Case Number:				
COMPLAINT ABOUT A GUARDIAN OR CONSERVATOR
ROA:  CGCO- Complaint about a Guardian or Conservator
													
Please answer each question. If you do not know the answer or it is not applicable please write “Unknown” or “N/A.” The court may not review this complaint if you do not fill in each blank.
Ward
Name of Ward: _________________________________________________________________
County where case is filed: ____________________Case Number: ________________________
(Note: You can check the iCourt Portal if above is unknown: https://mycourts.idaho.gov/odysseyportal)  
Complainant
Your Name: ____________________________________________________________________
Your Address: __________________________________________________________________
Your Phone Number (___) __________  Your Email: ___________________________________
Your relationship to the ward or to the case: _________________________________________ ______________________________________________________________________________
Guardian or Conservator
Type of Case:	☐ Guardianship		☐ Conservatorship   			☐ Both
Name of Guardian or Conservator __________________________________________________
Guardian or Conservator Address: __________________________________________________
Phone Number (___) ___________ Email: ___________________________________________
Description of your complaint
Have you notified or sent a complaint to other authorities?             ☐ Yes		☐ No
If yes, include the name of the authority (example: Adult Protection services, nursing home staff, law enforcement, Attorney General’s Office, Idaho State Bar, a Licensing Board) and date you complained or sent complaint and result? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Attach a copy of the complaint, if any.
Is the ward aware of your concern?
☐ Yes		☐ No		If yes, what was the ward’s response? ______________________ ______________________________________________________________________________
Have you discussed your concerns with the guardian or conservator?
☐ Yes		☐ No		If yes, what was the response? ______________________ ____________________________________________________________________________________________________________________________________________________________
Briefly describe how the guardian or conservator has failed to comply with his or her statutory duties and responsibilities. Describe what the guardian or conservator did or did not do, what they said, or any other actions of the guardian/conservator you are concerned about. Be as specific as possible and include dates, times, and places. Please attach copies of relevant documents, such as court orders, petitions, letters to the ward, etc. 
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Consent and Affirmation
I understand that the filing of a complaint constitutes my consent to the disclosure of the content of my complaint to the appointed guardian or conservator, judicial officers, and others. I understand that my complaint will be filed in the court file.
I certify (or declare) under penalty of perjury pursuant to the law of the State of Idaho that, to the best of my knowledge, the aforementioned is true and correct.
____________________			_________________________________________
Date						Name

Mail or deliver completed form to the courthouse located in the county where the case is filed. A list of mailing addresses can be found at: www.isc.idaho.gov. Please keep a copy of this complaint for your records. The court may not review this complaint if you fail to complete this form in its entirety.