	for guardianship order: the conditions for appointment of a guardian are 
satisfied, namely,
	?	the adult does not have capacity to make decisions about the 
personal matters with respect to which the guardian is given 
authority by this order;
	?	less intrusive and less restrictive alternative measures than the 
appointment of a guardian have been considered or have been 
implemented and would not likely be or have not been effective to 
meet the needs of the adult;
	?	it is in the adult's best interests for a guardian to be appointed;
	?	for trusteeship order: the conditions for appointment of a trustee are 
satisfied, namely,
	?	the adult does not have the capacity to make decisions respecting 
any or all financial matters;
	?	less intrusive and less restrictive alternative measures than the 
appointment of a trustee would not adequately protect the adult's 
interests in respect of financial matters;
	?	it is in the adult's best interests for a trustee to be appointed;
	?	for trusteeship order (section 54(4)a)of the Act): has considered whether it 
would be in the adult's best interests to impose any limits or conditions on 
the trustee's authority.
And the Court Orders:
1   Appointment of Guardian
[Include in all cases]
? 

is (are) appointed guardian of 

< Name of adult >
with authority to act and make decisions with respect to:
? 
the adult's health care;
? 
where, with whom and under what conditions the adult is to live, either 
permanently or temporarily;
? 
with whom the adult may associate;
? 
the adult's participation in social activities;
? 
the adult's participation in any educational, vocational or other training;
? 
the adult's employment;
? 
the carrying on of any legal proceeding that does not relate primarily to the 
financial matters of the adult;
? 
the following personal matter(s) of the adult that the Court considers 
necessary, namely:


Include only if requested in application]
1.2
< Name of one of two or more 
guardians>
has (have) exclusive authority to act and make 

decisions respecting the following personal matters of the adult:


[Include only if requested in application]
1.3
The guardians must act jointly with respect to the following personal matters 
of the adult: 


[Include only if requested in application]
1.4
< Name of alternate guardian(s)>
is (are) appointed as alternate

guardians for the adult with  authority to act as guardian without further 
proceeding on an event referred to in section 32(3) of the Act.
[Include in all cases]
1.5
The guardianship plan as submitted is approved.
[Include in all cases]
1.6
The authority of the guardian is subject to the following conditions, limits or 
requirements:

< reserved for conditions, limits or requirements considered 
appropriate by Court >


[Include only if requested in application]
1.7
The authority of


under the adult's personal directive dated


? 
is wholly 
terminated
? 
is terminated for the following areas of 
authority but otherwise remains in effect:


[Include in all cases]
1.8   
must apply for a review of this guardianship order 

? 
within

years of the date of this order, OR

? 
as circumstances require (no fixed review date),
AND in any event

? if there has been a significant change in the needs, circumstances or capacity 
of the represented person that the guardian considers would make a variation or 
termination of the order in the represented adult's best interests, OR
? if there has been a change in circumstances that affects the guardian's ability 
to exercise the authority or carry out the duties and responsibilities of guardian 
or suitability to be a guardian for the  adult.
[Include if the adult is the subject of a co-decision-making order]
1.9
The co-decision-making order dated

is terminated.
2   Appointment of Trustee
[Include in all cases]
2.1

is (are) appointed trustee of 

[Include only if requested in application]
2.2
< Name of alternate trustee>
is (are) appointed alternate trustees for 
the adult with 

authority to act as trustee(s) without further proceeding on an event referred 
to in section 53(3) of the Act.
[Include unless application requests narrower scope for order]
2.3
This order applies 
? to all personal property of the adult;
? to all real property of the adult in Alberta.
[Include only if requested in application]
2.4
This trusteeship order applies only to the following property or financial 
matter(s) of the adult: 

< property or financial matter(s)to which the order is to apply> 


[Include only if requested in application]
2.5
To the extent it is recognized by the courts of, and subject to compliance with 
the laws of,

 
this order applies to the following real 
property of the adult: 

 




[Include in all cases]
2.6
The trusteeship plan as submitted is approved.
[Include in all cases]
2.7
Except as otherwise provided by the Act, the regulations or this order, the 
trustee has authority, with respect to the property to which this order applies 
to:
?  take possession and control of the property;
?  do anything in relation to the adult's financial matters that the adult could 
do if capable of making decisions with respect to such financial matters;
?sign all documents and do all things necessary to give effect to any power or 
authority vested in the trustee.
[Include unless Public Trustee is proposed trustee]
2.8
The trustee has no authority to sell, transfer, or encumber real property of the 
adult, or to purchase real property of the adult, except as follows:
?  the trustee may lease real property of the adult for a term not exceeding 3 
years;
?  the trustee may register this order against the title to the adult's real 
property, and the Registrar of Land Titles shall register this order 
notwithstanding section 191(1) of the Land Titles Act.

? 
The trustee is authorized to:

 


[Include only if requested in application]
2.9
The trustee is authorized to permit the adult to open or maintain a deposit 
account, subject to the following limitations:

no more than
$
may be deposited into the account in any 
month;

the total balance must not exceed 
$
at any time
[Include only if requested in application]
2.10

has exclusive authority with respect to the 
following

financial matters of the adult:

[Include only if requested in application]
2.11
Any one of the trustees may exercise the authority granted to the trustees by 
this order with respect to the following financial matters of the adult:


Include in all cases]
2.12
The trustee's authority is subject to the following additional limits or 
conditions: 

< reserved for additional limits or conditions imposed by Court >




[Include in all cases]
2.13

must apply for a review of this trusteeship 
order 

? 
within

years of the date of this order, OR

? 
as circumstances require (no fixed review date),

AND in any event

?  if there has been a significant change in the needs, circumstances or 
capacity of the represented person that the trustee considers would make a 
variation or termination of the order in the represented adult's best interests, 
OR
?  if there has been a change in circumstances that affects the trustee's 
ability to exercise the authority or carry out the duties and responsibilities 
of trustee or suitability to be a trustee for the adult.
[Include if inventory of assets and liabilities is not submitted with application.
2.14
The trustee(s) must submit an inventory of the assets and liabilities of the 
adult within 6 months of the date of this order.
[Include in all cases]
2.15

must apply for a review of this trusteeship 
order 

? 
within

years of the date of this order, OR

? 
as circumstances require (no fixed review date),

AND in any event, whenever directed to do so by the Court.
[Include if the adult is the subject of a co-decision-making order]
2.16
The co-decision-making order dated

is terminated.
[Include if the adult has signed an enduring power of attorney]
2.17
The enduring power of attorney dated

is terminated.
3   Costs of Application
3.1   The following order is made regarding costs (legal fees and disbursements) of 
this application:
? 
Legal fees for this application

? 
in the amount of 
$


? 
to be taxed

plus reasonable disbursements shall be 
paid by

? 
Reasonable disbursements only shall be 
paid by 

? 
No order is made regarding payment of legal fees or disbursements.
4   Other Matters
4.1   All requirements of the Act and regulations regarding service or sending of 
notice of this application are deemed to have been satisfied including requirements 
as to:
  ? the persons to be notified of this application;
  ? the documents to be served or sent to such persons; 
  ? the manner of and time for serving or sending documents
? 
Notice of this application to the following person(s) is dispensed with:

NAME
RELATIONSHIP







4.2   The following direction is given regarding service of this order:
? 
Except as otherwise provided below, a copy of this order must be sent by 
ordinary mail to the adult, the review officer, and every other person who 
was notified of this application.
? 
A copy of this order must be served on


by the following method of service:

[Include if application is made in respect of a person who has not attained the age of 
majority referred to in section 24(1) or 43(2) of the Act]
4.3   This order does not come into effect until the person in respect of whom it is 
made attains the age of majority.

Justice of the Court of Queen's Bench of  Alberta

Entered at

, Alberta

Filed by

City / Town / Municipality



on





Date


Address



Clerk of the Court of Queen's Bench of Alberta


Phone Number

Form 19  
 
Application for Review of Guardianship or Trusteeship 
Order or for Examination and Approval of  
Trusteeship Accounts (in any combination)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Application 
Applicant


APPLICANT'S ADDRESS FOR SERVICE (Omit lawyer information if inapplicable)



Law Firm Name
Responsible Lawyer's Name
Lawyer's File Number



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail

1   Information About the Application
1.1   Which of the following are you applying for (check all that apply and provide 
relevant dates)?

? 
Review of a guardianship 
order granted on

and most recently 
reviewed (if ever) on

? 
Review of a trusteeship 
order granted on

and most recently 
reviewed (if ever) on

? 
Examination and approval 
of accounts for a 
trusteeship order granted 
on

and for which 
accounts were most 
recently approved 
(passed) on


1.2   Are you proposing that your application proceed as a desk application or by 
hearing?

? 
Desk
You submit the application documents to a review officer. The 
review officer will serve or send notice of the application to 
everyone who is required to be served or notified and will file 
the application documents with the Court. A court hearing 
before a judge will be required only if someone requests a 
hearing or a judge directs a hearing.
? 
Hearing
You begin by filing the application documents with the clerk of 
the Court and setting a date for a hearing before a judge. You 
must then serve or send notice of the application and hearing to 
the adult, the review officer and various other persons. You will 
then need to complete and file affidavits of service and attend 
the hearing, either in person or by legal counsel.
2   Information About the Represented Adult
2.1   What is the adult's name, date of birth and marital status?




Last Name
First Name
Middle Name
Other (maiden / 
nickname)



Marital 
Status
?  
Single
? 
Married
YYYY
MM
DD

?  
Adult Interdependent 
Partnership
? 
Separated
Date of Birth

? 
Divorced
? 
Widowed

2.2   What is the adult's permanent address?



Name of Residential 
Facility (if any)
Street Address
Suite




City
Province
Postal Code
Telephone No.

2.3   What is the adult's present address, if different from 
permanent address?
? 
Same address



Name of Residential 
Facility (if any)
Street Address
Suite




City
Province
Postal Code
Telephone No.
3   Information About Guardians, Trustees, Attorneys and Agents
3.1   Provide the following information for each person who is CURRENTLY a 
guardian, alternate guardian, trustee or alternate trustee of the adult or who is 
PROPOSED for any of these positions. Indicate both the current and proposed 
position, if any, for each person.




Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Currently:
? 
Guardian
? 
Alternate 
Guardian
? 
Trustee
? 
Alternate 
Trustee
Proposed 
as:
? 
Guardian
? 
Alternate 
Guardian
? 
Trustee
? 
Alternate 
Trustee




Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Currently:
? 
Guardian
? 
Alternate 
Guardian
? 
Trustee
? 
Alternate 
Trustee
Proposed 
as:
? 
Guardian
? 
Alternate 
Guardian
? 
Trustee
? 
Alternate 
Trustee

3.2   Has the adult signed an enduring power of attorney? If 
yes provide the following information for each attorney. 
? 
Yes
? 
No



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code

3.3   Does the adult have a personal directive?
? 
Yes
? 
No
If yes, has an agent been named under the personal 
directive?
? 
Yes
? 
No
If yes, provide the following information for each agent:

1



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Areas of agent's authority that may impact 
the application


2



Last Name
First Name
Telephone Number




Street Address
City
Province
Postal Code
Areas of agent's authority that may impact 
the application

4   Information About Family Members and Other Interested Persons
4.1   Provide the following information for each living family member of the adult 
who fits into any of the following categories and lives in Canada:
?  Spouse 
?  Parents
?  Children 18 years of age of older
?  Adult interdependent partner
?  Brothers and sisters 18 years of age or 
older



Last Name
First Name
Family Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / Station)




City
Province
Postal Code




Last Name
First Name
Family Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / Station)




City
Province
Postal Code


4.2   If the adult who is an Indian who is a member of a band and is ordinarily 
resident on a reserve, provide the following information: 

Name of Band




Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail


4.3   If there are any other interested persons who are 18 years of age or older who 
you think should be given notice of this application, please provide their contact 
information and their relationship to the adult.





Last Name
First Name
Relationship to Adult



Street Address
Suite
Other Address Information (e.g. P.O. Box / Station)




City
Province
Postal Code

5   Information for Guardianship Order Review
Complete this item if you are applying for a review of a guardianship order.

5.1   What are you requesting the Court to do (check all that apply)?
? 
Continue the guardianship order

? 
as is without any amendment (except for the required review date, if 
any)

? 
with amendments as requested
? 
Terminate the guardianship order 
? 
Replace the guardianship order*
? 
Discharge the following person(s) as 
guardian or alternate guardian




* If the current order was issued under the Dependent Adults Act and you are not 
requesting the Court to terminate it, the order must be replaced with an order with 
wording that conforms with the Adult Guardianship and Trusteeship Act.

5.2   Unless you are requesting the Court to terminate the guardianship order, 
indicate the personal matters for which the guardian CURRENTLY has authority 
and the personal matters for which you are PROPOSING the guardian be given 
authority when the order is reviewed. 
[Check all that are applicable].
Now
Proposed

? 
? 
the adult's health care
? 
? 
where, with whom and under what conditions the adult is to 
live, either permanently or temporarily
? 
? 
the persons with whom the adult may associate
? 
? 
the adult's participation in social activities
? 
? 
the adult's participation in any educational, vocational or other 
training
? 
? 
the adult's employment
? 
? 
the carrying on of any legal proceeding that does not relate 
primarily to the financial matters of the adult
? 
*
to decide whether the dependent adult should apply for any 
licence, permit, approval or other consent or authorization 
required by law
? 
*
to make normal day to day decisions on behalf of the 
dependent adult including the diet and dress of the dependent 
adult;
? 
? 
any other personal matter the Court considers necessary, 
specifically:




* These matters are not specifically provided for by the Adult Guardianship and 
Trusteeship Act but might be identified in a guardianship order made under the 
Dependent Adults Act.

5.3   Are you requesting the Court to make an order under section 31(2) of the Act 
where there are two or more guardians?
? 
No
? 
Yes
If yes, describe the order you are requesting the Court to 
make: 


5.4   Does the capacity assessment report indicate that the adult's capacity to make 
decisions in personal matters is likely to improve?
? 
Yes
? 
No
If yes, you must propose a review date below. If no, 
you may propose  a review date or request the Court not 
to require a review within a certain period.*
? 
I propose* that the Court require the guardianship 
order to be reviewed within 

years.
? 
I propose* that the Court  not require the order to be reviewed within a 
certain period.
*Your affidavit must state why you believe your proposal  is in the best interests of 
the adult.
6   Information for Trusteeship Order Review
Complete this item if you are applying for review of a trusteeship order.

6.1   What are you requesting the Court to do (check all that apply)?
? 
Continue the trusteeship order

? 
as is without any amendment (except for the required review date, if 
any)

? 
with amendments as requested
? 
Terminate the trusteeship order 
? 
Replace the trusteeship order*
? 
Discharge the following person(s) as 
trustee(s) or alternate trustee




* If the current order was issued under the Dependent Adults Act and you are not 
requesting the Court to terminate it, the order must be replaced with an order with 
wording that conforms with the Adult Guardianship and Trusteeship Act.

6.2   Are you requesting that the Court give the trustee any special authority or 
direction or impose any special limitation or condition on the trustee's authority?

? 
Yes*
? 
No

* If yes, indicate the special authority or direction you are requesting.

? 
Limit the trustee's  authority to the following property or financial matters of 
the adult (s54(5)(a) of the Act):





? 
Extend the trustee's authority to the following land situated outside of 
Alberta, subject to the laws of the jurisdiction where the land is located 
(s54(5)(b) of the Act):





? 
Authorize the trustee to permit the adult to open or maintain a deposit account 
at a financial institution, subject to any conditions that may be imposed by the 
Court, including (s54(6) of the Act):


Maximum permitted monthly deposit to account:
$

Maximum permitted balance of account:
$

? 
Authorize the trustee to sell, encumber or purchase real property of or for the 
adult, as detailed below (s55(2) of the Act):





? 
Give exclusive 
authority to 

over the following financial 
matters (s52(2)(a) of the Act):


Name of Trustee






? 
Authorize any one of the trustees to act separately in respect of the following 
financial matters of the adult (where there will be two or more trustees - 
s52(2)(b) of the Act):





? 
Approve the following security to be provided by a non-resident trustee 
(s49(5) of the Act): 





? 
Dispense with requirement for a non-resident trustee to provide a bond or 
other security (s49(6) of the Act)

6.3   Does the capacity assessment report indicate that the adult's capacity to make 
decisions in financial matters is likely to improve?
? 
Yes
? 
No
If yes, you must propose a review date below. If no, 
you may propose  a review date or request the Court not 
to require a review within a certain period.*
? 
I propose* that the Court require the trusteeship order to 
be reviewed within 

years.
? 
I propose* that the Court  not require the trusteeship order to be reviewed 
within a certain period.
* Your affidavit must state why you believe your proposal  is in the best interests of the adult.
7   Information for Examination and Approval of Accounts
Complete this item if you are applying for examination and approval of trusteeship 
accounts.

7.1   The Court is requested to examine and approve the trustee's accounts for the 
accounting period 

from

to



7.2   Trustee Compensation
? 
I am requesting the Court to approve the taking of compensation for the 
accounting period in accordance with an election made under section 66(2) of 
the Act.
? 
I am requesting the Court to set the trustee's compensation and approve the 
taking of compensation for the accounting period.
? 
I am not asking for compensation for the accounting period.
? 
other (describe):

7.3   What is your proposal regarding subsequent examination and approval of the 
trustee's accounts by the Court?

? 
I propose the Court require the trustee to submit accounts for the Court's 
examination and

approval within

years.
? 
I propose the trustee not be required to submit accounts for the Court's 
examination and approval within a certain period.
8   Other Documents Submitted with Application
8.1   Along with this application form, I am submitting the following application 
documents to be filed with the clerk of the Court (check all that apply):
? 
Affidavit of applicant
? 
Capacity assessment report dated *
? 
Guardian's record of decisions
? 
Guardianship plan
? 
Trusteeship plan
? 
Consent to act of each proposed guardian, alternate guardian, trustee, or 
alternate trustee
? 
Notice of Application and Hearing (if not proposing that application proceed 
as desk application)

Documents relating to other current decision-making arrangements:

? 
Personal directive

? 
Enduring power of attorney
? 
Financial statements (for examination and approval of accounts) including:

? 
Overview of Trusteeship Accounts

? 
Inventory 

? 
Statement of Transactions

? 
Other (describe):



* The capacity assessment report must be dated not more than 6 months before you 
start the application unless you are specifically requesting the Court to accept an 
older report.  (You may make a request by completing 10.2 below.)

8.2   I am submitting or will submit the following documents to a review officer for 
each proposed guardian, alternate guardian, trustee, or alternate trustee who is not 
already a guardian, alternate guardian, trustee, or alternate trustee where required 
by the Adult Guardianship and Trusteeship Regulation.  I understand these 
documents will not be filed with the Court unless the Court subsequently directs 
the review officer to do so:
? 
2 personal references 
9   Request to Dispense with Service or Notice
9.1   The Court may dispense with service of the application documents on the 
adult only if the Court is satisfied service would be harmful to the adult. Are you 
requesting the Court to dispense with service of the application documents on the 
adult?
? 
No
? 
Yes
The capacity assessment report must state that service is likely to 
cause harm to the adult or you must provide other evidence that 
satisfies the Court service will cause harm to the adult.

9.2   Are you requesting the Court to dispense with the requirement to give notice 
of this application to a person (other than the adult) to whom notice must otherwise 
be given?
? 
No

? 
Yes
Give the following information for each person for whom you are 
asking the Court to dispense with notice. Your affidavit must state 
why you are requesting the Court to dispense with the requirement to 
give notice to the person.
Name of Person 
Person's Relationship to Adult





NOTE:   On a desk application the review officer will NOT send notice of the application to a 
person to whom you request the Court to dispense with notice. If you make such a request but the 
Court decides not to dispense with notice, a decision on your application will be delayed until the 
person is notified and given an opportunity to respond.
10   Costs and Other Matters
10.1   How or by whom do you request all or part of the costs (i.e. legal fees, if 
applicable, and disbursements) of the application to be paid?
? 
I am asking the Court to order that my lawyer's fees for this application
? 
in the amount of
$

? 
in an amount to be taxed

plus reasonable disbursements, be paid by or from the property of the adult.
? 
I am asking the Court to order that the reasonable disbursements only be 
paid by or from the property of the adult.
? 
I am asking the Court to order that the costs be paid by the Crown and have 
provided supporting information in my affidavit.
? 
I am not asking the Court to make an order regarding costs. I will pay the 
costs myself.
? 
Other:


10.2 Are you requesting the Court to give any direction, approval or dispensation 
not already described in this application?
? 
No

? 
Yes
Describe the requested direction, approval or dispensation.




Applicant's Signature or Signature of Lawyer on behalf of Applicant
Date
Form 20  
 
Affidavit of Applicant 
Review of Guardianship or Trusteeship Order or Examination 
and Approval of Trusteeship Accounts (in any combination)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")



Document
Affidavit of Applicant

The contents of this affidavit must be adjusted as necessary to ensure that your 
affidavit accurately reflects the circumstances of your application.

I, 

of

,

Name

Address
having personal knowledge of the facts and matters referred to in this affidavit 
except where stated to be based on information and belief, swear or affirm as 
follows:
1   Information applicable to all applications
This section of the affidavit must be completed for all applications.

1.1
I am the 
? 
guardian
? 
trustee for 

(the "adult").
1.2   I make this affidavit in support of my application for

? 
review of the guardianship order 

? 
review of the trusteeship order

? 
examination and approval of accounts for the accounting 
period beginning



and ending

1.3   I have personally completed or carefully read the application form and all other 
forms and documents submitted in support of my application, as set out in section 8 of 
the application form, and to the best of my knowledge the information in them is 
accurate and complete.
2   Information Applicable to Guardianship Review
This section of the affidavit must be completed if you are applying for review of a 
guardianship order. Otherwise, this section should be omitted and the following 
sections and paragraphs renumbered accordingly.
2.1   I believe the adult continues to lack the capacity to make decisions about the 
personal matters for which I am requesting the Court to continue the authority of the 
guardian. This belief is based on my review of the capacity assessment report.
2.2   I believe that less intrusive and less restrictive alternative measures than 
guardianship would not be effective in meeting the adult's needs, for the following 
reasons:

2.3   In addition to information set out elsewhere in this affidavit, I have the following 
reasons for believing it would be in the adult's best interests for the Court to continue 
the guardianship order with amendments, if any, requested in my application: 

2.4   I believe that each proposed guardian and each proposed alternate guardian (if 
any) will act in the best interests of the adult and is suitable as a guardian for the 
adult. This belief is based on the following information:
 
2.5   I believe that my proposal with respect to periodic review of the guardianship 
order by the Court, as set out in item 5.4 of the application form is in the best interests 
of the adult for the following reasons:

3   Information Applicable to Trusteeship Review
This section of the affidavit must be completed if you are applying for review of a 
trusteeship order. Otherwise, this section should be omitted and following sections 
and paragraphs renumbered accordingly.
3.1   I believe the adult continues to lack the capacity to make decisions about 
financial matters. This belief is based on my review of the capacity assessment report.
3.2   I believe that less intrusive and less restrictive alternative measures than 
trusteeship would not adequately protect the adult's interests in respect of financial 
matters for the following reasons:

3.3   In addition to information set out elsewhere in this affidavit, I have the following 
reasons for believing it would be in the adult's best interests for the Court to continue 
the trusteeship order with amendments, if any, requested in my application:

3.4   I believe that each proposed trustee and each proposed alternate trustee (if any) 
will act in the best interests of the adult and is suitable as a trustee for the adult. This 
belief is based on the following information:

4   Information Applicable to Application for Examination and Approval of 
Accounts
This section of the affidavit must be completed if you are applying for examination 
and approval of your trusteeship accounts. Otherwise, the section should be 
omitted and the following sections and paragraphs renumbered accordingly.

4.1   The financial statements submitted in support of my application as set out in 
item 8 of the application form

? 
show all the property and liabilities (debts) of the adult that I have been 
able to ascertain by the exercise of reasonable care, skill and diligence

? 
show all transactions respecting the adult's property for the accounting 
period, including payments made or received and property acquired or 
disposed of by sale or otherwise.
4.2   During this accounting period all of my actions as trustee have been taken in the 
best interests of the adult and in accordance with the trusteeship order and the 
trusteeship plan approved by the Court.
4.3   I believe that my proposal with respect to periodic examination and approval of 
trusteeship accounts by the Court, as set out in item 7.3 of the application form, is in 
the best interests of the adult for the following reasons:

5   Request to Dispense with Notice
NOTE:   Include this section only if you are requesting the Court to dispense with 
the requirement to send notice of the application to a particular person. If you are 
requesting the Court to dispense with notice to two or more persons, include a 
separate paragraph for each person.
5.1   I am requesting the Court to dispense with the requirement to send notice of the 
application to  for the following reason:
.
6   Costs
This section should only be completed if you are requesting that the Crown in right 
of Alberta pay the costs of the application.
6.1   To the best of my information and belief, the adult's financial resources and 
obligations are as follows:
Estimated monthly income from all sources
$
Estimated value of cash and liquid assets, including bank accounts, GICs, 
investments and all assets that can readily be converted into cash
$
Estimated value of real estate and personal property not mentioned above
$
Estimated total debts
$
6.2   It would be a hardship for me, as applicant, to pay the costs of this application 
personally.
6.3   It would be a hardship for the adult to pay the costs of this application or for the 
costs of the application to be paid out of the adult's property.
Sworn or affirmed before me at

)

Alberta, on

)


)

A Commissioner for Oaths in the Province of Alberta
)
SIGNATURE

)

PRINT NAME AND EXPIRY/LAWYER/ STUDENT-AT-LAW
)
NAME
Form 21 
 
Notice of Application 
Review of Guardianship or Trusteeship Order or Examination 
and Approval of Trusteeship Accounts (in any combination)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Notice of Application
Applicant


Items that are inapplicable to an application should be omitted.

1   An application has been commenced by the applicant for 
? 
Review of a guardianship order 

? 
Review of a trusteeship order  

? 
Examination and approval of accounts on a trusteeship order

regarding

(the "adult")

2   The application requests the Court to appoint or continue the appointment of the 
following persons to the positions indicated:
Name
Relationship to Adult
Proposed Position


? 
Guardian
? 
Trustee


? 
Alternate Guardian
? 
Alternate Trustee


? 
Guardian
? 
Trustee


? 
Alternate Guardian
? 
Alternate Trustee

3   The application requests the Court to do the following on reviewing the 
guardianship order:
? 
Continue the guardianship order
? 
Replace the current guardianship order with a new guardianship order
? 
Terminate the guardianship order 
? 
Discharge the following person(s) as 
guardian or alternate guardian


4   The following are the personal matters for which the guardian CURRENTLY 
has authority and the personal matters for which the applicant is PROPOSING the 
guardian be given authority after the order is reviewed.
Now
Proposed

? 
? 
the adult's health care
? 
? 
where, with whom and under what conditions the adult is to 
live, either permanently or temporarily
? 
? 
the persons with whom the adult may associate
? 
? 
the adult's participation in social activities
? 
? 
the adult's participation in any educational, vocational or other 
training
? 
? 
the adult's employment
? 
? 
the carrying on of any legal proceeding that does not relate 
primarily to the financial matters of the adult
? 
*
to decide whether the dependent adult should apply for any 
licence, permit, approval or other consent or authorization 
required by law
? 
*
to make normal day to day decisions on behalf of the 
dependent adult including the diet and dress of the dependent 
adult
? 
? 
the carrying on of any legal proceeding that does not relate 
primarily to the financial matters of the adult


any other personal matter the Court considers necessary, 
specifically:


Now
Proposed
? 
? 



5   The applicant requests the Court to do the following on reviewing the 
trusteeship order:
? 
Continue the trusteeship order
? 
Replace the current trusteeship order with a new trusteeship order
? 
Terminate the trusteeship order 
? 
Discharge the following person(s) as 
trustee or alternate trustee





6   Subject to certain limitations, a trustee appointed under the Act has authority to 
do anything in relation to the adult's financial affairs that the adult could do if the 
adult had capacity. One limitation is that a trustee other than the Public Trustee 
cannot sell land owned by the adult unless expressly authorized to do so by the 
Court.  The box below will be checked if the application asks the Court to 
authorize a trustee to sell land of the adult.
? 
The application asks the Court to authorize the trustee to sell land owned by 
the adult.

7   The application requests the Court to examine and approve the trustee's 
accounts for the accounting

period from 

to



Start Date

End Date

You have received an Overview of Trusteeship Accounts along with this 
Notice of Application.

8   The Court may consider the application and grant an order without holding a 
hearing unless the represented person or an interested person requests a hearing in 
accordance with the regulations. 

9   You have received a Request for Hearing form along with this notice. You 
may request the Court to hold a hearing regarding the application by completing 
the Request for Hearing and 
submitting it to a review officer on or before this date:




 10   The following documents have been submitted in support of this application:
? 
Application form
? 
Consent to act 
? 
Affidavit of applicant
? 
Capacity assessment report
? 
Guardianship plan
? 
Trusteeship plan
? 
Guardian's record of decisions
? 
Financial Statements


To make enquiries about the application, you may contact the review officer by 
telephone at


The review officer's file number is



Phone Number

File Number

Form 22 
 
Notice of Application and Hearing Review of Guardianship 
or Trusteeship Order or Examination and Approval of 
Trusteeship Accounts (in any combination)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Notice of Application and Hearing
Applicant


Paragraphs that are inapplicable to an application should be omitted.

1   An application has been commenced by the applicant for 
? 
Review of a guardianship order 

? 
Review of a trusteeship order 

? 
Examination and approval of accounts on a trusteeship order 

regarding

(the "adult")

2   The application will be heard by a judge of the Court of Queen's Bench of 
Alberta:
Date:


Time:


Place:


3   The application requests the Court to appoint or continue the appointment of the 
following persons to the positions indicated:
Name
Relationship to Adult
Proposed Position


? 
Guardian
? 
Trustee


? 
Alternate Guardian
? 
Alternate Trustee


? 
Guardian
? 
Trustee


? 
Alternate Guardian
? 
Alternate Trustee

4   The applicant requests the Court to do the following on reviewing the 
guardianship order:
? 
Continue the guardianship order
? 
Replace the current guardianship order with a new guardianship order
? 
Terminate the guardianship order 
? 
Discharge the following person(s) as 
guardian or alternate guardian:





5   The following are the personal matters for which the guardian CURRENTLY 
has authority and the personal matters for which the applicant is PROPOSING the 
guardian be given authority when the order is reviewed.
Now
Proposed

? 
? 
the adult's health care
? 
? 
where, with whom and under what conditions the adult is to 
live, either permanently or temporarily
? 
? 
the persons with whom the adult may associate
? 
? 
the adult's participation in social activities
? 
? 
the adult's participation in any educational, vocational or other 
training
? 
? 
the adult's employment
? 
? 
the carrying on of any legal proceeding that does not relate 
primarily to the financial matters of the adult
? 
*
to decide whether the dependent adult should apply for any 
licence, permit, approval or other consent or authorization 
required by law
? 
*
to make normal day to day decisions on behalf of the 
dependent adult including the diet and dress of the dependent 
adult;
? 
? 
the carrying on of any legal proceeding that does not relate 
primarily to the financial matters of the adult


Any other personal matter the Court considers necessary, 
specifically:


Now
Proposed
? 
? 



6   The applicant requests the Court to do the following on reviewing the 
trusteeship order:
? 
Continue the trusteeship order
? 
Replace the current trusteeship order with a new trusteeship order
? 
Terminate the trusteeship order 
? 
Discharge the following person(s) as 
trustee or alternate trustee:





7   Subject to certain limitations, a trustee appointed under the Act has authority to 
do anything in relation to the adult's financial affairs that the adult could do if the 
adult had capacity. One limitation is that a trustee other than the Public Trustee 
cannot sell land owned by the adult unless expressly authorized to do so by the 
Court.  The box below will be checked if the application asks the Court to 
authorize a trustee to sell land of the adult.
? 
The application asks the Court to authorize the trustee to sell land owned by 
the adult.

8   The application requests the Court to examine and approve the trustee's 
accounts for the accounting

period from 

to



Start Date

End Date

You have received an Overview of Trusteeship Accounts along with this 
Notice of Application.

 9   You may obtain any or all of the following documents filed in support of the 
application by requesting them from the applicant as soon as possible after you 
receive this notice.
? 
Application form
? 
Consent to act 
? 
Affidavit of applicant
? 
Capacity assessment report
? 
Guardianship plan
? 
Trusteeship plan
? 
Guardian's record of decisions
? 
Financial Statements

If you consent to or do not oppose the application, you may:
	?	Do nothing further, or
	?	Attend at the hearing and indicate your position to the court.
If you oppose any part of the application, you should come to the hearing and tell 
the judge what part of the application you are opposed to, and why you are 
opposed.  If you do not attend either in person or by your lawyer before the Court 
at the time and place shown above, the Court may give the applicant(s) what they 
want in your absence.

APPLICANT'S ADDRESS FOR SERVICE (Omit lawyer information if inapplicable)



Law Firm Name
Responsible Lawyer's Name
Lawyer's File Number



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail

Form 23 
 
Order 
Review of Guardianship or Trusteeship Order or Examination 
and Approval of Trusteeship Accounts (in any combination)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Order
Applicant


Considered by the Honourable Justice 

on

ORDER

Include only those provisions that are appropriate for the application presented to 
the Court. Standard provisions should be modified as appropriate to the context, 
e.g. to refer to multiple guardians or trustees.
The Court:
	?	has reviewed the written material filed in this application;
	?	has considered the application in the absence of the applicant and any other 
person, being satisfied that
	?	no person entitled to do so has requested a hearing in accordance with the 
regulations, and
	?	it is unnecessary to hold a hearing;
	?	has determined that
	?	the adult is 18 years of age or older;
	?	for review of guardianship order: the conditions for appointment of a 
guardian continue to be satisfied, namely,
	?	the adult does not have capacity to make decisions about the 
personal matters with respect to which the guardian is given 
authority by this order;
	?	less intrusive and less restrictive alternative measures than the 
appointment of a guardian have been considered or have been 
implemented and would not likely be or have not been effective to 
meet the needs of the adult;
	?	it is in the adult's best interests for a guardian to remain appointed;
	?	alternative for review of guardianship order that is to be terminated: the 
adult is no longer in need of a guardian; 
	?	for trusteeship order: the conditions for appointment of a trustee continue 
to be satisfied, namely,
	?	the adult does not have the capacity to make decisions respecting 
any or all financial matters;
	?	less intrusive and less restrictive alternative measures than the 
appointment of a trustee would not adequately protect the adult's 
interests in respect of financial matters;
	?	it is in the adult's best interests for a trustee to remain appointed;
	?	for trusteeship order - s54(4)(a): has considered whether it would be in 
the adult's best interests to impose any limits or conditions on the 
trustee's authority.
	?	alternative for trusteeship order that is to be terminated: the adult is no 
longer in need of a trustee.
And the Court Orders:
1   Appointment of Guardian  
[Include in all cases unless application requests termination of guardianship order]
1.1

is (are) appointed or continues to be 
guardian(s) of 

< Name of adult >
with authority to act and make decisions with respect to:
? 
the adult's health care;
? 
where, with whom and under what conditions the adult is to live, either 
permanently or temporarily;
? 
with whom the adult may associate;
? 
the adult's participation in social activities;
? 
the adult's participation in any educational, vocational or other training;
? 
the adult's employment;
? 
the carrying on of any legal proceeding that does not relate primarily to the 
financial matters of the adult;
? 
the following personal matter(s) of the adult that the Court considers 
necessary, namely:


[Include only if requested in application]
1.2
The guardianship order is terminated. 
[Include only if requested in application]
1.3
< Name of guardian who is to be 
discharged>
Is discharged as guardian of the 
adult.
[Include only if requested in application]
1.4
< Name of one of two or more guardians>
has (have) exclusive authority to 
act and make 

decisions respecting the following personal matters of the adult:



[Include only if requested in application]
1.5
The guardians must act jointly with respect to the following personal matters 
of the adult: 


[Include only if requested in application]
1.6
< Name of alternate guardian(s)>
is (are) appointed or continues 
as alternate

guardian(s) for the adult with  authority to act as guardian(s) without further 
proceeding on an event referred to in section 32(3) of the Act.
[Include if guardianship plan has been submitted with application for Court's 
approval]
1.7
The guardianship plan as submitted is approved.
[Include in all cases, unless application requests termination of guardianship order]
1.8
The authority of the guardian is subject to the following conditions, limits, 
or requirements:




[Include only if requested in application]
1.9
The authority of


under the adult's personal directive dated

? 
is wholly terminated
? 
is terminated for the following areas of 
authority but otherwise remains in effect:


[Include in all cases, unless application requests termination of guardianship order]
1.10

must apply for a review of this 
guardianship order 

? 
within

years of the date of this order, OR

? 
as circumstances require (no fixed review date),

AND in any event

?  if there has been a significant change in the needs, circumstances or 
capacity of the represented person that the guardian considers would make 
a variation or termination of the order in the represented person's best 
interests, OR
?  if there has been a change in circumstances that affects the guardian's 
ability to exercise the authority or carry out the duties and responsibilities 
of guardian or suitability to be a guardian for the represented person.
2   Trusteeship Order Review
[Include in all cases, unless application requests termination of trusteeship order]
2.1

is (are) appointed or continues to be 
trustee(s) of 



[Include only if requested in application]
2.2
The trusteeship order is terminated. 
[Include only if requested in application]
2.3
< Name of trustee who is to be 
discharged>
Is discharged as trustee of the adult.
[Include only if requested in application]
2.4
< Name of alternative trustee(s)>
is (are) appointed or continues as alternate

trustee(s) for the adult with  authority to act as trustee(s) without further 
proceeding on an event referred to in section 53(3) of the Act.
[Include unless application requests narrower scope for order]
2.5
This order applies 
	?	to all personal property of the adult;
	?	to all real property of the adult in Alberta.
[Include only if requested in application]
2.6
This trusteeship order applies only to the following property or financial 
matter(s) of the adult: 

< property or financial matter(s)to which the order is to apply> 


[Include only if requested in application]
2.7
To the extent it is recognized by the courts of, and subject to compliance 
with the laws of,

 
this order applies to the following real property 
of the adult: 

 




[Include if trusteeship plan has been submitted with application for court's approval]
2.8
The trusteeship plan as submitted is approved.
[Include unless application requests termination of trusteeship]
2.9
Except as otherwise provided by the Act, the regulations or this order, the 
trustee has authority, with respect to the property to which this order applies 
to:
?	take possession and control of the property;
?	do anything in relation to the adult's financial matters that the adult 
could do if capable of making decisions with respect to such financial 
matters;
?	sign all documents and do all things necessary to give effect to any 
power or authority vested in the trustee.
[Include unless Public Trustee is proposed trustee or application requests termination of trusteeship]
2.10
The trustee has no authority to sell, transfer, or encumber real property of 
the adult, or to purchase real property of the adult, except as follows:
?	The trustee may lease real property of the adult for a term not 
exceeding 3 years;
?	The trustee may register this order against the title to the adult's real 
property, and the Registrar of Land Titles shall register this order 
notwithstanding section 191(1) of the Land Titles Act;

? 
The trustee is authorized to:

 


[Include only if requested in application]
2.11
The trustee is authorized to permit the adult to open or maintain a deposit 
account, subject to the following limitations:

no more than
$
may be deposited into the account in any month;

the total balance must not exceed 
$
at any time
[Include only if requested in application]
2.12

has (have) exclusive authority with respect 
to the following

financial matters of the adult:

[Include only if requested in application]
2.13
Any one of the trustees may exercise the authority granted to the trustees by 
this order with respect to the following financial matters of the adult:


[Include in all cases, unless application requests termination of trusteeship]
2.14
The trustee's authority is subject to the following additional limits or 
conditions: 

< reserved for additional limits or conditions imposed by Court >




[Include in all cases, unless application requests termination of trusteeship]
2.15

must apply for a review of this trusteeship order 

? 
within

years of the date of this order, OR

? 
as circumstances require (no fixed review date),

AND in any event

?	if there has been a significant change in the needs, circumstances or 
capacity of the represented person that the trustee considers would make a 
variation or termination of the order in the represented person's best interests, 
OR
?	if there has been a change in circumstances that affects the trustee's ability 
to exercise the authority or carry out the duties and responsibilities of trustee or 
suitability to be a trustee for the represented person.
3   Examination and Approval of Trusteeship Accounts
[Include in all cases]
3.1
The accounts of the trustee(s)


for the  period
< period start date>
to

are approved.
[Include if requested in application]
3.2   The trustee is entitled to compensation  in the amount of 

[Include in all cases unless application requests termination of trusteeship order]
3.3

must submit trusteeship accounts for 
examination and approval by the Court

? 
and within

years of the date of this order, OR

? 
as circumstances require (no fixed review date),

AND in any event, whenever directed to do so by the Court.
4   Costs of application
4.1   The following order is made regarding costs (legal fees and disbursements) of 
this application:
? 
Legal fees for this application

? 
in the amount of 
$


? 
to be taxed

plus reasonable disbursements shall be 
paid by

? 
Reasonable disbursements only shall be 
paid by 

? 
No order is made regarding payment of legal fees or disbursements.
5   Other Matters
5.1
All requirements of the Act and regulations regarding service or sending of 
notice of this application are deemed to have been satisfied including 
requirements as to:
?  the persons to be notified of this application;
?  the documents to be served or sent to such persons; 
?  the manner of and time for serving or sending documents.

? 
Notice of this application to the following person is dispensed with:

NAME
RELATIONSHIP







5.2
The following direction is given regarding service of this order:

? 
Except as otherwise provided below, a copy of this order must be sent 
by ordinary mail to the adult, the review officer, and every other person 
who was notified of this application.

? 
A copy of this order must be 
served on


by the following method of 
service:



Justice of the Court of Queen's Bench of  Alberta

Entered at

, Alberta

Filed by

City / Town / Municipality



on





Date


Address



Clerk of the Court of Queen's Bench of Alberta


Phone Number
Form 24  
 
Consent and Undertaking Guardian (Individual)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Consent of Proposed Guardian
Applicant Name


1   I,
< name of proposed 
guardian>,  
consent to act as 
guardian for
< name of 
adult>
("adult").
2   I am 18 years of age or older.
3   I believe that I am a suitable person to be a guardian for the adult.
4
? 
I am unaware of any conflict of interest that exists or could potentially 
come into existence if I am appointed guardian
OR

? 
Details of any potential conflict of interest are set out below, together 
with an explanation of why I believe it will not prevent me from acting in 
the best interest of the adult.


5   I understand and acknowledge that as guardian I must comply with any limits, 
conditions or requirements set out in the guardianship order and I must exercise my 
authority:
?	in the adult's best interests, diligently, and in good faith,
?	in a way that encourages the adult to become, to the extent possible, capable of 
caring for himself or herself and of making decisions in respect of matters relating 
to his or her person, and
?	in the least intrusive and least restrictive manner that, in the opinion of the 
guardian, is likely to be effective.
6   I further understand that in determining whether a decision is in the adult's best 
interests, consideration must be given to 
?	any wishes known to have been expressed by the adult while the adult had 
capacity, and
?	any values and beliefs known to have been held by the adult while the adult 
had capacity.
7   I further understand that on being appointed guardian I must promptly and in a 
manner that the adult is likely to best understand, inform the adult of my 
appointment, the extent of my authority and any conditions, limits or requirements 
to which the guardianship order is subject.
8   I have personally prepared or have carefully read the proposed guardianship 
plan submitted with the application. I understand that I must act in accordance with 
the guardianship plan as approved by the Court.
9   I authorize a review officer or a person acting on behalf of a review officer to 
obtain a criminal records check  if required by the review officer for the purpose of 
preparing a report to the Court regarding my suitability to be guardian for the adult.



Signature of Proposed Guardian
Signature of Witness 


Date Signed
Full Name (Printed) of Witness
Form 25  
 
Consent and Undertaking Guardian (Public Guardian)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Consent of Proposed Guardian
Applicant Name


1   I,
< name of proposed 
guardian>,  
consent to act as 
guardian for
< name of 
adult>
("adult").



Signature of Proposed Guardian
Signature of Witness 


Date Signed
Full Name (Printed) of Witness
Form 26  
 
Consent and Undertaking 
Alternate Guardian (Individual)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Consent of Proposed Guardian
Applicant Name


1   I,
< name of proposed  
alternate guardian>,  
consent to act as 
alternate guardian for
< name of 
adult>
("adult").
2   I am 18 years of age or older.
3   I believe that I am a suitable person to be an alternate guardian for the adult.
4
?
 
I am unaware of any conflict of interest that exists or could potentially 
come into existence if I am appointed guardian
OR

?
 
Details of any potential conflict of interest are set out below, together with 
an explanation of why I believe it will not prevent me from acting in the 
best interest of the adult.


5   I understand and acknowledge that when acting as guardian I must comply with 
any limits, conditions or requirements set out in the guardianship order and I must 
exercise my authority:
?	in the adult's best interests, diligently, and in good faith;
?		in a way that encourages the adult to become, to the extent possible, capable of caring for himself or herself and of making decisions in respect of matters relating to his or her person, and
?	in the least intrusive and least restrictive manner that, in the opinion of the 
guardian, is likely to be effective.
6   I further understand that in determining whether a decision is in the adult's best 
interests, consideration must be given to 
?	any wishes known to have been expressed by the adult while the adult had 
capacity, and
?	any values and beliefs known to have been held by the adult while the adult 
had capacity.
7   I understand that I must advise the clerk of the Court as soon as I commence 
acting as a guardian because of an event referred to in section 32(3)(a) of the Act 
(death or incapacity of former guardian) and to provide evidence of the event to the 
clerk in accordance with the regulations.
8   I have carefully read the proposed guardianship plan submitted with the 
application. I understand that I must act in accordance with the guardianship plan 
as approved by the Court.
9   I authorize a review officer or a person acting on behalf of a review officer to 
obtain a criminal record check if required by the review officer for the purpose of 
preparing a report to the Court regarding my suitability to be alternate guardian for 
the adult.



Signature of Proposed Alternate Guardian
Signature of Witness 


Date Signed
Full Name (Printed) of Witness
Form 27  
 
Consent and Undertaking Trustee (Individual)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Consent of Proposed Trustee
Applicant Name


1  I,
< name of proposed 
trustee>,  
consent to act as 
trustee for
< name of 
adult>
("adult").
2   I am 18 years of age or older.
3   I am
? 
a resident of Alberta.

? 
a resident of the province or state of 

4
? 
I am unaware of any conflict of interest that exists or could potentially 
come into existence if I am appointed trustee.
OR

? 
Details of any potential conflict of interest are set out below, together 
with an explanation of why I believe it will not prevent me from acting 
in the best interest of the adult.


5
? 
A true and complete inventory of the adult's assets and liabilities has 
been submitted with the trusteeship application.
OR

? 
I  undertake to file with the clerk of the Court of Queen's Bench of 
Alberta a true and complete inventory of the adult's assets and 
liabilities within six months after I am appointed trustee. 

If any significant asset or liability of the adult is discovered after the filing of 
the original inventory, I undertake to file a true inventory of the asset or 
liability upon its discovery.
6   I understand:
?	that I must maintain accounts of the trusteeship in accordance with the 
regulations under the Adult Guardianship and Trusteeship Act and submit my 
accounts for the Court's examination and approval if directed to do so by the 
Court;
?	that in determining whether a decision is in the adult's best interests, 
consideration must be given to any wishes known to have been expressed by the 
adult while the adult had capacity, and any values and beliefs known to have been 
held by the adult while the adult had capacity.
7   I have personally prepared or have carefully read the proposed trusteeship plan 
submitted with the application. I understand that I must act in accordance with the 
trusteeship plan as approved by the Court.
8   I authorize a review officer or a person acting on behalf of a review officer
?	to investigate my credit history and financial standing, including without 
limitation obtaining a report containing my credit information from a reporting 
agency as defined in the Fair Trading Act,
?	to obtain a criminal record check
if required by the review officer for the purpose of preparing a report to the Court 
regarding my suitability to be trustee for the adult.



Signature of Proposed Trustee
Signature of Witness 


Date Signed
Full Name (Printed) of Witness
Form 28  
 
Consent and Undertaking Trustee (Public 
Trustee or Trust Corporation)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Consent of Proposed Trustee
Applicant Name


1   I,
< name of proposed 
trustee>,  
consent to act as 
trustee for
< name of 
adult>
("adult").
2
? 
A true and complete inventory of the adult's assets and liabilities has 
been submitted with the trusteeship application.
OR

? 
The proposed trustee undertakes to file with the clerk of the Court of 
Queen's Bench of Alberta a true and complete inventory of the adult's 
assets and liabilities within six months after I am appointed trustee. 


Signature of Authorized Representative
Name of Authorized Representative


Date Signed
Title of Authorized Representative
Form 29  
 
Consent and Undertaking  
Alternate Trustee (Individual)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Consent of Proposed Alternate Trustee
Applicant Name


1   I,
< name of proposed 
alternate trustee>,  
consent to act as 
alternate trustee for
< name of 
adult>
("adult").
2   I am 18 years of age or older.
3   I am
? 
a resident of Alberta.

? 
a resident of the 
province or state of 

4
? 
I am unaware of any conflict of interest that exists or could potentially 
come into existence if I am appointed alternate trustee.
OR

?
 
Details of any potential conflict of interest are set out below, together 
with an explanation of why I believe it will not prevent me from acting 
in the best interest of the adult.



5  
 
I undertake to file with the clerk of the Court of Queen's Bench of Alberta a 
true and complete inventory of the adult's assets and liabilities within six 
months after I commence acting as trustee because of an event referred to in 
section 53(3)(a) of the Act (death or incapacity of the trustee). If any 
significant asset or liability of the adult is discovered after the filing of my 
original inventory, I undertake to file a true inventory of the asset or liability 
upon its discovery.
6   I understand that I must advise the clerk of the Court as soon as I commence 
acting as trustee because of an event referred to in section 53(3)(a) of the Act and 
to provide evidence of the event to the clerk in accordance with the regulations. 
7   I understand that if I commence to act as trustee, I must maintain accounts of 
the trusteeship in accordance with the regulations under the Adult Guardianship 
and Trusteeship Act and submit my accounts for the Court's examination and 
approval if directed to do so by the Court.
8   I have carefully read the proposed trusteeship plan submitted with the 
application. I understand that I must act in accordance with the trusteeship plan as 
approved by the Court.
9   I authorize a review officer or a person acting on behalf of a review officer
?	to investigate my credit history and financial standing, including without 
limitation obtaining a report containing my credit information from a reporting 
agency as defined in the Fair Trading Act,
?	to obtain a criminal record check
if required by the review officer for the purpose of preparing a report to the Court 
regarding my suitability to be alternate trustee for the adult.


Signature of Proposed Alternate trustee
Signature of Witness 


Date Signed
Full Name (Printed) of Witness
Form 30  
 
Personal References
My Name:

Name of the person who the application is about ("the adult")


Each person named below has consented to be my personal reference for the 
purposes of an application under the Adult Guardianship and Trusteeship Act to 
appoint me as
? 
Guardian
? 
Alternate Guardian
? 
Trustee
? 
Alternate Trustee
? 
Co-decision-maker
for the adult.

I consent to a review officer or a person acting on behalf of a review officer 
contacting personal references being contacted for the purpose of obtaining 
personal information about me, to be used by a review officer for the purpose of 
preparing a report to the Court regarding my suitability to be a co-decision-maker, 
guardian, alternate guardian, trustee or alternate trustee.

PERSONAL REFERENCES
Name
Telephone Number (Day)
Telephone Number (Evening)









Signature of Proposed Guardian
Signature of Witness 


Date Signed
Full Name (Printed) of Witness
Form 31  
 
Request for Hearing
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Request for Hearing
Applicant Name


To request the Court to hold a hearing regarding this application you must 
complete this Request for 
Hearing and return it by fax or mail to the review officer. The completed Request 
for Hearing must be
received by the review officer on or before 
this date:




? 
I request that the Court hold a hearing to consider this application, for the 
following reason(s)

? 
I do not believe the adult requires a co-decision-maker, guardian or 
trustee, for the following reason(s):

? 
I believe that a proposed co-decision-maker, guardian, alternate 
guardian, trustee or alternate trustee is unsuitable for the proposed 
function, for the following reason(s):

? 
I believe the application for examination and approval of the trustee's 
accounts raises issues that should be considered by the Court at a 
hearing, for the following reasons:

? 
Other (explain):

I understand that the Court may order the costs of an application to be paid to 
someone who objects to the application if the Court is satisfied the objection is 
frivolous or vexations.

NAME OF PERSON REQUESTING HEARING 
ADDRESS FOR SERVICE (Omit lawyer information if inapplicable)



Law Firm Name
Responsible Lawyer's Name
Lawyer's File Number



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail




Signature of person requesting Hearing or Signature of Lawyer 
on behalf of person requesting Hearing
Date
INFORMATION FOR RETURNING THIS FORM
Review Officer Mailing Address:

Review Officer Fax No. 

Review Officer File  No.


If you do not request a hearing, you will not receive notice of any hearing that does 
take place regarding this application.
Form 32 
 
Guardianship Plan
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Guardianship Plan

Proposed Represented Adult
Proposed Guardian and Alternate 
Guardian
Name

Name

Date of Birth (mm/dd/yr)



Address

Address

City/Province/PC

City/Province/PC

Telephone (incl. area code)

Telephone (incl. area code)

Living Situation (i.e. group 
home, long term care, etc.)



1   I have reviewed the Capacity Assessment Report, dated _____ which was prepared 
to support an application for a guardianship order for                  (proposed represented 
adult). In that report, the proposed represented adult was assessed as needing a 
guardian to make decisions about the following personal matters: 	
2   Do you have any additional information, other than the Capacity Assessment 
Report, about why the adult needs a guardian?  	
3   What types of decisions about personal matters for the proposed represented adult 
are expected to come up in the next year? [Only list the types of decisions that relate 
to the personal matters noted in #1 above]  	
4   What types of decisions about personal matters for the proposed represented adult 
are expected to come up in the next five years? [Only list the types of decisions that 
relate to the personal matters listed in #1 above]  	
5   How do you plan to involve the proposed represented adult in making decisions?  	
6   How do you plan to inform the represented adult about the decisions that you make 
as a guardian?  	
7   After you are appointed, how do you plan to encourage the proposed represented 
adult to become, to the extent possible, able to care for himself or herself and able to 
make decisions about personal matters?  	
8   The Adult Guardianship and Trusteeship Act says that decisions of a guardian 
must be made in the best interests of a represented adult and consideration must be 
given to (i) any wishes known to have been expressed by the adult while the adult had 
capacity, and (ii) any values and beliefs known to have been held by the adult while 
the adult had capacity. 
	(a)	Describe any known values and beliefs of the proposed represented adult 
that you will take into consideration when making decisions in his or her 
best interests? 	
	(b)	How do you plan to ensure your future decisions as a guardian are in the 
best interests of the proposed represented adult? 	
9   If more than one person is appointed as a guardian for the proposed represented 
adult, how do you intend to carry out your roles as guardians? 
	(a)	Is it your intention that all decisions will be made jointly by the guardians? 
Yes        No      
OR 
	(b)	Is it your intention that each guardian will have responsibility to make 
decisions about certain specified personal matters?  Set out the personal 
matters that it is proposed each guardian would be responsible for making 
decisions about.  	
_________________________________________________________________NOT
E:   This does not apply to alternate guardians - see section 32 of the Adult 
Guardianship and Trusteeship Act
10   Are there any other issues or comments that you would like to share with the 
Court. 	
If I am appointed guardian, I agree to bring a review application back to Court on the 
date identified in the Court Order, if a date was identified.
                                                                                                                                  
Signature of proposed guardian                                          Date
                                                                                                                                    
Signature of proposed guardian                                          Date 
(if more than one guardian is proposed)
                                                                                                                                    
Signature of proposed alternate guardian                            Date
                                                                                                                                    
Signature of proposed alternate guardian                            Date 
(if more than one alternate guardian is proposed) 
Form 33 
 
Guardian's Record of Decisions
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Guardian Annual Record of Decisions
(Include only major or important decisions made within your court-ordered areas of 
authority - e.g. health care, accommodations, etc.)
1   I,    (name of guardian)    am the guardian for    (name of represented adult)   .
2   My Guardianship Plan said that during the period    (day/month/year)    to  
   (day/month/year)    , I expected to make the following decisions about personal 
matters on behalf of the represented adult: 	
3   During the period    (day/month/year)    to     (day/month/year)    , I made the 
following decisions about personal matters on behalf of the represented adult:
Date of Decision
Decision Made
Comments






OR
4   I did not make the decisions that I expected to make as stated in my Guardianship 
Plan because: 	
                                                                                                                               
Signature(s) of guardian(s)                                             Date
Form 34  
 
Trusteeship Plan
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Trusteeship Plan

In this form the word "adult" refers to the person for whom an application for a 
trusteeship order is being made or, if  there is already a trusteeship order in place, 
to the represented adult.

1   Provide the following information for each proposed trustee
Last Name (or Corporate Name)
First Name
Province of Residence (if an individual) 







1   Provide the following information for each proposed alternate trustee (if any)
Last Name (or Corporate Name)
First Name
Province of Residence (if an individual) 






ADULT'S ASSETS AND LIABILITIES
Assets
3   Does the adult own any land in Alberta, either as sole owner or co-owner with 
someone else?

? 
Yes *
? 
No
? 
Do Not Know
*If Yes, complete Schedule 1

4   Does the adult own any mineral titles either as sole owner or co-owner with 
someone else?

? 
Yes *
? 
No
? 
Do Not Know
*If Yes, complete Schedule 1

5   Does the adult have one or more bank accounts (e.g. chequing account, savings 
account)?

? 
Yes *
? 
No
? 
Do Not Know

* If yes, provide following information for each known account.
Financial 
Institution 
Estimated 
balance
Joint Account?
Other Joint Holder's Name and 
Relationship to Adult


?  yes  ?  no



?  yes  ?  no

Explain your plan for taking control of funds in the accounts (e.g. close account 
and transfer funds to a trust account operated by you). For a joint account, indicate 
how you will identify and protect the adult's share of the funds.


6   Does the adult have one or more tax sheltered investment accounts (e.g. RRSP, 
RRIF, RESP, TFSA or RDSP)?

? 
Yes *
? 
No
? 
Do Not Know

*If yes, provide the following information for each known account.
Type (e.g. 
RRSP)
Issuer     (Financial Institution 
the account is with)
Estimated 
Value
Designated 
Beneficiary (if known)








Briefly explain your plan for dealing with the adult's tax sheltered accounts (e.g.  
leave funds in registered account(s) unless it is necessary to withdraw funds to 
provide for the adult's  support and care).


7   Does the adult have one or more non-tax sheltered investment accounts (e.g. 
GIC, term deposit, brokerage account, savings bonds, mutual funds, segregated 
accounts, life insurance with cash value)?

? 
Yes *
? 
No
? 
Do Not Know

* If yes, provide following information for each known account.
Financial 
Institution 
Estimated 
balance
Joint Account?
Other Joint Holder's Name and 
Relationship to Adult


?  yes  ?  no



?  yes  ?  no

Briefly explain your plan for taking control of assets in such investment accounts 
(e.g. close account and transfer assets to a trust account operated by you on behalf 
of the adult). For a joint account, indicate how you will identify and protect the 
adult's share of the account.


8   Does the adult own other financial assets? Examples of other financial assets 
that an adult might own include cash on hand; account at a residential facility; 
shares in private companies or partnerships; security certificates held outside of a 
brokerage account (e.g. in a safety deposit box); shareholder loans; private loans 
made by the adult (e.g. to family members or friends); an interest in a trust or in a 
deceased person's estate.

? 
Yes *
? 
No
? 
Do Not Know

*If Yes, provide the following information about other known financial assets.
Description
Estimated Value




Briefly explain your plan for taking control of, realizing or protecting such 
financial assets. 


9   What other types of assets with significant monetary value does the adult own? 
Type of Property
Yes
No 
Not 
Known
Estimated 
Value
Other information 
(if any)
Vehicles, mobile 
homes, boats
? 
? 
? 


Household effects 
and furnishings
? 
? 
? 


Valuables (e.g. 
jewelry, collectibles)
? 
? 
? 


Farm machinery, 
livestock, crops, etc
? 
? 
? 


Tools, equipment, 
business inventory
? 
? 
? 


Other 
? 
?  
? 


Briefly explain your plan for taking control of such property and your plan for 
dealing with any property that is no longer required for the adult's own use. For 
example, what will you do with a car that the adult no longer requires for his or her 
own use (e.g. sell it, store it)? You may describe a specific plan for dealing with 
property that you know the adult owns but no longer requires for his or her own 
use. Alternatively, or in addition, you may describe generally how you will 
evaluate available options (e.g. storing, renting, selling) for dealing with property 
no longer required for the adult's own use.

Liabilities
Does the adult currently owe money to anyone (e.g. mortgage loans, personal 
loans, credit card balances, outstanding taxes)?

? 
Yes* 
? 
No
? 
Do Not Know

*If Yes, provide details below
Type of debt (e.g. 
personal loan)
Estimated 
Amount*
Name of 
Creditor
Other information, 
including name of any 
other person jointly 
responsible for debt








Briefly explain your plan for dealing with the adult's debts.

ADULT'S INCOME AND EXPENSES 
 
Income
11   What is the adult's estimated monthly income from all sources?*
$
* You may use the worksheet in Schedule 3 as a guide for estimating the adult's 
monthly income.

12   Do you anticipate any substantial change (increase or decrease) in the amount 
of the adult's monthly income? 
? 
Yes* 
? 
No
? 
Do Not Know
*If Yes, provide details below.


13   Are you sure that the adult is currently receiving (or that application been made 
for) all benefits (e.g. pension payments, disability benefits, veterans' benefits) for 
which he or she may be eligible?

? 
Yes
? 
No*
*If No, explain how you plan to ensure the adult is receiving all benefits for which 
they are eligible.

Expenses
14   What is the adult's estimated average monthly expenditure?*

* You may use the worksheet in Schedule 4 as a guide for estimating the adult's 
expenditures.

15   Do you anticipate any substantial change (increase or decrease) in the amount 
of the adult's monthly expenditures? 

? 
Yes *
? 
No
? 
Do Not Know
*If Yes, provide details below.


16   Do you anticipate having to make any substantial non-recurring expenditure(s) 
(e.g. one-time purchases) on the adult's behalf?

? 
Yes *
? 
No
? 
Do Not Know
*If Yes, describe the purpose and amount of anticipated expenditures below.


17   Do you expect the adult's income to be sufficient to cover all expenditures 
required for his or her education, support and care?

? 
Yes 
? 
No*

*If No, explain your plan for dealing with the anticipated shortfall of income 
versus expenditures (e.g. by using the adult's savings or by selling assets no longer 
required for the adult's own use to help pay for required expenditures).

Administration of Adult's Financial Matters
18  Are there any financial matters that require immediate attention if you are 
appointed trustee?

? 
Yes *
? 
No
? 
Do Not Know
*If Yes, provide details of the matters requiring attention and explain your plan for 
dealing with them. 


19  Is the Court being requested to give exclusive authority over certain matters to 
one of two or more trustees? 
? 
Yes*
? 
No
? 
Not Applicable: There will be only one trustee
*If Yes, identify the trustee who would be given exclusive authority and the 
matters with respect to which the trustee would be given exclusive authority, and 
explain the reason for your request.


20   Is the Court being requested to allow each of two or more trustees to act 
separately, rather than jointly?
? 
Yes*
? 
No
? 
Not Applicable: There will be only one trustee
*If Yes, explain the reason for your request.


21   As trustee you must make investment decisions in accordance with sections 2 
through 8 of the Trustee Act (the "prudent investor rule"), subject to a contrary 
intention expressed in the trusteeship order or trusteeship plan approved by the 
Court.  
 Are you requesting the Court's advance approval of a specific investment decision 
or investment plan (e.g. to retain specific financial assets the adult already owns)?

? 
Yes  *
? 
No
*If Yes, describe below or in a separate schedule the specific investment 
decision(s) or investment plan for which you are requesting the Court's advance 
approval.


? 
See attached schedule.

22   Do you plan to set up or maintain an account for the adult at a residential 
facility into which you will deposit money to be used to pay for incidental 
expenses incurred by the adult?*

? 
Yes *
? 
No
? 
Do Not Know
*If you do set up or maintain such an account, you must ensure that payments out 
of the account are properly documented by the facility.

23   Are you requesting the Court's authority to permit the adult to open or 
maintain a deposit account at a financial institution, into which you would deposit 
funds and from which the adult could make withdrawals or payments without your 
involvement? 

? 
Yes*
? 
No

*If Yes, provide the following information:
Proposed maximum monthly deposit
$

Proposed maximum balance
$


24   You must hold money and other financial assets of the adult in an account(s) 
that identifies the adult as the sole beneficial owner of the funds or assets in the 
account, unless the Court specifically authorizes you to do otherwise. 
Are you requesting the Court to authorize you to hold any money or other financial 
assets of the adult otherwise than in an account that identifies the adult as the sole 
beneficial owner? 

? 
Yes*
? 
No 
*If Yes, describe the proposed arrangement for which you are requesting the 
Court's authority and explain why it would be appropriate for the Court to give you 
the requested authority.


25   You must keep property of the adult separate from your own property unless 
the Court specifically permits you to do otherwise.  Are you requesting the Court 
to authorize you to keep certain property of the adult together with your own 
property?*

? 
Yes*
? 
No
*If Yes, describe the property and explain why it would be appropriate to keep the 
adult's property together with your own property.

Use of Adult's Property for Benefit of Others
26   Will you make any payment, loan or gift from the adult's property to yourself? 

? 
Yes* 
? 
No
*If Yes, provide details of the proposed payment, loan or gift and explain why it 
would be appropriate for you to make it.


27   Will you make any payment, loan or gift from the adult's property to a person 
you live with or to a person (other than the adult) to whom you are related or to a 
business or corporation in which you have a substantial financial interest?

? 
Yes* 
? 
No
*If Yes, provide details of the proposed payment or loan and explain why it would 
be appropriate for you to make it.


28   Are you requesting the Court's authority to make payments or expenditures 
from or use the adult's property for the benefit of any other person?

? 
Yes*
? 
No
*If Yes, explain why it would be appropriate for the Court to authorize the 
proposed payments, expenditures or use.

Other Matters
29   An individual trustee who is not a resident of Alberta must provide a bond or 
other form of security (collateral) unless the Court dispenses with this requirement.
Are you requesting that the Court dispense with the requirement for a non-resident 
trustee to provide a bond or other form of security?

? 
Yes* 
? 
No
*If Yes, explain why it would be in the adult's best interest for the Court to 
dispense with a bond or security, and describe any alternative safeguard you are 
proposing.


30   Has the adult made a will?

? 
Yes*
? 
No 
? 
Do Not Know**
*If Yes, briefly describe how you plan to safeguard the adult's will and to perform 
your duties as trustee taking into account the adult's testamentary intentions.
**If you do not know, briefly describe the steps you will take to find out.


31   Does the adult have a safety deposit box?

? 
Yes*
? 
No
? 
Do Not Know**
*If Yes, explain your plan for dealing with the safety deposit box and its contents.
**If you do not know, briefly describe the steps you will take to find out.


32   Are there any outstanding tax matters (e.g. unfiled tax returns) for you to deal 
with on the adult's behalf?

? 
Yes 
? 
No
? 
Do Not Know
Briefly explain your plan for dealing with outstanding tax matters of the adult, if 
any, and for dealing with future tax matters on the adult's behalf.


33   Is the adult involved in any ongoing legal proceedings relating to property or 
financial matters? 

? 
Yes*
? 
No
? 
Do Not Know
*If Yes, briefly describe the proceedings and your plan for protecting the adult's 
interests in them.


34   Trustees may elect to be compensated in accordance with the compensation 
schedule in the regulations, or may choose to ask the Court to determine 
compensation at a later date, or may choose not to receive compensation. Indicate 
your choice with respect to compensation below.
? 
I elect to be compensated in accordance with the compensation schedule in 
the regulations.*
? 
I am requesting the Court to approve compensation in accordance with a 
compensation plan attached to this trusteeship plan as Schedule  ? 
? 
I will ask the Court to determine my compensation at a later date.
? 
I choose to not receive compensation for acting as trustee.**
*If you elect to be compensated in accordance with the schedule in the regulations, 
you may only take compensation when authorized to do so by the Court.
** If you forego compensation you will still be entitled to reimbursement for direct 
expenses incurred and disbursements made on the adult's behalf.

35   If there is any other information about your plans for managing the adult's 
financial matters that you wish to bring to the attention of the Court, you may 
provide the information below.  Each proposed trustee must sign below
Name (Printed)
Signature
Date Signed






Schedule 1 - Real Property (Land)
Complete this schedule if the adult owns real property (land) in Alberta. If the 
adult owns more than one property, provide the indicated information for each 
property owned by the adult.

City /Town / Municipality 


Municipal Address or Legal Description

The adult is:
? 
Sole owner
? 
Co-owner with someone else - Provide 
details below
Co-ownership 
details (if 
applicable)
? 
Joint ownership (with right 
of survivorship)
? 
Tenancy in common 

Name(s) of co-owner(s) and relationship to adult

Type of Property 
and Current Use 
(check all that 
apply)
? 
Residential
? 
Adult's residence
? 
Agricultural 
? 
Co-owner's residence
? 
Vacant 
? 
Rented at fair market value
? 
Other type or use (Describe)


Valuation
Estimated Market Value
$
Mortgage Amount
$
YOUR PLAN FOR THIS PROPERTY
What is your 
plan for this 
property?
? 
Keep as the adult's residence
? 
Sell*

? 
Rent at fair market value*
? 
Other *(describe):


*As trustee you will have no authority to sell or mortgage land or to lease land for a 
term in excess of 3 years, unless the trusteeship order authorizes you to do so. If such 
authority is requested, an affidavit must be filed explaining why the proposed 
transaction is in the adult's best interest.
Schedule 2 - Mineral Titles
Complete this schedule if the adult owns any freehold mineral titles in Alberta. If 
the adult owns more than one mineral title, provide the indicated information for 
each title owned by the adult.

Legal Description, including fractional interest (e.g. 1/4)

The adult is:
?
 
Sole owner 
? 
Co-owner with someone else - Provide 
details below
Co-ownership 
details (if 
applicable)
?  Joint ownership (with right 
of survivorship)
? 
Tenancy in common

Name(s) of co-owner(s) and relationship to 
adult

Current 
status
? 
Leased
Monthly lease income:
$

? 
Subject to pooling order
Monthly income, if any
$

? 
Not leased or subject to pooling order
Valuation
Estimated Market Value
$
OR
? 
Unknown
YOUR PLAN FOR THIS PROPERTY
What is your plan 
for the mines & 
minerals?
? 
Continue to receive income  under current lease or pooling order

? 
Lease*

? 
Other* (Describe)

*As trustee you will have no authority to sell land (including minerals), grant a lease for 
a term in excess of 3 years, or encumber (e.g. mortgage) land unless the trusteeship 
order authorizes you to do so. If such authority is requested, an affidavit must be filed 
explaining why the proposed transaction is in the adult's best interest.
Schedule 3 - Income Worksheet
Source of Income
Estimated 
Monthly 
Amount
Assured Income for the Severely Handicapped (AISH)

Support for Independence (SFI) Income Support

Old Age Security (OAS) Program


Pension


Guaranteed Income Supplement


Spouse / Partner allowance


Survivor Allowance

Alberta Seniors Benefit

Canada Pension Plan (CPP)


Retirement Pension


Disability Benefits


Survivor Benefits

Veteran's Pension

Employment Pension Plan


Retirement Pension


Disability Benefits


Survivor Benefits

Other Disability Pension

Workers Compensation Payments

Life Annuity (issued by insurance company)

Investment income (e.g. RRSP, RRIF, dividends, interest)

Rental income 

Employment Income 

Self-employment income

Spousal / partner support (e.g. under court order or agreement)

Other (describe):


Estimated Total Monthly Income

Schedule 4 - Expenditures Worksheet
Expenditure Type
Estimated 
Monthly 
Amount
Home ownership expenses


Mortgage payment


Utilities


Repairs & maintenance


Property taxes

Accommodation, food and care in residential care facility (e.g. 
nursing home)

Rent payments or other accommodation costs not included above

Food not included above

Prescriptions not included above

Personal care not included above

Recreation and entertainment

Travel (including local travel)

Education and training

Insurance 


Life


General  (e.g. household)


Other:


Spousal / Partner or child support (e.g. under court order or 
agreement)

Income tax

Payments on existing debts (e.g. mortgage loan, personal loan, credit 
card)

Other recurring expenditures not included above

Estimated Total Recurring Expenses:

Form 35  
 
Trusteeship Plan (Public Trustee)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Trusteeship Plan

In this form the word "adult" refers to the person for whom an application for a 
trusteeship order is being made or, if  there is already a trusteeship order in place, 
to the represented adult.

1   Briefly describe the Public Trustee's approach to administering land (including 
mines and minerals, where applicable) owned by a represented adult for whom the 
Public Trustee is appointed trustee, including how the Public Trustee decides 
whether to sell land owned by a represented adult.


2   Briefly describe the Public Trustee's approach to taking control of funds in 
bank accounts owned by the adult, including how the Public Trustee identifies and 
protects the adult's share of joint bank accounts.


3   Briefly describe the Public Trustee's approach to dealing with tax sheltered 
accounts (e.g. RRSP, RRIF, RESP, TFSA, RDSP) of the adult.


4   Briefly describe the Public Trustee's approach to taking control of assets in 
other ( non-tax sheltered) investment accounts (e.g. GIC, term deposit, brokerage 
account, savings bonds, mutual funds, segregated accounts, life insurance with 
cash value), including how the Public Trustee identifies and protects the adult's 
share of joint investment accounts.


5   Briefly describe the Public Trustee's approach to taking control of, realizing or 
protecting other financial assets owned by an adult (e.g. cash on hand; account at a 
residential facility; shares in private companies or partnerships; security certificates 
held outside of a brokerage account; shareholder loans; private loans made by the 
adult; interest in a trust or in a deceased person's estate).


6  Briefly describe the Public Trustee's approach to taking control of other assets 
of significant monetary value and dealing with assets that are no longer required 
for the adult's own use (e.g. storing, renting, selling)


7   Briefly describe the Public Trustee's approach to dealing with the adult's debts 
and liabilities (e.g. mortgage loans, personal loans, credit card balances, 
outstanding taxes).


8   Briefly describe the Public Trustee's approach to ensuring that the adult is 
receiving all benefits (e.g. pension payments, disability benefits, veterans' benefits) 
for which he or she may be eligible.


9   Briefly describe the Public Trustee's approach for dealing with any shortfall of 
income versus expenditures (e.g. by using the adult's savings or by selling assets 
no longer required for the adult's own use to help pay for required expenditures).


10   Is the Court being requested to give exclusive authority over certain financial 
matters to the Public Trustee as one of two or more trustees? 
?  
Yes*
?  
No
?  
Not Applicable: There will be only one trustee
*If Yes, identify the matters with respect to which the Public Trustee would be 
given exclusive authority.


11. Briefly describe the Public Trustee's approach to investing the adult's money 
available for investment.


12. Briefly describe the Public Trustee's approach to setting up or maintaining an 
account for the adult at a residential facility into which the Public Trustee would 
deposit money to be used to pay for incidental expenses incurred by the adult.


13   Is the Public Trustee requesting the Court's authority to permit the adult to 
open or maintain a deposit account at a financial institution, into which the Public 
Trustee would deposit funds and from which the adult could make withdrawals or 
payments without the Public Trustee's involvement? 

?  
Yes*
? 
No

*If Yes, provide the following information:
Proposed maximum monthly deposit
$

Proposed maximum balance
$


14   Is the Public Trustee requesting the Court to authorize the Public Trustee to 
hold any money or other financial assets of the adult otherwise than in an account 
that identifies the adult as the sole beneficial owner? 

?  
Yes*
?  
No 
*If Yes, describe the proposed arrangement for which the Public Trustee is 
requesting the Court's authority and explain why it would be appropriate for the 
Court to give the Public Trustee the requested authority.


15   Briefly describe the Public Trustee's approach to finding out whether the adult 
has a last will and, if the adult does have a will, the Public Trustee's approach to 
safeguarding the will and performing the Public Trustee's duties as trustee taking 
into account the adult's testamentary intentions.


16   Briefly describe the Public Trustee's approach to protecting the adult's 
interests in legal proceedings that may arise in relation to the adult's financial 
matters.


17   If there is any other information about the Public Trustee's approach to 
managing an adult's financial matters that the Public Trustee wishes to bring to the 
attention of the Court, provide it below.



Signature of Authorized Representative
Name of Authorized Representative


Date Signed
Title of Authorized Representative
Form 36  
 
Statement of Transactions 
(Optional Prescribed Form)
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Applicant 

Document
Statement of Transactions 

I, 




Trustee Name

Trustee Address
and I




Trustee Name

Trustee Address
trustee for the adult, swear or affirm that this statement of transactions 
accurately discloses and describes all transactions relating to my duties as 
trustee for the adult for the accounting period from 

to


Start Date

End Date

I have personal knowledge of the facts and matters referred to in this statement of 
transactions except where stated to be based on information and belief.
Section 1 - Bank Account Transactions


Financial Institution

Account No.

Account Type


Date 
YYYY/MM/DD
Reference 
No.
Transaction 
Description
Transaction Amount
Balance



Payment, Fee, 
Withdrawal (-)
Deposit (+)



Balance Forward













Section 2 - Investment Account Transactions


Financial Institution

Account No.

Account Type


Tran Date 
YYYY/MM/DD
Transcription Described  (e.g. see 
100 shares of XYZ Inc. at $20/share)
Amount Received 
/ Transferred In 
(+)
Amount Paid / 
Transferred Out (-)








Section 3 - Other Transactions


No.
Date 
YYYY/MM/DD
Description of transaction including 
estimated market value of property
Name of 
other Party
Authority, 
if Gift











Sworn or affirmed before me at

)

Alberta, on

)
SIGNATURE

)


)
NAME
A Commissioner for Oaths in the Province of Alberta
)


)
SIGNATURE

)

PRINT NAME AND EXPIRY/LAWYER/ STUDENT-AT-LAW
)
NAME
Form 37 
 
Inventory
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Applicant 

Document
Inventory 

I, 




Trustee Name

Trustee Address
and I




Trustee Name

Trustee Address
trustee for the adult, swear or affirm that this inventor accurately discloses and 
describes the adult's financial position as of this date: ___________
I have personal knowledge of the facts and matters referred to in this statement of 
transactions except where stated to be based on information and belief.
Summary
This inventory shows the adult's financial position as of                                 

Value of Adult's Assets and Liabilities
Amount
Line
Land  (net of mortgages)
Schedule A, Line A1

1
Financial Assets
Schedule B, Line B5

2
Other  Assets
Schedule C, Line C3

3
Total Assets 
Add Lines 1,2, & 3

4

Total Liabilities (excluding mortgages on 
land)
Schedule D, 
Line D1

5

Adult's Net Financial Position
 Line 4 minus Line 5

6
Adult's Average Monthly Income and Expenses
Amount

Average Monthly Income
Schedule E, Line E1

7
Average Monthly Expenditures
Schedule F, Line F1

8

Average Monthly Income Surplus 
(Deficiency) 
Line 7 minus 
Line 8

9

Schedule A - Land Owned by Adult
Land owned by the adult could include any combination of the following: 
? residential property (e.g. a house, condominium, cottage), agricultural land, 
commercial or industrial property, vacant land; 
? mineral title (ownership of minerals on or under land);
? land owned solely by the adult or owned by the adult as co-owner with someone 
else (as joint owners or tenants in common)
Does the 
adult own 
any land?
? 
Yes
How many  different properties does the 
adult own, either solely or as co-owner?


? 
No
Enter $0 in Line A1 below.
If the adult owns any land, complete Schedule AA (or Schedule AB for mineral 
titles) for each property owned by the adult. Please make as many copies of 
Schedule AA and /or Schedule AB as you require.


Line
Total net value of adult's interest in land*
$
A1
*This is the total of the adult's share of the net value of all land owned by 
the adult, as recorded in line AA5 of Schedule AA (and/or line AB3 of 
Schedule AB) for each property owned by the adult. 


SCHEDULE AA - Land other than mineral titles
Line
City, Town, Municipality



Municipal Address



Legal Description




? 
Adult is sole owner   Insert "100%" in Line AA1



? 
Adult is 
co-owner
Type of 
co-ownership
? 
Joint (right of survivorship)




? 
In-common (no right of survivorship)

Ownership  
Status
Co-owner's name




Co-owner's relationship to adult





Adult's percent ownership 
share in this property
%
AA1
Type and 
Current Use 
(check all that 
apply)
?  
Residential 
? 
Adult's residence



? 
Agricultural
? 
Co-owner's residence



? 
Vacant
? 
Rented at fair market value



? 
Other (describe)



Basis of 
valuation
?
 
Recent valuation by 
accredited appraiser
? 
Other (describe 
below):



?
 
Most recent municipal 
assessment



Estimated total market value 
$
AA2
Amount owed on mortgages (or other encumbrances) against this title
$
AA3
Net Value (Line AA2 minus Line AA3)
$
AA4
Adult's share of Net Value (Line AA1 multiplied by Line AA4)
$
AA5
A current copy of the certificate of title for this land is attached as 
Exhibit 



Schedule AB - Mineral Titles 

Line
Legal Description, including fractional interest (e.g. 1/4)



? 
Adult is sole owner   Insert "100%" in Line AB1



? 
Adult is 
co-owner
Type of 
co-ownership
? 
Joint (right of  survivorship)




? 
In-common (no right of 
survivorship)

Ownership  
Status
Co-owner's name




Co-owner's relationship to adult





Adult's percent ownership share in this 
property
%
AB1
Current status
? 
Leased
Monthly lease 
income:
$


? 
Subject to 
pooling order
Monthly income, if 
any
$


? 
Not leased or subject to pooling order



? 
Subject to gross royalty trust


Basis of 
valuation
? 
Recent appraisal 




? 
Other:

Estimated Value
$
AB2
Adult's share of Net Value (Line AB1 multiplied by Line AB2)
$
AB3

A current copy of the certificate of title for this land is attached 
as Exhibit 



Schedule B - Financial Assets Owned by Adult
Type
Note
Value
Line
Bank Accounts
Sum of Schedule BA, Line 
BA3 for all bank accounts
$
B1
Solely Owned  
Investment Accounts
Schedule BB, Line BB1 
$
B2
Joint Investment 
Accounts
Schedule BC, Line BC1
$
B3
Other Financial Assets
Schedule BD, Line BD1
$
B4
Total Value of Adult's Financial Assets
$
B5

Schedule BA - Bank Account
For the purposes of this schedule a bank account includes a chequing account or 
savings account at a financial institution such as a chartered bank, trust 
corporation, credit union, or treasury branch. If cheques may be written on or bills 
paid directly from an account, it should be recorded here as a bank account. 
Investment products like GICs and term deposits should be included in the 
"Investment Accounts" category below, even if issued by a bank.
?  Complete a copy of this schedule for each bank account of the adult. Include 
bank accounts of which the adult is the sole owner as well as accounts of which 
the adult is a joint owner with someone else.
?  If the adult has more than one bank account, please copy this schedule as 
required. The amount entered in line B1 above will be the sum of the amount 
entered in Line BA3 for each of the accounts.

Line
Financial Institution

Branch



Account 
Number

Type (e.g. Savings, 
Chequing)



Account 
Ownership 
Status
?
 
Adult is sole owner 
Enter 100% in 
Line BA1



?
 
Adult is 
joint owner
Name of co-owner






Co-owner's 
relationship to adult



What is the adult's proportionate (%) beneficial interest in this 
account?
%
BA1
What is the account balance? 
$
BA2
What is the adult's share of the account balance (Line BA1 
multiplied by Line BA2)
$
BA3

A copy of a current statement of account is attached as 
Exhibit 




Schedule BB - Investment Accounts Solely Owned by Adult
This schedule records financial assets held in investment accounts with financial 
institutions (other than bank accounts included in Schedule BA) where the account 
is owned solely by the adult. The following are examples of financial assets that 
might be held in such an investment account:
?  cash balances (e.g. within a brokerage account) or money market instruments 
(e.g. treasury bills, corporate paper, bankers' acceptances); 
?  GICs, term deposits, savings bonds;
?  marketable bonds (e.g. government, municipal, corporate);
?  common shares, preferred shares, share warrants, limited partnership units;
?  units or shares of mutual funds, exchange traded funds (ETFs), income trusts, 
gross royalty trusts; 
?  life insurance products with a cash value (e.g. segregated funds, whole life 
policies, variable life policies, universal life policies).
If a financial asset owned by the adult is held outside of an investment account 
with a financial institution (e.g. cash or security certificates held in a safety deposit 
box), they should be recorded in Schedule BD Other Financial Assets
Instructions for completing this schedule:
? Financial Institution  Insert the name of the financial institution with whom 
the adult has the investment account. 
? Account ID  Insert the account identification number provided by the financial 
institution. You may enter a partial account number so long as it is sufficient to 
clearly distinguish the account.
? Tax Shelter Type  Insert the type of tax sheltered account (e.g. RRSP, RRIF, 
RDSP, RESP, TFSA) or leave column blank or write "N/A" if it is not a tax 
sheltered account.
? Asset Type  Insert the type of financial assets held in the account, as described 
in account statements provided by the financial institution. You are not required 
to describe each individual financial asset held within a particular investment 
account; description by type is sufficient.  Record different types of financial 
assets held in the same investment account on separate lines of the table. 
? Valuation Basis  Insert the basis upon which the value of the financial assets is 
stated. For life insurance products, give the cash value of the product. For other 
financial assets, give the market value if provided by the financial institution; 
otherwise, give the face value or book value.
? Value  Insert the value of the financial assets, as set out in the account 
statement from the financial institution.

Financial 
Institution
Account 
ID
Tax Shelter 
Type
Asset 
Type
Valuation 
Basis 
Value
Line














Total Value of Adult's Solely Owned Investment Accounts

BB1

A copy of a the current statement of account for each account 
referenced above is attached as Exhibit(s) 


Schedule BC - Investment Accounts held Jointly 
                               by Adult with someone else
This schedule records financial assets held in investment accounts with financial 
institutions where the account is owned jointly by the adult with someone else. 
The following are examples of financial assets that might be held in such a joint 
investment account:
?  cash balances (e.g. within a brokerage account) or money market instruments 
(e.g. treasury bills, corporate paper, bankers' acceptances); 
?  GICs, term deposits, savings bonds;
?  marketable bonds (e.g. government, municipal, corporate);
?  common shares, preferred shares, share warrants, limited partnership units;
?  units or shares of mutual funds, exchange traded funds (ETFs), income trusts, 
gross royalty trusts; 
?  life insurance products with a cash value (e.g. segregated funds, whole life 
policies, variable life policies, universal life policies).
Instructions for completing this schedule
? Financial Institution  Insert the name of the financial institution with whom 
the adult has the investment account. 
? Account ID  Insert the account identification number provided by the financial 
institution. You may enter a partial account number so long as it is sufficient to 
clearly distinguish the account.
? Joint Owner  Insert name of the other joint owner of the account. 
? Asset Type  Insert the type of financial assets held in the account, as described 
in account statements provided by the financial institution. You are not required 
to describe each individual financial asset held within a particular investment 
account; description by type is sufficient. Record different types of financial 
assets held in the same investment account on separate lines of the table. 
? Total Value  Insert the total value of the financial assets, as set out in the 
account statement from the financial institution. For life insurance products, give 
the cash value of the product. For other financial assets, give the market value if 
provided by the financial institution; otherwise, give the face value or book 
value.
? Adult's share (%)  Insert the adult's proportionate share of the account; the 
percentage of the account's total value to which the adult would be entitled if the 
account were closed now.
? Adult's share ($)  This is the dollar value of the adult's share of the financial 
assets recorded on a particular line (e.g. if the Total Value is $5000 and the 
Adult's Share (%) is 50%, the Adult's Share ($) is $2500).

Financial 
Institution
Account 
ID
Joint Owner's 
Name and 
Relationship
Asset 
Type
Total 
Value ($)
Adult's 
Share 
(%)
Adult's 
Share 
($)
Line
















Total Value of Adult's Share of Joint Investment Accounts
$
BC1

A copy of a the current statement of account for each account referenced 
above is attached as Exhibit(s) 


Schedule BD - Other Financial Assets
Provide details of any financial assets owned by the adult that are not included in 
schedules BA, BB, or BC. This could include, for example:
?  cash on hand; 
?  balance in account maintained for adult's use with residential facility;
?  security certificates (e.g. share certificates, gross royalty trust certificates, 
savings bonds) not held in an investment account; 
?  shares of private corporations;
?  shareholder loans to private corporations;
?  interest in a partnership or sole proprietorship;
?  interest in a trust or in a deceased person's estate;
?  interest in ongoing or potential lawsuit (e.g. personal injury claim);
?  private debts owed to the adult.
Description and Location (e.g. safety deposit 
box)
Valuation 
Basis
Value
Line


$



$

Total
$
BD1

Schedule C - Other Assets
This schedule includes all of the assets owned by the adult other than land included 
in Schedule A and financial assets included Schedule B.
For estimated value, give the estimated amount for which the property could be 
sold to an arm's length purchaser.
Type
Note
Estimated 
Value
Line
Motor vehicles, mobile homes, 
boats
Schedule CA, Line CA1
$
C1
Other property 
Schedule CB, Line CB1
$
C2
Total value of all other assets owned by adult 
$
C3

Schedule CA - Motor Vehicles, Mobile Homes, Boats
For the purpose of this schedule, motor vehicles include, for example, cars, trucks, 
motorcycles, recreational vehicles, off-road vehicles, snowmobiles.
Enter $0 in Line CA1 if the adult does not own a motor vehicle, mobile home, or 
boat.
Type 
Description (make, model, year)
Estimated Value
Line


$



$

Total value of motor vehicles, mobile homes and boats
$
CA1

Schedule CB - Other Property
This schedule should include all property owned by the adult that is of significant 
monetary value and is not included in any other schedule. Examples of other types 
of property that might be owned by the adult and included in this schedule include:
?  Farm assets (e.g. equipment, tools, livestock, crops, seed, quotas)
?  Business assets (e.g. equipment, inventory)
?  Household and personal effects
?  Identify an item or a distinct set of items (e.g. a coin collection) individually in 
the space provided only if the estimated market value of the item or set is at least 
$1000.
?  If the adult owns property of a certain description that has significant monetary 
value, but it is not currently possible to give a reasonable estimate of fair market 
value, describe the property and indicate "Unknown" in the Estimated Value 
column.
Description
Estimated Value
Line

$


$

Total value of other property
$
CB1

Schedule D - Liabilities
This schedule should include all money owed by the adult, other than loans secured 
by mortgages against land.
?  It includes, for example, credit card debts, personal loans, car loans, lines of 
credit, and ongoing or potential lawsuits against the adult.
?  State the total amount owing on the loan, not the amount of the monthly 
payment, if any
Creditor
Account 
No.
Co-debtor, if any (i.e. someone also 
legally responsible for the debt)
Amount 
Owed
Line



$




$

Adult's total liabilities (excluding encumbrances on land)
$
D1

Schedule E - Income
State the adult's sources of income and the average monthly amount received from 
each source. If a source pays at non-monthly intervals (e.g. quarterly), convert the 
payments to an equivalent monthly amount.
Source of Income
Average Monthly 
Amount
Line
Assured Income for the Severely Handicapped (AISH)
$

Income Support
$

Alberta Seniors Benefit
$

Old Age Security (OAS) Program


Pension
$


Guaranteed income supplement
$


Spouse / Partner allowance
$


Survivor allowance
$

GST rebate
$

Child tax benefit
$

Canada Pension Plan (CPP)


Retirement pension
$


Disability benefits
$


Survivor benefits
$

Veteran's pension
$

Employment pension plan


Retirement pension
$


Disability benefits
$


Survivor benefits
$

Other disability pension
$

Workers compensation payments
$

Life annuity (issued by insurance company)
$

Investment income (e.g. interest, dividends, distributions)
$

Rental income 
$

Employment income 
$

Self-employment income
$

Spousal / partner support (e.g. under court order or 
agreement) received
$

Child support payment received
$

Other (describe)

$

Other (describe)

$

Other (describe)

$

Estimated Total Monthly Income
$
E1

Schedule F - Expenses
Indicate the type of expenses incurred by the adult and give the average monthly 
amount of each type of expense. 
?  If an expense is incurred at non-monthly intervals (e.g. quarterly) or 
irregularly, convert the payments to an equivalent average monthly amount.
Expenditure Type
Average Monthly 
Amount
Line
Land (e.g. home or rental property) ownership expenditures



Mortgage payment (including both principal and 
interest portion)
$


Utilities
$


Repairs & maintenance
$


Property taxes
$

Accommodation, food and care in residential care facility 
(e.g. nursing home)
$

Rent payments or other accommodation costs not included 
above
$

Food not included above
$

Prescriptions not included above
$

Caregiver and companionship expenses
$

Adult's personal allowance
$

Recreation and entertainment
$

Vehicle expenses (e.g. gas, maintenance, insurance)
$

Other transportation and travel expenses
$

Education and training
$

Storage charges for adult's property
$

Insurance 



Life
$


General  (e.g. household)
$


Other (describe)

$

Spousal / partner support paid
$

Child support paid
$

Income tax
$

Payments on existing debts not included above (e.g. 
personal loan, credit card)
$

Other (describe)

$

Other (describe)

$

Other (describe)

$

Total Average Monthly Expenses:
$
F1

Sworn or affirmed before me at

)

Alberta, on

)
SIGNATURE

)


)
NAME
A Commissioner for Oaths in the Province of Alberta
)


)
SIGNATURE

)

PRINT NAME AND EXPIRY/LAWYER/ STUDENT-AT-LAW
)
NAME
Form 38  
 
Overview of Trusteeship Accounts
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Applicant 

Document
Overview of Trusteeship Accounts

I, 




Trustee Name

Trustee Address
and I




Trustee Name

Trustee Address
trustee for the adult, swear or affirm that this overview of trusteeship accounts 
provides an accurate overview of trusteeship accounts for the adult for the 
accounting period from 

to


Start Date

End Date

I have personal knowledge of the facts and matters referred to in this statement of 
transactions except where stated to be based on information and belief.

The Start Date is the date as of which the adult's financial position was most 
recently reported to the Court, which occurred in the following context:
? 
Filing of initial inventory when I became the adult's trustee
? 
Application to pass accounts under the Dependent Adults Act ("DAA")
? 
Filing of accounts with clerk and approval by Court in form filed under DAA
? 
Filing of summary accounting statement under DAA
? 
Application for examination and approval of accounts under the AGTA
? 
Other (explain): 


Adult's Assets and Liabilities (Debts)

Start Date

End Date
Land (net of mortgages)



Bank Accounts



Other Financial Assets



Other Assets







Total Assets 







Total Liabilities (excluding mortgages on land)







NET FINANCIAL POSITION 



Adult's Monthly Income and Expenditures
For Start Date income and expenditures, use amounts previously reported to the 
Court. For End Date income and expenditures, use the average for the 12 months 
immediately preceding the End Date.

Start Date

End Date
Average monthly income from all sources



Average monthly expenditures for all 
purposes







Average Monthly Surplus (Deficit)



Section 1 - Summary of Assets and Liabilities as of End Date
Land  (including mineral titles, if any)
Description
Market 
Value 
Mortgage 
Amount 
Net Value 
Adult's 
Share %
Net Market Value 
of Adult's Share 












Total Net Value of Adult's Share of Land				

Financial Assets
Market Value
Bank Accounts (adult's share if joint accounts)		

Solely Owned Investment Accounts

Joint Investment Accounts (adult's share)

Other Financial Assets (e.g. cash, private company shares, 
partnership interest, private debts)

Total Financial Assets

Other Assets
Market Value
Motor Vehicles, Mobile Homes, Boats

Other (e.g. farm assets, business assets, personal and 
household effects)

Total Other Assets



TOTAL ASSETS

Liabilities (other than encumbrances on land)
Name of Creditor
Description of Loan or Liability
Amount






TOTAL LIABILITIES

Section 2 - Detailed Reconciliation of Bank Accounts
START DATE BALANCE
$
RECEIPTS
Pension and Program Benefits (describe sources)


Source

$


Source

$


Source

$


Source

$


Employment or self-employment earnings
$


Rental Income
$


Spousal / partner / child support received
$


Proceeds received from sale of property 
$


Bank interest received
$


Transfers from other financial asset accounts
$


Other receipts
$


TOTAL RECEIPTS
$

PAYMENTS AND TRANSFERS


Land ownership payments (e.g. mortgage, taxes)
$


General expenditures for adult's benefit



Paid to residential care facility (e.g. nursing 
home) 
$


Other accommodation expenses (e.g. rent)
$


Other food expenses
$


Other personal care and companionship 
expenses
$


Advances to adult for personal use
$


Recreation expenses
$


Vehicle, transportation and travel expenses
$


Insurance premiums
$


Income tax paid
$


Payments on debts (e.g. personal loans, credit 
cards)
$


Spousal / partner / child support paid
$


Property purchased for adult
$


Gifts and donations made
$


Bank charges paid
$


Transfers to other financial asset accounts
$


Reimbursement of guardian's expenses
$


Trust administration expenses
$


Trustee compensation taken 
$


Other payments
$


TOTAL PAYMENTS AND TRANSFERS
$

END DATE BALANCE 
$
Section 3 - Summary Reconciliation of Other Assets and Liabilities
LAND - Net Value of 
Adult's Interest
Start Date 
Net Value
End Date  
Net Value
Change During 
Period

$
$
$
Provide details of any increase or decrease in net land value. An insufficient 
explanation of changes may delay the approval of your accounts or cause the Court 
not to approve your accounts as submitted.


FINANCIAL ASSETS - Value of 
Adult's Interest
(excluding bank accounts)
Start Date 
Value
End Date 
Value
Change During 
Period

$
$
$
Provide details of any increase or decrease in value. An insufficient explanation of 
changes may delay the approval of your accounts or cause the Court not to approve 
your accounts as submitted.


OTHER ASSETS - Value 
of Adult's Interest
Start Date 
Value
End Date 
Value
Change During 
Period

$
$
$
Provide details of any increase or decrease in value. An insufficient explanation of 
changes may delay the approval of your accounts or cause the Court not to approve 
your accounts as submitted.

LIABILITIES - Amounts 
Owed by Adult
(excluding mortgages on land)
Start Date 
Amount 
Owed
End Date 
Amount 
Owed
Change During 
Period

$
$
$
Provide details of any increase or decrease in amount owed by adult. An 
insufficient explanation of changes may delay the approval of your accounts or 
cause the Court not to approve your accounts as submitted.

Section 4 - Other Matters
 During the accounting period the trustee or members of the trustee's family (other 
than the represented adult) 
? 
have not
received any benefit as a result of the exercise of the 
trustee's authority or made any personal use of the adult's 
property. Details of any such benefit or use are as follows:
? 
have



Section 5 - Proposed Compensation

Compensation Calculation 
Category
Category Amount 
for Period
Compensation 
%
Compensation 
Amount
Money received by trustee 
during accounting period
$
2.5%
$
Payments made by trustee 
during accounting period
$
2.5%
$
                     Total Compensation Claimed for Period
$

Sworn or affirmed before me at

)

Alberta, on

)
SIGNATURE

)


)
NAME
A Commissioner for Oaths in the Province of Alberta
)


)
SIGNATURE

)

PRINT NAME AND EXPIRY/LAWYER/ STUDENT-AT-LAW
)
NAME

Form 39 
 
Notice of Application and Hearing
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Notice of Application and Hearing
Applicant 


1   An application has been commenced by the applicant requesting the Court to 
order the following:


2   The application will be heard by a judge of the Court of Queen's Bench of 
Alberta:
Date:


Time:


Place:


3   The reasons for the application are as follows:

4   The application is made under or relies on the provisions of the following acts 
and regulations:

Name of Act or Regulation
Section Number(s)
? 
Adult Guardianship and Trusteeship Act

? 
Adult Guardianship and Trusteeship Regulation







5   The following persons other than the applicant or the adult are likely to be 
directly affected if the Court makes an order or gives a direction requested in this 
application.

Name or title
Capacity in which the person would be affected  
(e.g. co-decision-maker, guardian, trustee, agent, attorney)






6   The applicant will serve this notice of this application on the following persons:

Name or Title
Capacity in which served          (e.g. co-decision-
maker, guardian, trustee, agent, attorney)
? 
The adult
The adult
? 
Review officer 
Review officer (only if required by AGTA 
regulation)






7   The applicant will request the Court to dispense with service of notice of this 
application on the following persons who would otherwise be required to be 
served: 

Name or Title
Capacity in which required to be served 
(e.g. co-decision-maker, guardian, trustee, agent, attorney)






8   The following documents are filed in support of this application.





9  How or by whom do you request all or part of the costs (i.e. legal fees, if 
applicable, and disbursements) of the application to be paid?
? 
I am asking the Court to order that my lawyer's fees for this application
?
in the amount of
$

?
in an amount to be taxed

plus reasonable disbursements, be paid by or from the property of the adult.
?
I am asking the Court to order that the reasonable disbursements only be 
paid by or from the property of the adult.
? 
I am asking the Court to order that the costs be paid by the Crown and have 
provided supporting information in my affidavit.
? 
I am not asking the Court to make an order regarding costs. I will pay the 
costs myself.
? 
Other:

10   If you consent to or do not oppose the application, you may:
?  Do nothing further, or
?  Attend at the hearing and indicate your position to the Court.
If you oppose any part of the application, you should come to the hearing and tell 
the judge what part of the application you are opposed to, and why you are 
opposed. If you do not attend either in person or by your lawyer before the Court at 
the time and place shown above, the Court may give the applicant(s) what they 
want in your absence.
APPLICANT'S ADDRESS FOR SERVICE (Omit lawyer information if inapplicable)



Law Firm Name
Responsible Lawyer's Name
Lawyer's File Number



Street Address
Suite
Other Address Information (e.g. P.O. Box)



Phone

City
Province
Postal Code
Fax



E-mail

Form 40 
 
Affidavit of Service
Court File Number

Court
Court of Queen's Bench of Alberta (Surrogate Matter)
Judicial Centre

Full name of the person 
whom the application is 
about ("the adult")

Document
Affidavit of Service

An affidavit of service must be made by someone with firsthand personal 
knowledge of the facts. The contents of this affidavit must be adjusted as necessary 
to ensure that your affidavit accurately reflects the facts. 

I, 

of

,

Name

Address
having personal knowledge of the facts and matters referred to in this affidavit 
except where stated to be based on information and belief, swear or affirm as 
follows:

1   The following documents, copies of which are attached as exhibits to this 
affidavit, were served on or sent to the persons indicated below.
Document Description
Exhibit Letter




2   The following additional documents (e.g. evidence of receipt of documents sent 
by recorded mail, fax confirmation receipt, e-mail reply) are also attached as 
exhibits to this affidavit.
Document Description
Exhibit Letter




Documents Served on Adult
3   I served the documents indicated below by leaving a copy of each document 
with the adult at

on

Address where service effected

Date service effected
The documents served on the adult were as follows: 
Exhibit

Exhibit

Exhibit

Exhibit

Exhibit

Documents Served on Review Officer
4   I served the documents indicated below on a review officer at 


on


Address where service effected

Date service effected
? 
by leaving copies of the documents at the above address
? 
by sending copies of the documents to the above address by recorded mail, as 
evidenced by Exhibit ___
? 
by 

, as evidenced by Exhibit

The documents served on the review officer were as follows:
Exhibit

Exhibit

Exhibit

Exhibit

Exhibit

Documents Served on Other Persons
5   I served the following documents -
Exhibit

Exhibit

Exhibit

Exhibit

Exhibit

-  on each of the persons and in the manner identified below:
on

as


Name of Person Served

Position (e.g. guardian)
at

on


Address where Service Effected

Date Service Effected
? 
by leaving copies of the documents with the person 
? 
by sending copies of the documents by recorded mail, as evidenced by 
Exhibit 
? 
by 

, as evidenced by Exhibit

on

as


Name of Person Served

Position (e.g. guardian)
at

on


Address where Service Effected

Date Service Effected
? 
by leaving copies of the documents with the person 
? 
by sending copies of the documents by recorded mail, as evidenced by 
Exhibit 
? 
by 

, as evidenced by Exhibit

Documents Sent by Ordinary Mail
6   I sent copies of following documents --
Exhibit

Exhibit

Exhibit

Exhibit

Exhibit

- by ordinary mail to each of the persons identified below:
to

as


Name of Person

Relationship to Adult
at

on


Address to which documents sent 

Date Mailed
to

as


Name of Person

Relationship to Adult
at

on


Address to which documents sent 

Date Mailed

Sworn or affirmed before me at

)

Alberta, on

)


)

A Commissioner for Oaths in the Province of Alberta
)
SIGNATURE

)

PRINT NAME AND EXPIRY/LAWYER/ STUDENT-AT-LAW
)
NAME




Alberta Regulation 220/2009
Mines and Minerals Act
OIL SANDS ROYALTY REGULATION, 2009 AMENDMENT REGULATION
Filed: July 22, 2009
For information only:   Made by the Lieutenant Governor in Council (O.C. 421/2009) 
on July 21, 2009 pursuant to section 36 of the Mines and Minerals Act. 
1   The Oil Sands Royalty Regulation, 2009 (AR 223/2008) is 
amended by this Regulation.

2   Section 14 is amended
	(a)	in subsection (4) by striking out "and (8)" and 
substituting ", (8) and (11)";


	(b)	by adding the following after subsection (10):
(11)  The Minister may include in the descriptions of 2 or more 
Projects any proportion of a well, any part of a well or any 
proportion of a part of a well where
	(a)	the entire well is within the area and strata from which 
oil sands products will be recovered or obtained 
pursuant to each of those Projects,
	(b)	the specified undivided interests of each of the 
agreements, the locations of which include the entire 
well, are commonly held according to the records of the 
Department, and
	(c)	the Minister is satisfied that each well event in the well 
is involved with production or injection from the area 
and strata of each of those Projects, which include the 
well in the Project description.
(12)  In making a decision under subsection (11), the Minister 
shall, without limiting any other factors that the Minister may 
consider, take into consideration the length of the well used for 
the purposes of production or injection in relation to each of 
those Projects, relative to the entire length of the well that is 
used for the purposes of production or injection, as determined 
by the Minister.
(13)  The Minister may at any time in the Minister's absolute 
discretion amend a decision under subsection (11) as to the 
proportion of a well, the part of a well or the proportion of part 
of a well that is included in the descriptions of each of those 
Projects so as to reflect additional considerations or 
information.

3   This Regulation is effective on and from January 1, 2009.


--------------------------------
Alberta Regulation 221/2009
Court of Appeal Act
ALBERTA RULES OF COURT AMENDMENT REGULATION
Filed: July 22, 2009
For information only:   Made by the Lieutenant Governor in Council (O.C. 424/2009) 
on July 21, 2009 pursuant to section 16 of the Court of Appeal Act. 
1   The Alberta Rules of Court (AR 390/68) are amended by 
this Regulation.

2   The heading preceding Rule 530 is struck out and the 
following is substituted:
Appeal Record

3   Rule 530.3(b) is amended
	(a)	by repealing subclause (i) and substituting the 
following:
	(i)	the written or transcribed oral reasons of
	(A)	the judge or tribunal directly appealed from, and
	(B)	all prior judges, Masters, sub-tribunals or 
committees whose decision led up to the decision 
now appealed,
	(b)	by repealing subclause (v) and substituting the 
following:
	(v)	if the appeal record has been prepared by anyone other 
than Transcript Management Services of the 
Department of Justice, the Clerk's Certificate in Form N 
of Schedule A,
	(c)	by striking out "and" at the end of subclause (viii), 
by adding "and" at the end of subclause (ix) and by 
adding the following after subclause (ix):
	(x)	the Lawyer's Certificate in Form O of Schedule A, if the 
appellant is represented by counsel.

4   Rule 538 is amended
	(a)	in subrule (2) by adding ", or a letter of intention not to 
file a factum," after "his factum";
	(b)	 by adding the following after subrule (5):
(6)  When neither a factum nor a letter of intention not to file 
a factum is filed by a respondent within the time period set 
out in subrule (2), or as ordered by the court, the party in 
default may not present oral argument, unless otherwise 
ordered by the panel.

5   Schedule A, Form O is amended by striking out "correct" 
and substituting "complete".


--------------------------------
Alberta Regulation 222/2009
Environmental Protection and Enhancement Act
PESTICIDE SALES, HANDLING, USE AND APPLICATION 
AMENDMENT REGULATION
Filed: July 22, 2009
For information only:   Made by the Lieutenant Governor in Council (O.C. 430/2009) 
on July 21, 2009 pursuant to sections 86, 166 and 239 of the Environmental 
Protection and Enhancement Act. 
1   The Pesticide Sales, Handling, Use and Application 
Regulation (AR 24/97) is amended by this Regulation.

2   The following is added after section 4:
Prohibition
4.1   No person shall use, apply, supply, sell or display any pesticide 
that is a herbicide formulated in combination with a fertilizer as an 
end-use product and registered under the Fertilizers Act (Canada) or 
the Pest Control Products Act (Canada).

3   Section 31 is repealed and the following is substituted:
Cancelled or prohibited registered pesticides
31(1)  No person shall use, apply, display or sell a pesticide where 
the pesticide registration has been cancelled.
(2)  Where a pesticide registration has been cancelled as referred to 
in subsection (1) or the use, application, display or sale of a pesticide 
has been prohibited under section 4.1, the registrant identified on the 
label must
	(a)	collect or accept the return of pesticides supplied by the 
registrant, and
	(b)	deal with all such pesticides in the registrant's possession
in a manner acceptable to the Director.


(3)  Where a pesticide registration has been cancelled as referred to 
in subsection (1) or the use, application, display or sale of a pesticide 
has been prohibited under section 4.1 and the registrant identified on 
the label has ceased to operate, the last registrant that acquired the 
registration of the pesticide before the pesticide became cancelled or 
the use, application, display or sale of the pesticide was prohibited 
must comply with the requirements of subsection (2).
(4)  For the purposes of this section a pesticide registration is 
cancelled when it has been cancelled under the Pest Control 
Products Act (Canada) or the pesticide is no longer eligible for 
registration under that Act.

4   Section 33 is amended in clause (a) by adding "4.1," 
before "5,".

5   This Regulation comes into force on January 1, 2010.



Alberta Regulation 223/2009
Marketing of Agricultural Products Act
ALFALFA SEED COMMISSION REGULATION
Filed: July 22, 2009
For information only:   Made by the Alfalfa Seed Commission on June 25, 2009 
pursuant to section 26 of the Marketing of Agricultural Products Act and approved by 
the Agricultural Products Marketing Council on June 25, 2009 pursuant to section 26 
of the Marketing of Agricultural Products Act.
Table of Contents
	1	Interpretation
	2	Application
	3	Amount of service charge
	4	Dealer submission of service charge
	5	Inspection of dealer records 
	6	Refund of service charge
	7	Use of funds
	8	Legal action
	9	Expiry
Interpretation
1(1)  In this Regulation,
	(a)	"Act" means the Marketing of Agricultural Products Act;
	(b)	"Commission" means the Alfalfa Seed Commission 
established under the Plan; 
	(c)	"crop class" means one of the following as determined in 
accordance with the Canadian Seed Growers' Association 
Regulations and Procedures for Pedigree Seed Crop 
Production: 
	(i)	foundation seed;
	(ii)	certified seed;


	(iii)	common seed;
	(d)	"dealer" means a person who is required to deduct a service 
charge under section 4; 
	(e)	"Plan" means the Alfalfa Seed Plan Regulation;
	(f)	"total sale price" means the amount paid with respect to the 
regulated product for the net clean seed.
(2)  Words used in this Regulation that are defined in the Plan have the 
same meaning as defined in the Plan.
Application
2   Any reference or obligation in respect of a service charge applies 
only in so far as the regulated product is grown in an area to which this 
Regulation applies.
Amount of service charge
3(1)  A producer who sells the regulated product shall pay 1.25% of 
the total sale price to the Commission as a service charge.
(2)  The service charge shall be deducted and forwarded to the 
Commission in accordance with section 4.
(3)  The Commission shall not amend the amount of the service charge 
in subsection (1) unless the amendment is approved by a general vote 
of the eligible producers at an annual general or special Commission 
meeting.
Dealer submission of service charge
4(1)  A person who purchases the regulated product from a producer or 
who sells the regulated product on behalf of a producer shall deduct 
the service charge from the money payable to the producer and 
forward the amount deducted to the Commission.
(2)  The service charge is due to the Commission
	(a)	if it is deductible from July 1 to December 31, by the 
following January 31, and
	(b)	if it is deductible from January 1 to June 30, by the following 
July 31.
(3)  Despite subsection (2), the Commission may, by agreement with a 
dealer, provide for an alternate period within which the dealer shall 
forward service charges to the Commission.
(4)  Compound interest at the rate of 1% per month is payable by a 
dealer to the Commission on an overdue service charge.
(5)  The service charge shall be accompanied by a report that includes 
the following:
	(a)	the dealer's name, address and telephone number;
	(b)	the producer's name, address and telephone number;
	(c)	the location where the regulated product was grown;
	(d)	the total sale price and quantity of the regulated product; 
	(e)	the amount of the service charge deducted;
	(f)	the type and crop class of the regulated product, if known; 
	(g)	any other information required by the Commission for the 
purposes of the Plan. 
Inspection of dealer records 
5   A dealer shall, on the written request of and in the form and manner 
required by the Commission, furnish any record in the possession or 
under the control of the dealer that relates to the collection of a service 
charge to the Commission.
Refund of service charge
6(1)  A producer may request a refund of a service charge that has 
been paid in respect of the producer's regulated product. 
(2)  The request must
	(a)	be made in writing and in the form and manner required by 
the Commission, 
	(b)	be received by the Commission at its office no later than 
January 31 of the year following the year in which it was 
deductible, and
	(c)	include the following:
	(i)	the producer's name, mailing address and telephone 
number;
	(ii)	the dealer's name, address and telephone number;
	(iii)	the location where the regulated product was grown;
	(iv)	the total sale price and quantity of the regulated product;
	(v)	the type and crop class of the regulated product, if 
known;
	(vi)	any other information required by the Commission for 
the purposes of the Plan.
(3)  The Commission shall not refund a service change if the request is 
not submitted as required by subsection (2)(b) unless the Commission 
is satisfied that there are extenuating circumstances and it is 
appropriate to do so.
(4)  If an application in accordance with subsection (2) is received by 
the Commission, it shall refund the service charge no later than April 
30 of the year following the year in which it was collected. 
Use of funds
7   Any funds received by the Commission under the Plan and any 
interest that accrues in respect of those funds must be used by the 
Commission for the purposes of paying its expenses and administering 
the Plan and the regulations.
Legal action
8   The Commission may take legal action to enforce the payment of a 
service charge.
Expiry
9   For the purpose of ensuring that this Regulation is reviewed for 
ongoing relevancy and necessity, with the opinion that it may be 
passed in its present or an amended form following a review, this 
Regulation expires on June 30, 2014.  


--------------------------------
Alberta Regulation 224/2009
Adult Guardianship and Trusteeship Act
ADULT GUARDIANSHIP AND TRUSTEESHIP 
(MINISTERIAL) REGULATION
Filed: July 27, 2009
For information only:   Made by the Minister of Seniors and Community Supports 
(M.O. 028/2009) on July 13, 2009 pursuant to section 116(2) of the Adult 
Guardianship and Trusteeship Act. 
Table of Contents
	1	Definitions
	2	Persons eligible to be supporter
	3	Supported decision-making authorizations
	4	Powers and responsibilities of supporters
	5	Validity of supported decision-making authorizations
	6	Standards of conduct for capacity assessors
	7	Forms
	8	Expiry
	9	Coming into force 
 
Schedule
Definitions
1   In this Regulation, "Act" means the Adult Guardianship and 
Trusteeship Act.
Persons eligible to be supporter
2   An adult may appoint as a supporter a person who 
	(a)	consents to act as a supporter,
	(b)	is not an assisted adult or represented adult, and
	(c)	does not have


	(i)	a personal directive that is in effect, or
	(ii)	an enduring power of attorney that is in effect because 
of the incapacity of the person.
Supported decision-making authorizations
3(1)  A supported decision-making authorization must be
	(a)	signed by the adult making the authorization or a person 
acting on behalf of the adult under subsection (4) in the 
presence of the witness referred to in clause (b), and
	(b)	witnessed by an adult who
	(i)	is not named as a supporter in the authorization, and
	(ii)	did not sign the authorization on behalf of the adult.
(2)  A supported decision-making authorization must contain the 
consent of each person appointed as a supporter in the authorization.
(3)  An amendment to or termination of a supported decision-making 
authorization must be 
	(a)	in writing,
	(b)	signed and dated by the supported adult or by a person acting 
on the supported adult's behalf under subsection (4), and
	(c)	witnessed by an adult who
	(i)	is not appointed as a supporter in the authorization, and
	(ii)	did not sign the authorization on behalf of the adult.
(4)  If an adult who is making, amending or terminating a supported 
decision-making authorization is not physically able to sign the 
authorization, amendment or termination,  an adult who is not named 
as a supporter in the supported decision-making authorization may, at 
the direction of the adult, sign the authorization, amendment or 
termination on behalf of the adult.
(5)  A person who signs a supported decision-making authorization or 
an amendment to or termination of a supported decision-making 
authorization on behalf of an adult shall, in the presence of the adult 
and the witness, sign his or her own name and indicate that he or she 
has signed on behalf of the adult.
Powers and responsibilities of supporters
4(1)  A supporter shall exercise the supporter's powers and 
responsibilities 
	(a)	in the supported adult's best interests,
	(b)	diligently, and
	(c)	in good faith.
(2)  A supporter shall keep a written record of all decisions that the 
supported adult makes or communicates by or with the assistance of 
the supporter.
(3)  If a supporter accesses, collects or obtains personal information 
about the supported adult from a public body, custodian or 
organization, the supporter shall keep a written record of
	(a)	the reason for accessing, collecting or obtaining the personal 
information,
	(b)	the name of the public body, custodian or organization that 
provides access to the personal information or from whom 
the personal information is collected or obtained,
	(c)	a brief description of the personal information that is 
accessed, collected or obtained, and
	(d)	the date on which the personal information is accessed, 
collected or obtained.
(4)  If a supporter uses or discloses personal information referred to in 
subsection (3), the supporter shall keep a written record of 
	(a)	the reason for using or disclosing the personal information,
	(b)	a brief description of the personal information that is used or 
disclosed,
	(c)	the name of any person to whom the personal information is 
disclosed, and
	(d)	the date on which the personal information is used or 
disclosed.
(5)  A supporter shall retain a written record referred to in subsections 
(2) to (4) for at least 2 years after the day on which the supporter 
ceases to have authority under the supported decision-making 
authorization.
Validity of supported decision-making authorizations
5(1)  If a supported decision-making authorization purports to give 
powers to a supporter respecting the financial matters of the supported 
adult, the supported decision-making authorization is not valid to the 
extent that it purports to give a supporter those powers.
(2)  A supported decision-making authorization is not valid unless
	(a)	it is in Form 1 as set out in the Schedule, and
	(b)	it includes a termination of any previous supported 
decision-making authorization.
Standards of conduct for capacity assessors
6   A person who is designated as a capacity assessor shall conduct 
himself or herself in accordance with the following standards:
	(a)	when conducting a capacity assessment, a capacity assessor 
shall
	(i)	comply with the guidelines for conducting capacity 
assessments established by the Minister;
	(ii)	exercise care and diligence;
	(iii)	act in good faith;
	(iv)	have regard to the fact that 
	(A)	the adult who is undergoing the capacity 
assessment is presumed to have the capacity to 
make decisions until the contrary is determined, 
and
	(B)	the adult who is undergoing the capacity 
assessment is entitled to communicate by any 
means that enables the adult to be understood, and 
the means by which the adult communicates is not 
relevant to a determination of whether the adult 
has the capacity to make decisions;
	(b)	a capacity assessor shall maintain his or her professional 
competency to conduct capacity assessments.
Forms
7(1)  The form for a supported decision-making authorization for the 
purposes of section 4(3) of the Act is set out as Form 1 in the 
Schedule.
(2)  A termination of a supported decision-making authorization for the 
purposes of section 7(2) of the Act must be in the form set out in
	(a)	item 1 of Form 1 in the Schedule, or
	(b)	Form 2 in the Schedule.
(3)  The form for a capacity assessment report in respect of an 
application for a co-decision-making order is set out in Form 3 in the 
Schedule.
(4)  The form for a capacity assessment report in respect of an 
application for a guardianship order or trusteeship order is set out in 
Form 4 in the Schedule.
(5)  The form for a complaint for the purposes of section 75 of the Act 
is set out in Form 5 in the Schedule.
(6)  The form for an assessment of an adult's capacity to make 
decisions respecting the adult's health care for the purposes of section 
87 of the Act is set out in Form 6 in the Schedule.
(7)  The form for an assessment of an adult's capacity to make 
decisions respecting the adult's temporary admission to or discharge 
from a residential facility for the purposes of section 87 of the Act is 
set out in Form 7 in the Schedule.
(8)  The form for a declaration of a specific decision maker for the 
purposes of section 90 of the Act is set out in Form 8 in the Schedule.
(9)  The form for a written record that a health care provider is 
required to keep for the purposes of section 91 of the Act is set out in 
Form 9 in the Schedule.
(10)  The form for a capacity assessment report for the purposes of 
section 96 of the Act is set out in Form 10 in the Schedule.
Expiry
8   For the purpose of ensuring that this Regulation is reviewed for 
ongoing relevancy and necessity, with the option that it may be 
repassed in its present or an amended form following a review, this 
Regulation expires on September 30, 2019.
Coming into force
9   This Regulation comes into force on the coming into force of the 
Adult Guardianship and Trusteeship Act.
Schedule  
 
Form 1 
 
Supported Decision-making Authorization
I, _____________________________________, am a resident of 
Alberta and make this supported decision-making authorization.
1   Termination of previous supported decision-making 
authorization
I terminate all previous supported decision-making authorizations 
made by me.    (initials of supported person and witness)   
2   Appointment of supporter(s)
I appoint the following person(s) as my supporter(s):
	(a)	   (name of supporter)   ;   (initials of supported person and 
witness)   
	(b)	   (name of supporter)   ;  (initials of supported person and 
witness)   
	(c)	   (name of supporter)   .   (initials of supported person and 
witness)   
(Under section 4(1) of the Act, a maximum of 3 supporters may be 
appointed.)
3   Decisions respecting personal matters for which supporter 
has authority
My supporter(s) has (have) authority in respect of decisions to be made 
by me relating to the following personal matters:
   (personal matters)   ;   (initials of supported person and witness)   
(Note:   See the definition of "personal matter" in section 1(bb) of the 
Act.)
4   Authority of supporter(s)
I give my supporter(s) the authority to (check the relevant boxes and 
initial at the end):
	?   (a)	access, collect or obtain or assist me in accessing, collecting 
or obtaining from any person any information that is relevant 
to the decision(s) related to the personal matters specified in 
item 3 and to assist me in understanding the information; 
________(initials of supported person and witness)  
	?   (b)	assist me in making the decision(s) related to the personal 
matters specified in item 3;    (initials of supported person 
and witness)   
	?   (c)	communicate or assist me in communicating the decision(s) 
related to the personal matters specified in item 3 to other 
persons.    (initials of supported person and witness)   
(Note:   If (a) is checked, the supporter(s) should refer to section 9 of 
the Act and section 4(3) to (5) of this Regulation for details about the 
supporter's authority and responsibilities.)
5   Effective dates of supported decision-making authorization
This supported decision-making authorization has effect from 
_______________________ to ___________________.
6   Consent of supporters
I consent to act as a supporter:
______________________                                                              
(signature of supporter)	(printed name of supporter)
______________________                                                              
(signature of supporter)	(printed name of supporter)
______________________                                                              
(signature of supporter)	(printed name of supporter)
7   Signature
Signed by me in the presence of    (name of witness)    at    (location)    
in the Province of Alberta this    (day)    of    (month)   ,    (year)   .
________________________________________________
(signature of supported adult in the presence of the witness)
________________________________________________
(signature of witness in the presence of the supported adult)
________________________________
(printed name and address of witness)
________________________________
(Note:  Witness should also initial provisions initialled by supported 
adult.)
Form 2 
 
Termination of Supported Decision-making Authorization
I, _____________________________________, terminate the 
supported decision-making authorization that I made on    (date)   .
Signed by me in the presence of    (name of witness)    at    (location)    
in the Province of Alberta this    (day)    of    (month)   ,    (year)   .
________________________________________________
(signature of supported adult in the presence of the witness)
________________________________________________
(signature of witness in the presence of the supported adult)
 ________________________________
(printed name and address of witness)
________________________________

Form 3 
 
Capacity Assessment Report 
(Co-decision-making)
(This form of capacity assessment report is to be used in respect of an 
application for a co-decision-making order.)
"capacity" means, in respect of the making of a decision about a 
matter, the ability to understand the information that is relevant to the 
decision and to appreciate the reasonably foreseeable consequences of
	(a)	a decision, and
	(b)	a failure to make a decision;
"significantly impaired", in respect of an adult's capacity to make 
decisions, means that the adult's cognitive and adaptive abilities
	(a)	are substantially limited as the result of an impairment, 
including, without limitation, a developmental disability, an 
organic, degenerative or neurological disease or disorder, an 
acquired brain injury or a chronic mental illness, and
	(b)	are not so substantially limited that the adult would not have 
the capacity to make decisions with appropriate guidance and 
support.
1. I,    (name of the capacity assessor)   , am a registered member of the 
   (name of the capacity assessor's professional college)   .
If the capacity assessor is not a physician or registered psychologist, 
the capacity assessor must complete the following:
? I am currently designated as a capacity assessor under the Act. My 
designation is dated _ (day/month/year)   .
2. The reason(s) or circumstances leading up to the request for this 
capacity assessment are:
_____________________________________________________
3.  I have obtained confirmation that a medical evaluation of the adult 
was conducted by    (name of physician)    on    (day/month/year)    
(must be within the 3-month period immediately preceding the 
capacity assessment) and that the results of the medical evaluation did 
not indicate that the adult was suffering from a reversible temporary 
medical condition that appeared likely to have a significant impact on 
his or her capacity to make a decision about a personal matter.
Comments:
______________________________________________________
4.  Prior to conducting an assessment of the capacity of    (name of the 
adult)    ("the adult") I met with the adult and I explained to him or her
	(a)	the purpose and nature of the capacity assessment,
	(b)	that he or she has the right to refuse 
	(i)	to undergo the capacity assessment, or
	(ii)	to continue with the capacity assessment at any point 
during the capacity assessment,
	(c)	that he or she has the right to have
	(i)	a person present to assist him or her in feeling 
comfortable and relaxed when undergoing the capacity 
assessment, and
	(ii)	the assistance of a person or the use of a device to 
communicate in order for the adult to be able to fully 
demonstrate his or her capacity during the capacity 
assessment,
	(d)	that if, in my opinion, a person who is present to assist the 
adult during the capacity assessment is interfering with the 
capacity assessment, the person may be asked to leave, and
	(e)	the significance and effect of a finding that his or her 
capacity to make decisions respecting a personal matter is 
significantly impaired.
Comments:
______________________________________________________
5. The adult
	?   (a)	has not refused to undergo or to continue with the capacity 
assessment, and
	?    (i)	in my opinion, the adult
	(A)	understands the purpose of the capacity assessment 
and that he or she has a right to refuse to undergo 
or continue with the capacity assessment,
	(B)	appears to be capable of consenting to the capacity 
assessment, and
	(C)	has consented to the capacity assessment,
			or
	?   (ii)	in my opinion
	(A)	the adult appears not to be capable of consenting to 
the capacity assessment, and
	(B)	it is in the best interests of the adult to conduct the 
capacity assessment;
		or
	?   (b)	has refused to undergo or to continue with the capacity 
assessment.
If (b) is checked,
	?   (i)	a capacity assessment was not conducted, or
	?  (ii)	the capacity assessment was discontinued.
Comments:
______________________________________________________
6. I have determined that
	?   (a)	it is not necessary for the adult to have and the adult has not 
requested to have
	(i)	a person present to assist the adult in feeling 
comfortable and relaxed when undergoing the capacity 
assessment, or
	(ii)	the assistance of a person or the use of a device to 
communicate in order for the adult to be able to fully 
demonstrate his or her capacity during the capacity 
assessment,
		or
	?   (b)	it is necessary for the adult to have or the adult has requested 
to have
	(i)	a person present to assist the adult in feeling 
comfortable and relaxed when undergoing the capacity 
assessment, or
	(ii)	the assistance of a person or the use of a device to 
communicate in order for the adult to be able to fully 
demonstrate his or her capacity during the capacity 
assessment.
If (b) is checked, set out what is considered necessary or what the adult 
has requested, as the case may be, as well as the steps taken to have a 
person present or to provide the adult with the assistance of a person or 
device. 
Comments:
______________________________________________________
7. Based on the information that was provided to me, I have 
determined that an assessment of the capacity of the adult to make 
decisions is warranted with respect to the following personal matter(s):
	?   (a)	the adult's health care;
	?   (b)	where, with whom and under what conditions the adult is to 
live, either permanently or temporarily;
	?   (c)	with whom the adult may associate;
	?   (d)	the adult's participation in social activities;
	?   (e)	the adult's participation in any educational, vocational or 
other training;
	?   (f)	the adult's employment;
	?  (g)	the carrying on of any legal proceeding that does not relate 
primarily to the financial matters of the adult;
Comments:
_____________________________________________________
8.  I asked the adult if there have been any significant changes recently 
in his or her beliefs and values related to making decisions about the 
personal matter(s) identified in item 7 and the adult informed me that
	?   (a)	there have been significant changes recently in his or her 
beliefs and values related to making decisions about the 
matter(s), or
	?   (b)	there have not been significant changes recently in his or her 
beliefs and values related to making decisions about the 
matter(s).
Comments:
	
9.  I assessed the capacity of the adult to make decisions about each 
personal matter identified in item 7 and my opinion respecting his or 
her capacity to make decisions about the personal matter(s) is indicated 
in column 1 or 2 below, as the case may be:

Adult 
has 
capacity
Capacity of adult 
is significantly 
impaired
Personal Matter
?
?
the adult's health care
?
?
where, with whom and under what 
conditions the adult is to live, either 
permanently or temporarily 
?
?
with whom the adult may associate
?
?
the adult's participation in social 
activities
?
?
the adult's participation in any 
educational, vocational or other 
training
?
?
the adult's employment
?
? 
the carrying on of any legal 
proceeding that does not relate 
primarily to the financial matters of 
the adult
?
?
other  (specify)
(Note: Cross out any matter in column 3 that is not identified in item 
7.)
The reasons for my opinion are as follows:
______________________________________________________
(set out the reasons)
	In forming my opinion about the adult's capacity to make decisions 
about the personal matter(s),
	(a)	I considered the adult's ability to understand the information 
that is relevant to a decision and to appreciate the reasonably 
foreseeable consequences of a decision and a failure to make 
a decision about the personal matter(s), and
	(b)	I took into account
	(i)	whether the adult has the ability to retain information 
that is relevant to decisions about the personal matter(s), 
and
	(ii)	the following additional factors, if any:    (specify)   .
Comments:
______________________________________________________
10.   In my opinion the adult has the capacity to consent to
	(a)	the appointment of any individual who is proposed to be 
appointed as a co-decision-maker, and
	(b)	a co-decision-making order.
11.  If in item 9 I have stated that in my opinion the capacity of the 
adult to make decisions about one or more personal matters is 
significantly impaired, I have considered whether the adult is likely to 
regain some or all of his or her capacity to make decisions about the 
matter(s) and I believe that the adult
	?   (a)	is likely to regain some or all of his or her capacity to make 
decisions about the matter(s), or 
	
(set out the reasons)
	?   (b)	is not likely to regain some or all of his or her capacity to 
make decisions about the matter(s).
	
(set out the reasons)
If (a) is checked, complete the following:
If the Court appoints a co-decision-maker for the adult, I recommend 
that another capacity assessment of the adult be conducted no later 
than   (day)    of    (month)   ,    (year)   .
12.  I have attached more detailed information respecting the capacity 
assessment. (Optional)     ?  Yes      ?  No
Dated at    (location)    in the Province of Alberta this    (day)    of 
   (month)   ,    (year)   .
_________________________________
(signature of capacity assessor)
Form 4 
 
Capacity Assessment Report 
(Guardianship or Trusteeship or both)
(This form of capacity assessment report is to be used in respect of an 
application for a guardianship order or trusteeship order or both.)
"capacity" means, in respect of the making of a decision about a 
matter, the ability to understand the information that is relevant to the 
decision and to appreciate the reasonably foreseeable consequences of
	(a)	 a decision, and
	(b)	a failure to make a decision.
1. I,    (name of the capacity assessor)   , am a registered member of the 
   (name of the capacity assessor's professional college)   .
If the capacity assessor is not a physician or registered psychologist, 
the capacity assessor must complete the following:
? I am currently designated as a capacity assessor under the Act. My 
designation is dated    (day/month/year)   .
2. The reason(s) or circumstances leading up to the request for this 
capacity assessment are:
_____________________________________________________
3.  I have obtained confirmation that a medical evaluation of the adult 
was conducted by    (name of physician)    on    (day/month/ year)    
(must be within the 3-month period immediately preceding the 
capacity assessment) and that the results of the medical evaluation did 
not indicate that the adult was suffering from a reversible temporary 
medical condition that appeared likely to have a significant impact on 
his or her capacity to make a decision about a personal matter or 
financial matters.
Comments:
______________________________________________________
4.  Prior to conducting an assessment of the capacity of    (name of the 
adult)    ("the adult") I met with the adult and, unless the level of 
consciousness of the adult was such that the adult was non-responsive, 
I explained to him or her
	(a)	the purpose and nature of the capacity assessment,
	(b)	that he or she has the right to refuse 
	(i)	to undergo the capacity assessment, or
	(ii)	to continue with the capacity assessment at any point 
during the capacity assessment,
	(c)	that he or she has the right to have
	(i)	a person present to assist him or her in feeling 
comfortable and relaxed when undergoing the capacity 
assessment, and
	(ii)	the assistance of a person or the use of a device to 
communicate in order for the adult to be able to fully 
demonstrate his or her capacity during the capacity 
assessment,
	(d)	that if, in my opinion, a person who is present to assist the 
adult during the capacity assessment is interfering with the 
capacity assessment, the person may be asked to leave, and
	(e)	the significance and effect of a finding that he or she does not 
have the capacity to make decisions respecting a personal 
matter or a financial matter.
Comments:
______________________________________________________
(NOTE:  Provide any comments you may have.  If the level of 
consciousness of the adult was such that the adult was non-responsive 
you must indicate that here.)
5. The adult
	?   (a)	has not refused to undergo or to continue with the capacity 
assessment, and
	?    (i)	in my opinion, the adult
	(A)	understands the purpose of the capacity assessment 
and that he or she has a right to refuse to undergo 
or to continue with the capacity assessment,
	(B)	appears to be capable of consenting to the capacity 
assessment, and
	(C)	has consented to the capacity assessment,
			or
	?   (ii)	in my opinion
	(A)	the adult appears not to be capable of consenting to 
the capacity assessment, and
	(B)	it is in the best interests of the adult to conduct the 
capacity assessment;
		or 
	?   (b)	has refused to undergo or to continue with the capacity 
assessment.
If (b) is checked,
	?   (i)	a capacity assessment was not conducted, or
	?  (ii)	the capacity assessment was discontinued.
Comments:
_____________________________________________________
6. I have determined that
	?   (a)	it is not necessary for the adult to have and the adult has not 
requested to have
	(i)	a person present to assist the adult in feeling 
comfortable and relaxed when undergoing the capacity 
assessment, or
	(ii)	the assistance of a person or the use of a device to 
communicate in order for the adult to be able to fully 
demonstrate his or her capacity during the capacity 
assessment,
		or
	?   (b)	it is necessary for the adult to have or the adult has requested 
to have
	(i)	a person present to assist the adult in feeling 
comfortable and relaxed when undergoing the capacity 
assessment, or
	(ii)	the assistance of a person or the use of a device to 
communicate in order for the adult to be able to fully 
demonstrate his or her capacity during the capacity 
assessment.
If (b) is checked, set out what is considered necessary or what the adult 
has requested, as the case may be, as well as the steps taken to have a 
person present or to provide the adult with the assistance of a person or 
device.  
Comments:
______________________________________________________
7. Based on the information that was provided to me, I have 
determined that an assessment of the capacity of the adult to make 
decisions is warranted
	?   (a)	with respect to the following personal matter(s):
	?   (i)	the adult's health care;
	?  (ii)	where, with whom and under what conditions the adult 
is to live, either permanently or temporarily;
	? (iii)	with whom the adult may associate;
	? (iv)	the adult's participation in social activities;
	?  (v)	the adult's participation in any educational, vocational 
or other training;
	? (vi)	the adult's employment;
	?(vii)	the carrying on of any legal proceeding that does not 
relate primarily to the financial matters of the adult;
Comments:
_____________________________________________________
	?  (b)	with respect to financial matters.
Comments:
_____________________________________________________
8.  Unless the level of consciousness of the adult was such that the 
adult was non-responsive, I asked the adult if there have been any 
significant changes recently in his or her beliefs and values related to 
making decisions about the matter(s) identified in item 7 and the adult 
informed me that
	?   (a)	there have been significant changes recently in his or her 
beliefs and values related to making decisions about the 
matter(s), or
	?   (b)	there have not been significant changes recently in his or her 
beliefs and values related to making decisions about the 
matter(s).
Comments:
	
(NOTE:  Provide any comments you may have.  If the level of 
consciousness of the adult was such that the adult was  non-responsive, 
you must indicate that here.)
9. The level of consciousness of the adult at the time of the capacity 
assessment was
	?   (a)	alert,
	?   (b)	fluctuating, or
	?   (c)	non-responsive.
Comments:
______________________________________________________
10.  I assessed the capacity of the adult to make decisions about the 
matter(s) identified in item 7 and my opinion respecting his or her 
capacity to make decisions about the matter(s) is indicated in column 1 
or 2, as the case may be:

Adult has 
capacity
Adult does not 
have capacity
Matter

 
 
?

 
 
?

(a)  personal matter(s)
    (i)  the adult's health care

?

?

    (ii)  where, with whom and under 
what conditions the adult is 
to live, either permanently or 
temporarily 

?

?

    (iii)  with whom the adult may 
associate

?

?

    (iv)  the adult's participation in 
social activities

?

?

    (v)  the adult's participation in 
any educational, vocational 
or other training

?

?

    (vi)  the adult's employment

?

?

    (vii)  the carrying on of any legal 
proceeding that does not 
relate primarily to the 
financial matters of the adult

?

?

    (viii)  other  (specify)

?

?

(b)  financial matters
(Note: Cross out any matter in column 3 that is not identified in item 
7.)
The reasons for my opinion are as follows:
______________________________________________________
(set out the reasons)
	In forming my opinion about the adult's capacity to make decisions 
about the matter(s),
	(a)	I considered the adult's ability to understand the information 
that is relevant to a decision and to appreciate the reasonably 
foreseeable consequences of a decision and a failure to make 
a decision about the matter(s), and
	(b)	I took into account
	(i)	whether the adult has the ability to retain information 
that is relevant to decisions about the matter(s), and
	(ii)	the following additional factors, if any:    (specify)  .
Comments:
______________________________________________________
11.  In my opinion, serving the adult with notice of an application for a 
guardianship or trusteeship order
	?   (a)	is likely to cause serious emotional or physical harm to the 
adult, or
	?   (b)	is not likely to cause serious emotional or physical harm to 
the adult.
______________________________________________________
(set out the reasons)
12.  If in item 10 I have stated that in my opinion the adult does not 
have the capacity to make decisions about one or more matter(s), I 
have considered whether the adult is likely to regain some or all of his 
or her capacity to make decisions about the matter(s) and I believe that 
the adult
	?   (a)	is likely to regain some or all of his or her capacity to make 
decisions about the matter(s);
	
(set out the reasons)
	?   (b)	is not likely to regain some or all of his or her capacity to 
make decisions about the matter(s).
	
(set out the reasons)
If (a) is checked, complete the following:
If the court appoints a guardian or trustee for the adult, I recommend 
that another capacity assessment of the adult be conducted by no later 
than    (day)    of    (month)   ,    (year)   .
13.  I have attached more detailed information respecting the capacity 
assessment. (Optional)           ?  Yes      ?  No
Dated at    (location)    in the Province of Alberta this    (day)    of 
   (month)   ,    (year)   .
_________________________________
(signature of capacity assessor)
Form 5 
 
Complaint Respecting a Co-decision-maker, 
Guardian or Trustee
1   Your contact information
	(a)	What is your name, address, preferred telephone contact 
number and alternate telephone number (if any), e-mail 
address (if any), and fax number (if any)? 
	
	(b)	What is your relationship to the assisted adult or represented 
adult? 
	
2   Information about the assisted adult or represented adult (if 
known)
What is the assisted adult's or represented adult's name, address, 
preferred telephone contact number and alternate telephone number (if 
any), e-mail address (if any), and fax number (if any)?
	
3   Information about the co-decision-maker, guardian or 
trustee who is the subject of your complaint (if known)
What is the co-decision-maker's or guardian's or trustee's name, 
address, preferred telephone contact number and alternate telephone 
number (if any), e-mail address (if any), and fax number (if any)?
	
4   Information about the co-decision-making, guardianship or 
trusteeship order (if known)
Provide any other relevant information you have about the co-decision-
making, guardianship or trusteeship order.  (For example, the matters 
with respect to which the co-decision maker, guardian or trustee has 
authority.)
	
5   Nature of your complaint
	(a)	What are your reasons for believing the co-decision-maker, 
guardian or trustee is failing to comply with the 
co-decision-making, guardianship or trusteeship order or the 
duties of a co-decision-maker, guardian or trustee?  Include 
the date or time period when your concerns arose. 
	
	(b)	What are your reasons for believing that the failure is
	(i)	likely to cause harm to the physical or mental health of 
the assisted adult or represented adult? 
	
	(ii)	likely to cause financial loss to the represented adult? 
	
	(c)	Have you taken any steps to resolve the matter? Set out the 
details in the space below. 
	
6   People who can provide further information 
Provide the full name, title (if any), address and preferred telephone 
contact number and alternate telephone number (if any), of any person 
who may be able to provide further information about this complaint or 
about the assisted adult's or represented adult's circumstances and set 
out the person's relationship to the assisted adult or represented adult.
	
(NOTE:  If the subject-matter of your complaint could be an 
offence under the Criminal Code (Canada), abuse against a 
client under the Protection for Persons in Care Act or an 
offence under another statute or regulation of Alberta, the 
complaints officer may refer the complaint to a police service 
or appropriate government ministry in accordance with s79(1) 
of the Adult Guardianship and Trusteeship Act.)
Dated at    (location)    in the Province of Alberta this    (day)     of 
   (month)   ,    (year)   .
                                                              
Signature of person making complaint
The personal information you have provided is being collected under 
section 78 of the Adult Guardianship and Trusteeship Act and may be 
used for the purposes of conducting an investigation or resolving a 
complaint under sections 75 to 79 of the Adult Guardianship and 
Trusteeship Act, making an application under section 26, 46 or 74 of 
the Adult Guardianship and Trusteeship Act or as authorized or 
required under the Freedom of Information and Protection of Privacy 
Act or another enactment. If you have any questions about this 
collection, you may contact the complaints officer at the Office of the 
Public Guardian.
Form 6 
 
Assessment of Capacity of Adult to Make  
Decisions Respecting the Adult's Health  
Care (Specific Decision Making)
1. I,    (name of physician, nurse practitioner or dentist)   , met with 
   (name of adult)    ("the adult") on    (day/month/year)    for the 
purpose of assessing the adult's capacity to make a decision about the 
following proposed health care for the adult:
	 
    (describe proposed health care)
2. I explained to the adult
	(a)	that the adult has the right to refuse to have his or her 
capacity assessed and the right to refuse to continue with the 
assessment at any time, and
	(b)	the likely effect that a refusal would have on my ability to 
provide health care to the adult.
3.  I provided the adult with information about the proposed health care 
to determine whether the adult understood what is being proposed, 
including the following information:
	(a)		the condition for which the health care is being proposed;
	(b)	the nature of the proposed health care;
	(c)	the material risks and expected benefits to the adult of the 
proposed health care;
	(d)	any likely side effects of the proposed health care;
	(e)	alternative forms of health care for the condition;
	(f)	the reasonably foreseeable consequences to the adult if the 
adult is not provided with the health care.
4.  I communicated with the adult in a manner that, in my opinion, was 
appropriate to the adult's skills and abilities, and allowed the adult's 
spouse, relatives or friends who accompanied the adult and offered 
their assistance to help the adult understand or to demonstrate an 
understanding of the matters referred to in item 3.
5.  I am of the opinion that    (name of adult)    
	?  (a)	has the capacity to make a decision respecting the proposed 
health care, including a decision to consent or refuse to 
consent to the proposed health care, because I am of the 
opinion that the adult has the ability to understand the 
information that is relevant to a decision about the proposed 
health care, and to appreciate the reasonably foreseeable 
consequences of a decision about the proposed health care 
and a failure to make a decision, or
	?  (b)	does not have the capacity to make a decision respecting the 
proposed health care, including a decision to consent or 
refuse to consent to the proposed health care, because I am of 
the opinion that the adult does not have the ability to 
understand the information that is relevant to a decision 
about the proposed health care, and to appreciate the 
reasonably foreseeable consequences of a decision about the 
proposed health care and a failure to make a decision.
The reasons for my opinion are as follows:
	
6.  I have informed the adult that I assessed the adult as not having the 
capacity to make a decision respecting the proposed health care, 
including a decision to consent or to refuse to consent to the proposed 
health care, and I advised the adult that he or she has the right
	(a)	under section 96 of the Adult Guardianship and Trusteeship 
Act to request a capacity assessor to conduct a capacity 
assessment;
	(b)	under section 97 of the Adult Guardianship and Trusteeship 
Act to apply to the Court for a review of my assessment of 
his or her capacity.
Comments:
	
   (name of physician, nurse practitioner or dentist conducting the assessment)   
  (signature of physician, nurse practitioner or dentist conducting the assessment)   
Dated at    (location)    in the Province of Alberta this    (day)    of 
   (month)   ,    (year)   .
Form 7 
 
Assessment of Capacity of Adult to Make Decisions 
Respecting the Adult's Temporary Admission to or  
Discharge from a Residential Facility  
(Specific Decision Making)
1. I,    (name of physician or nurse practitioner)   , met with    (name of 
adult)    ("the adult") on    (day/month/year)    for the purpose of 
assessing the adult's capacity to make a decision respecting the adult's 
proposed
	?  (a)	temporary admission to, or
	?  (b)	discharge from 
the following residential facility or type of residential facility, as the 
case may be:
  (set out the name or type of proposed residential facility, including a 
transitional facility)  	
2. I explained to the adult
	(a)	that the adult has the right to refuse to have his or her 
capacity assessed and the right to refuse to continue with the 
assessment at any time, and
	(b)	the likely effect that a refusal would have on my ability
	?	(i) to admit the adult to, or
	?	(ii) to discharge the adult from
a residential facility.
3.  I provided information about the proposed temporary admission to 
or discharge from a residential facility, as the case may be, to 
determine whether the adult understood what was being proposed, 
including information about
	(a)	the reasons for the proposed admission or discharge,
	(b)	the location and type of residential facility to which it is 
proposed that the adult would be admitted, in the case of a 
proposed admission,
	(c)	the material risks and expected benefits to the adult of the 
proposed admission or discharge,
	(d)	the alternatives available to the adult if the adult is not 
admitted to or discharged from the residential facility, and
	(e)	the reasonably foreseeable consequences to the adult if the 
adult is not admitted to or discharged from the residential 
facility.
4.  I communicated with the adult in a manner that, in my opinion, was 
appropriate to the adult's skills and abilities, and allowed the adult's 
spouse, relatives or friends who accompanied the adult and offered 
their assistance to help the adult understand or to demonstrate an 
understanding of the matters referred to in item 3.
5.  I am of the opinion that    (name of adult)    
	?  (a)	has the capacity to make a decision respecting his or her 
proposed
	?	(i) admission to, or
	?	(ii) discharge from 
		a residential facility, including a decision to consent or refuse 
to consent to the proposed admission or discharge, because I 
am of the opinion that the adult has the ability to understand 
the information that is relevant to the decision about his or 
her temporary admission to or discharge from a residential 
facility and to appreciate the reasonably foreseeable 
consequences of the decision and a failure to make the 
decision,
		or
	?  (b)	does not have the capacity to make a decision respecting his 
or her proposed
	?	(i) admission to, or
	?	(ii) discharge from 
		a residential facility, including a decision to consent or refuse 
to consent to the proposed admission or discharge, because I 
am of the opinion that the adult does not have the ability to 
understand the information that is relevant to the decision 
about his or her temporary admission to or discharge from a 
residential facility and to appreciate the reasonably 
foreseeable consequences of the decision and a failure to 
make the decision.
The reasons for my opinion are as follows:
	
6. I have informed the adult that I assessed the adult as not having the 
capacity to make a decision respecting his or her proposed temporary 
admission to or discharge from a residential facility, including a 
decision to consent or refuse to consent to the admission or discharge, 
and I advised the adult that he or she has the right
	(a)	under section 96 of the Adult Guardianship and Trusteeship 
Act to request a capacity assessor to conduct a capacity 
assessment;
	(b)	under section 97 of the Adult Guardianship and Trusteeship 
Act to apply to the Court for a review of my assessment of 
his or her capacity.
Comments:
	
   (name of physician or nurse practitioner conducting the assessment)   
  (signature of physician or nurse practitioner conducting the assessment)   
Dated at    (location)    in the Province of Alberta this    (day)    of 
   (month)   ,    (year)   .
Form 8 
 
Declaration of Specific Decision Maker
1. I,    (name and mailing or street address of specific decision 
maker)   , have been selected by    (name of health care provider who 
selected the specific decision maker)    to make a decision for    (name 
of adult)    ("the adult") to consent or refuse to consent to:
	?   (a)	proposed health care for the adult;
	?   (b)	the adult's temporary admission to a residential facility;
	?   (c)	the adult's discharge from a residential facility.
2. I understand that I may not make the decision referred to in item 1 
until I have made this declaration.
3. I declare that I
	(a)	am 18 years of age or older,
	(b)	am available and willing to make the decision,
	(c)	am able to make the decision,
	(d)	have been in contact with the adult in the previous 12 
months,
	(e)	have knowledge of the adult's wishes respecting the decision 
to be made or of the beliefs and values of the adult,
	(f)	do not have a dispute with the adult that might affect my 
ability to comply with the duties of a specific decision maker,
	(g)	will carry out the duties and responsibilities of a specific 
decision maker, and
	(h)	will comply with the requirements of Part 3, Division 1 of the 
Adult Guardianship and Trusteeship Act in making a 
decision for the adult.
4. I understand that I do not have the authority to make decisions 
respecting the following types of health care for the adult: 
	(a)	psychosurgery as defined in the Mental Health Act; 
	(b)	sterilization that is not medically necessary to protect the 
adult's health; 
	(c)	removal of tissue from the adult's living body 
	(i)	for implantation in the body of another living person 
pursuant to Part 1 of the Human Tissue Gift Act, or 
	(ii)	for medical education or research purposes; 
	(d)	health care that involves participation by the adult in research 
or experimental activities, if the health care offers little or no 
potential benefit to the adult; 
	(e)	treatment decisions for an adult who is a formal patient as 
defined in the Mental Health Act;
	(f)	a decision respecting the provision of or withdrawal or 
withholding of health care for the adult that would be likely 
to result in the imminent death of the adult.
5. I understand that I am required to make reasonable efforts to notify 
the nearest relative of the adult of the decision made and to notify the 
Public Guardian of the decision made if I am not able to notify the 
nearest relative.
      (name of specific decision maker)        
       (signature of specific decision maker)      
       (signature of witness)      
Dated at    (location)    in the Province of Alberta this    (day)    of 
   (month)   ,    (year)   .
Form 9 
 
Health Care Provider's Record of  
Specific Decision Making
1. On    (day/month/year)   , I,    (name of health care provider)    
assessed    (name of adult)    ("the adult") as not having the capacity to 
make a decision respecting 
	?  (a)	the adult's health care, or
	? (b) 	?	(i)	the adult's temporary admission to, or
	?	(ii)	discharge from
		a residential facility.
2. I have attached to this record
	  ? (a)	the Assessment of Capacity of Adult to Make Decisions 
Respecting the Adult's Health Care (Specific Decision 
Making) in Form 6 respecting the adult dated 
   (day/month/year)   , or
	  ? (b)	the Assessment of Capacity of Adult to Make Decisions 
Respecting the Adult's Temporary Admission to or 
Discharge from a Residential Facility (Specific Decision 
Making) in Form 7 dated    (day/month/year)   ,
3. I selected    (name of specific decision maker)    to make the 
decision for the adult.
4. I have attached to this record the Declaration of Specific Decision 
Maker required by section 90 of the Adult Guardianship and 
Trusteeship Act that was completed by the specific decision maker.
5. The specific decision maker made the following specific decision 
for the adult on    (day/month/year)   :
	
      (name of health care provider)            
       (signature of health care provider)      
Dated at    (location)    in the Province of Alberta this    (day)    of 
   (month)   ,    (year)   .
Form 10 
 
Capacity Assessment Report  
(Section 96 of the Act,  Health Care or 
Temporary Admission to or Discharge 
from a Residential Facility)
(This form of capacity assessment report is to be used in respect of a 
capacity assessment under section 96 of the Act.)
"capacity" means, in respect of the making of a decision about a 
matter, the ability to understand the information that is relevant to the 
decision and to appreciate the reasonably foreseeable consequences of
	(a)	a decision, and
	(b)	a failure to make a decision.
1. I,    (name of the capacity assessor)   , am a registered member of the 
   (name of the capacity assessor's professional college)   .
If the capacity assessor is not a physician or registered psychologist, 
the capacity assessor must complete the following:
? I am currently designated as a capacity assessor under the Act. My 
designation is dated    (day/month/year)   .
2. The reason(s) or circumstances leading up to the request for this 
capacity assessment are:
_____________________________________________________
3.  I have obtained confirmation that a medical evaluation of the adult 
was conducted by    (name of physician)    on    (day/month/year)    
(must be within the 3-month period immediately preceding the 
capacity assessment) and that the results of the medical evaluation did 
not indicate that the adult was suffering from a reversible temporary 
medical condition that appeared likely to have a significant impact on 
his or her capacity to make a decision about his or her health care or 
temporary admission to or discharge from a residential facility.
Comments:
______________________________________________________
4.  Prior to conducting an assessment of the capacity of    (name of the 
adult)    ("the adult") I met with the adult and I explained to him or her
	(a)	the purpose and nature of the capacity assessment,
	(b)	that he or she has the right to refuse 
	(i)	to undergo the capacity assessment, or
	(ii)	to continue with the capacity assessment at any point 
during the capacity assessment,
	(c)	that he or she has the right to have
	(i)	a person present to assist him or her in feeling 
comfortable and relaxed when undergoing the capacity 
assessment, and
	(ii)	the assistance of a person or the use of a device to 
communicate in order for the adult to be able to fully 
demonstrate his or her capacity during the capacity 
assessment,
	(d)	that if, in my opinion, a person who is present to assist the 
adult during the capacity assessment is interfering with the 
capacity assessment, the person may be asked to leave, and
	(e)	the significance and effect of a finding that he or she does not 
have the capacity to make a decision respecting a personal 
matter or a financial matter.
Comments:
______________________________________________________
5. The adult
	?   (a)	has not refused to undergo or to continue with the capacity 
assessment, and
	?    (i)	in my opinion, the adult
	(A)	understands the purpose of the capacity assessment 
and that he or she has a right to refuse to undergo 
or to continue with the capacity assessment,
	(B)	appears to be capable of consenting to the capacity 
assessment, and
	(C)	has consented to the capacity assessment, or
	?   (ii)	in my opinion
	(A)	the adult appears not to be capable of consenting to 
the capacity assessment, and
	(B)	it is in the best interests of the adult to conduct the 
capacity assessment,
		or
	?   (b)	has refused to undergo or to continue with the capacity 
assessment.
If (b) is checked,
	?   (i)	a capacity assessment was not conducted, or
	?  (ii)	the capacity assessment was discontinued.
Comments:
_____________________________________________________
6. I have determined that
	?   (a)	it is not necessary for the adult to have and the adult has not 
requested to have
	(i)	a person present to assist the adult in feeling 
comfortable and relaxed when undergoing the capacity 
assessment, or
	(ii)	the assistance of a person or the use of a device to 
communicate in order for the adult to be able to fully 
demonstrate his or her capacity during the capacity 
assessment,
		or
	?   (b)	it is necessary for the adult to have or the adult has requested 
to have
	(i)	a person present to assist the adult in feeling 
comfortable and relaxed when undergoing the capacity 
assessment, or
	(ii)	the assistance of a person or the use of a device to 
communicate in order for the adult to be able to fully 
demonstrate his or her capacity during the capacity 
assessment,
If (b) is checked, set out what is considered necessary or what the adult 
has requested, as the case may be, as well as the steps taken to have a 
person present or provide the adult with the assistance of a person or 
device. 
____________________________________________________
Comments:
______________________________________________________
7. I have determined that an assessment of the capacity of the adult to 
make decisions is warranted with respect to the adult's
	?   (a)	health care,
	?   (b)	temporary admission to a residential facility, or
	?   (c)	discharge from a residential facility.
Comments:
_____________________________________________________
8.  I have asked the adult if there have been any significant changes 
recently in his or her beliefs and values related to making decisions 
about the personal matters identified in item 7 and the adult has 
informed me that
	?   (a)	there have been significant changes recently in his or her 
beliefs and values related to making decisions about those 
personal matters, or
	?   (b)	there have not been significant changes recently in his or her 
beliefs and values related to making decisions about those 
personal matters.
Comments:
	
9. The level of consciousness of the adult at the time of the capacity 
assessment was
	?   (a)	alert, or
	?   (b)	fluctuating.
10. I assessed the capacity of the adult to make the decision about
	?   (a)	his or her health care, and in my opinion he or she 
	?   (i)	has the capacity to make the decision, because he or she 
has, or
	?  (ii)	does not have the capacity to make the decision, 
because he or she does not have
the ability to understand the information that is relevant to the decision 
about his or her health care and to appreciate the reasonably 
foreseeable consequences of the decision or a failure to make the 
decision about his or her health care for the following reasons: 
	 
   (set out the reasons for the opinion)
	?   (b)	his or her temporary admission to a residential facility, and in 
my opinion he or she
	?   (i)	has the capacity to make the decision, because he or she 
has, or
	?   (ii)	does not have the capacity to make the decision, 
because he or she does not have
the ability to understand the information that is relevant to the decision 
about his or her temporary admission to a residential facility and to 
appreciate the reasonably foreseeable consequences of the decision or 
a failure to make the decision about his or her temporary admission to 
a residential facility for the following reasons:  
	 
  (set out the reasons)
	?   (c)	his or her discharge from the residential facility, and in my 
opinion he or she
	?   (i)	has the capacity to make the decision, because he or she 
has, or
	?  (ii)	does not have the capacity to make the decision, 
because he or she does not have
the ability to understand the information that is relevant to the decision 
about his or her discharge from the residential facility and to appreciate 
the reasonably foreseeable consequences of the decision or a failure to 
make the decision about his or her discharge from the residential 
facility for the following reasons: 
	 
  (set out the reasons)
11.  In forming my opinion about the matter referred to in item 10, I 
took into account the following:
	?   (a)	whether the adult has the ability to retain information that is 
relevant to decisions;
	?   (b)	the following:
				
		   (set out additional matters, if any)    
Comments:
	
12. In my opinion, the adult
	?  (a)	has the capacity to make decisions about his or her
	?   (i)	health care,
	?  (ii)	temporary admission to a residential facility, or
	? (iii)	discharge from a residential facility, 
		or
	?   (b)	does not have the capacity to make decisions about his or her
	?   (i)	health care,
	?  (ii)	temporary admission to a residential facility, or
	? (iii)	discharge from a residential facility.
13. If in item 12 I have stated that in my opinion the adult does not 
have the capacity to make the decision about the health care or 
temporary admission to or discharge from a residential facility, I have 
considered whether the adult is likely to regain some or all of his or her 
capacity to make the decision, and I believe that the adult
	?   (a)	is likely to regain some or all of his or her capacity to make 
decisions (the decision) about his or her
	?   (i)	health care,
	?  (ii)	temporary admission to a residential facility, or
	? (iii)	discharge from a residential facility;
	
(set out the reasons)
	?   (b)	is not likely to regain some or all of his or her capacity to 
make decisions (the decision) about his or her
	?   (i)	health care,
	?  (ii)	temporary admission to a residential facility, or
	? (iii)	discharge from a residential facility.
	
(set out the reasons)
If (a) is checked, complete the following:
If a specific decision maker is appointed for the adult, I recommend 
that another capacity assessment of the adult be conducted no later 
than     (day)    of    (month)   ,    (year)   .
14.  I have attached more detailed information respecting the capacity 
assessment. (Optional)            ?  Yes      ?  No
Dated at    (location)    in the Province of Alberta this    (day)    of 
   (month)   ,    (year)   .
___(signature of capacity assessor)__


--------------------------------
Alberta Regulation 225/2009
Energy Resources Conservation Act
ENERGY RESOURCES CONSERVATION BOARD ADMINISTRATION 
FEES AMENDMENT REGULATION
Filed: July 30, 2009
For information only:   Made by the Energy Resources Conservation Board on July 
27, 2009 pursuant to section 27.2 of the Energy Resources Conservation Act. 
1   The Energy Resources Conservation Board 
Administration Fees Regulation (AR 114/2008) is amended 
by this Regulation.

2   Section 4 is repealed and the following is substituted:
Coal mines
4(1)  In this section, "coal production" means the total tonnes of coal 
produced by an operator of an Alberta coal mine in the 2008 
calendar year, including
	(a)	coal produced from a sub-bituminous mine, and
	(b)	coal produced from a bituminous mine, including
	(i)	clean coal from a coal processing plant, and
	(ii)	raw coal for sale.
(2)  An operator of a coal mine shall pay an administration fee with 
respect to a coal mine calculated as follows:
coal production x $0.053744 for each tonne of coal = 
administration fee.