17-A Guardianship Proceeding Checklist
of Mentally Retarded/Developmentally Disabled Person

(Person and/or Property)

(see Surrogate's Court Form GMD-1, rev. 4/98)

Fill in All Areas On All Pages - Also Mark When Not Applicable When Necessary

Check All Forms To Make Sure Venue Is Correct - Appropriate County Is Listed
PET ¶ #




Does the Court have jurisdiction over the subject MR/DDP, hereinafter referred to as respondent [see SCPA §1702]?
NOTE: The respondent must be domiciled in the county, have sojourned in the county immediately preceding the application for guardianship, or if a non-domiciliary of the state, must have property situate in the county. The domicile of the respondent's parent(s) or spouse if respondent is married, or custodial parent in the case of an infant respondent is the domicile of the respondent.
Is the captioned name the same as the birth certificate and ¶2 of petition? 22NYCRR 207.15(a) and SCPA §1752(1)
1. Is the petitioner a proper party? [see SCPA §1751]
Is the petitioner ... both parents or the survivor, or one parent
any person eighteen (18) years of age or older, including a corporation authorized to serve as a guardian, interested in the welfare of the respondent
the respondent when such person is eighteen (18) years of age or older
Are all A/K/A's listed?
2. Is the name and date of birth of the respondent in ¶2 the same as that listed on the Birth Certificate? [SCPA §1752(1)]
Copy of Birth Certificate from official registrar (not hospital) to be filed with petition [see NYCRR §207.15(a)]
Confirm that all required addresses are set forth.
3. Check that names and post office addresses of the parents, children, adult siblings (18 years of age or older) or spouse and primary care physician of the respondent are listed. [see SCPA §1752(3)]
If any relatives are deceased their names must still be shown and death noted. (Court may require copy of death certificate)
3. cont. If the name of the father is not shown on petition or birth certificate, determine if a proceeding has been brought to establish paternity. (Court may require copy of filiation order) [see page 5 - Comments & Court Notes]
NOTE: If it is claimed that the identity of the father is unknown, the Court may require an affidavit showing diligent efforts to identify him.
NOTE: If the natural mother was married at the time of respondent's birth, there is a rebuttable presumption that her husband is the father of the respondent and is a necessary party unless a filiation order has established otherwise. [see DRL §24(1)]
4. List names/addresses of adults with whom respondent resides if other than parent or facility at which respondent resides. [see SCPA §1752(4)]
5. Check that names and addresses, education and other qualifications of proposed guardian, standby or alternate guardian, if other than respondent's parents, spouse, adult children or adult siblings is properly listed. [see SCPA §1752(5)]
Check that any necessary waivers/renunciations/consents are filed by any parent not a petitioner. (Form GMD-3)
NOTE: SCPA §1753(1) requires that process shall issue to:

1. Parent or Parents (if other than petitioner)

2. Adult children, adult siblings (if other than parents)

3. Spouse (if respondent is married);

4. Person having care and custody or with whom respondent resides (if other than parent or spouse);

5. The respondent (if fourteen (14) years of age or older).

NOTE: SCPA §1753(2) requires that a Notice of Petition be served by certified mail to:

1. Adult siblings

2. Mental Hygiene Legal Services

3. Director of any State Facility where respondent resides

4. Adult children

5. Any other person Court deems proper

6. Any person designated in writing by respondent

NOTE: No process or notice is necessary to any person above who has been declared by the court as incompetent or who has, as appears to the Court's satisfaction, abandoned the respondent or to a spouse who is divorced from the respondent. [see SCPA §1754(2)]
6. Check that names and addresses of the proposed guardians, standby guardians or alternate guardians are listed and confirm that the boxes checked reflect the relief requested.
Check that proper consents/oaths/designations or consents/designations are completed. (GMD-4)
7. Confirm that a box is checked to show if respondent is/is not admitted to a facility. If respondent is in a facility, check to see if the name of the director of the facility and the director of MHLS is listed and the location.
8. Confirm that boxes checked reflect the relief requested.
9. Confirm that boxes checked reflect the relief requested.
10. Check that the estimated value of real and personal property and the annual income therefrom and any other income including governmental entitlements to which the respondent is entitled is listed in detail, i.e. account/policy numbers and titles, estate information, etc. [see SCPA §1752(6)]
NOTE: This information will be used to compare and verify the guardian's report on the first annual inventory and account.
11. Verify that the doctors' certifications (Form GMD-2A and 2B) are attached to petition and that their names and the dates of the certifications are completed on the petition. Check certifications/affidavits to be certain all required information is contained therein. [see SCPA §1750, 1750-a]
12. Verify that respondent's place of employment is listed, if applicable. [see SCPA §1756]
13. Check to see if respondent's presence will be necessary at hearing and that appropriate box is checked. If request is made to dispense with respondent's presence, verify that physician's certification so attests or other circumstances are stated. [see SCPA §1754]
14. Verify that the respondent has never had a guardian appointed by will or deed or any acting guardian in socage, or a guardian appointed pursuant to Social Services Law §384-b. [see SCPA §1704(3) and SCPA §1761]
15. Verify whether petitioner indicated knowledge of self, respondent or nominated guardian being the subject of or another person indicated in a child abuse report; or has been subject of or a respondent in a child protective proceeding which resulted in a court order finding that the child is an abused or neglected child [see SCPA §1704(6) and §1761].
NOTE: If knowledge of a report is indicated, verify that an affidavit explaining circumstances in detail is included.
16. Check that Request for Information Guardianship form has been submitted with petition.
NOTE: Some Courts may require submission of form DCJS-6, Fingerprint Card, for each proposed guardian in order to conduct a criminal record search.
17. This paragraph states that there are no other persons interested in this proceeding other than those already mentioned.
18. This paragraph states that no prior application for guardianship of the subject respondent has been made in any court.
Under WHEREFORE Clause: has all relief requested been checked and completed?
If petitioner is seeking guardianship of property, verify that names and addresses of any financial institutions are listed.
Is petition dated, signed, verified, properly notarized (including proper jurat and expiration date of notary's commission)?
Is oath and designation signed?
does it set forth proposed guardian's physical address?
Is proposed guardian a Bank?
has corporate consent and designation been submitted? [see SCPA §708(4)]
Is attorney's name, address and phone number listed?
Has Part 130 Certification been completed?
if NOT, has a separate attorney certification as to Part 130 signing requirements been included?
If forms are computer generated, has a certification pursuant to Court Rules §207.4 been attached?


or Rule #

Have the proper fees been included with petition?

$15.00 for filing petition

$5.00 for each Certificate of Appointment.


Form Number

or Rule #

When Permitted Whenever the interests of a respondent will be promoted by the appointment of a guardian of the person or of property or both. 1750, 1750-a
Forms Always Required •Petition for Appointment of Guardian

•Copy of Birth Certificate

•Request for Information Guardianship Form

•Affidavit (Certification) of Examining Physician or Psychologist

•Affirmation (Certification) of Examining Physician


•Notice of Petition







1751, 1752







Forms or Documents Sometimes Required •Waiver, Renunciation and Consent

•Consent, Oath and Designation of Guardian/Standby Guardian

•Decree Appointing Limited Guardian of Property

•Guardian's Annual Account

•Affidavit of Due Diligence

•Affidavit of Service (Personal/Mail/Publication)


•Death Certificate of deceased spouse, distributee or parent

•Birth Certificate of spouse or distributees who are under the age of 18

•Copies of Divorce Decrees, Surrenders, Court Orders

•Orders of Filiation

•Fingerprint Card









Proofs of Service of Citation must be filed with the Court at least two (2) working days before the return date.

Some courts may conduct additional inquiries of Putative Father Registry. (Court submits inquiry form to Registry - NYS OCFS Form LDSS-2725,); some courts may also check if natural father has acknowledged being father in any other manner (possible sources of information may be Family Court, Department of Social Services, hospital of birth, local registrar and/or Department of Health ).

Guardian Ad Litem will be appointed when respondent is not a resident of a state facility. Guardian ad litem will be appointed on or before the return day of process for all unknowns and persons under disability (SCPA §403).

Documents signed by Power of Attorney (Provide certified copy of POA and comply with Section 13-2.3 EPTL and 207.48 Uniform Rules).

Check to be certain all documents are properly acknowledged.


THIS MATERIAL IS PROVIDED FOR INFORMATIONAL/TRAINING PURPOSES ONLY. It is intended for use in conjunction with review of the applicable statute and rules of the Surrogate's Court and the Surrogate's Court Operations Manual.