Preview
Hearing Date: 7/6/2023 11:00 AM
Location: Court Room 1810
Judge: MacCarthy, Aicha
P0200 (12/01/20) FILED
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS 6/6/2023 10:57 AM
COUNTY DEPARTM! — PROBATE DIVISION IRIS Y. MARTINEZ
CIRCUIT CLERK
File No COOK COUNTY, IL
ZUZ5P UU4ULZ
2023P 004012
te of
Calendar, 10
THEODA SMITII 23019942
Alleged Person with a Disability
PETITION FOR APPOINTMENT OF GUARDIAN OF A PERSON WITH A DISABILITY
Does the Petitioner expect the Alleged Person With A Disability to appear in court? (_]) Yes [No
In accordance with §11a-8 of the Probate Act of 1975 (“Probate Act”) [755 ILCS 5/11a-8] and §§201 - 204 of the
Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act (SUAGPPJA”) [755 ILCS 8/201 - 204], the
Petitioner, Gisele Smith
[printed name of the Petitioner],
states under the penaltics of perjury:
1 Theoda Smith (the “Respondent”),
[printed name of the alleged person with a disability]
whose year of birth is 1940 , who is 18 years or older, who resides in Cook County, and whose
place of residence is 19030 John Avenue, Country Club Hills, Iinois 60478 in Cook County
, is a person with a disability;
Jaddress/city/county/state/sip code]
The relationship to and interest in the Respondent of the Petitioner is Father
3 The asons for the guardianship are that the Respondent is a person with a disability due to Cerebrovascular
accident with resulting Aphasia and because of that disability
[description of disability]
Im) (a) lac sufficient understanding or capacity to make or communicate responsible decisions concerning the
care of the R pondent’s person;
(i) (b) is unable to manage the Respondent's estate or financial affairs;
(a) The approximate value of the Respondent's estate is: Person: al $500.00 Real $180,000.00
(b) The amount of the Respondent’s anticipated annual gross income and other receipts are: 568,000.00 _
The names and post office addres: s of the Respondent’s Guardian, if ny, or of the Respondent weni(s) appointed
under any Power of Attorney Act, if any, and of the Respondent's nearest relatives entitled lo notic listed on
Exhibit A attached to this Petition “Nea relativ means, in the following order, (a) the spou (including a
party to a civil union) and adult children, the parents and adult brothers and s 1s or, if none, (b) the nearest adult
kindred known to the Petitione!
6 The names and post offic addr of any minor or adult who is dependent upon the Respondent are also listed on
Exhibit A attached to this Pe ion
The name and addi of the person with whom, or the facility in which, the Respondent is residing is
{@) (a) No Petition for the appointment of a Guardian of the Respondent is pending in any other jurisdiction;
LJ (b) A Petition for the appointment of a Guardian of the Respondent is pending in
40), {i (a) Illinois is the Respondent’s “home state” as defined in §201(a)(2) of the UAGPPJA.
0 &) is the Respondent’s “home stat but Iinois ignificant-connection state” as
defined in §201(a)(3) of the UAGPPJA, and one of the additional requirements specified in $203(2)(A)-(B)
of UAGPPJA applies.
Check the appropriate box or boxes
Check the appropriate basis for jurisdiction
IRIS Y. MARTINEZ, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
Pape | of S
2023P 004012
CCP 0200 B (12/01/20) File No.
{] (c) Minois is not the Respondent’s “home state” or a “significant-connection state” as defined in
§201(a)(2)-(3) of the UAGPPJA, but the “home state” and every “significant-connection state” have
declined to exer jurisdiction because Mlinois is the most appropriate forum.
(1 (d) Mlinois is not the Respondent’s “home state” or a “significant-connection state” as defined in
§201(a)(2)-(3) of the UAGPPJA, but the circumstances involved constitute an “emergency” as detined
in §20](a)(J) of the UAGPPJA, and, as a result, the Court has “special jurisdiction” under §204(a) of the
UAGPPIA.
‘The Petitioner asks that Theoda Smith be adjudged a person with a disability, and that
[printed name of the Respondent]
A Gisele Smith and Marcus Grey
[printed name of the proposed Guardian]
19030 John Avenue, Country Club Hills, IL 60478/Marcus Grey, 530 E. 102nd St, Chg, IL 60628
[post office address/city/state/zip cade]
age 23/62
£2 years, daughter and brother , customer service representative/retiree
[relationship to the Respondent] [occupation]
who is qualified and willing fo act and who have not been convicted of a felony, be
(has) (h not)
appointed as Guardian of the estate and person of the Respondent.
(estate and person) (estate only)
wr
2
[printed name of the proposed Guardian]
[post office address/eity/state/zip code]
age years,
[relationship to the Respondent] Joceupation)
who is qua fied and willing to act and who been convicted of a felony, be
(has) (has not)
appointed as Guardian of the person only of the Respondent.
RIC
[printed name of the proposed Guardian]
be appointed even though has been convicted of a felony because:
(he) (she)
(i) the appointment is in the Respondent's be: inte after considering the nature and date of the offense
and the evidence of the proposed Guardian’s rehabilitation, and
(ii) the offense is not one which, under §11a-5(5) of the Probate Act, would prohibit the appointment.
Strike if not applicable.
[signature of the Petitioner}
Attorney Number 17042 a
19030 John Avenue
Name Byron L.Mason address of the Petitioner]
Firm Name Byron L. Mason, Attorney at Law
Country Club HIlls, 1160478
Attorneys for Petitioners {city/state/zip code]
Service via mail will be accepted at:
Address 1525 East 53rd Street-Suite 453
Masonlaw3 | @sbeglobal.net
City/State/Zip Chicago, IL 60615 by consent pursuant to TI. Sup. Court Rules (1 and 131.
Telephone 773/955-7457 a 2
Attorney Certification
Email Masonlaw31@sbeglobal.net
IRIS Y. MARTINEZ, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
Page 2 of 5
2023P 004012
CCP 0200 C (12/01/20) File No.
Exuisir A
Attached to and made a part of a
PETITION FOR APPOINTMENT OF GUARDIAN OF A PERSON WITH A DISABILITY
List the names and post office addr s (i) of the persons entitled to receive notice under pi ph 5, and (ii)
of the minors or adults who are dependent upon the Respondent under paragraph 6, of the Petition to which this
Exhibit A is attached,
I Respondent’s Guardian(s) or agent(s) appointed under the Illinois Power of Attorney Act
Has a Court appointed a Guardian for the Respondent? C1Yes []No (] Unknown
Has the Respondent executed a Power of Attorney for Property? (1 Yes [i] No [] Unknown
Has the Respondent executed a Power of Attorney for Health Care? {) Yes l@)No [J] Unknown
Provide the following information with respect to cach Guardian and agent:
[name] jname]
-
~ [address] Taddress]
[eityistate/sip] Teity/state/zip]
— —_
relationship to the Respondent] [relationship to the Respondent]
~ [telephone] fenvail] {ielephone] Temail|
‘Type of guardianship: ‘Type of Power of Attorney: ‘Type of guardianship: ‘Type of Power of Attorney:
|_JAdutt LJ Minor {_] Property LJAdult {| Minor [J] Property
{J Person LJ estate () Health Care C]Person Lh LJtlealth Care
If the Respondent has one or more additional Guardian(s) or agent(s), provide the above information with
respect to cach on an additional page.
Il. Respondent’s Nearest Relatives Entitled to Notice
A. Does the Respondent have a spouse (by marriage or civil union) and adult children, parents and adult
brothers and sisters living’?
If “No” or “Unknown”, proceed to paragraph B below.
If “Yes”, provide the following information with respect to each:
Spouse Adult Child
Cleofe Smith ss Gisele Smith
Frame] Tname]
19030 John Avenue 19030 John Avenue
[address] [address]
Country Club Hills, IL 60478 Country Club Hils, TL 60478
[city/state/zip] [eity/state/zip}
708/897-6612 a
Trelephone] femaily [telephone] — Jemail]
IRIS Y. MARTINEZ, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
p. age 3 of §
2023P 004012
CCP 0200 D (12/01/20) File No.
Adult Child Adult Child
Christpher Smith _ Tanya Cu is
[name] Trae]
403 North Wabash Ave,, Unit 6C Unknown .
address] $8
Chicago, IL 60611 Unknown
jeity/tate/7ip| [city/state/7ip]
[iciephone] [email] [telephone] Temail]
If the Respondent has one or more additional adult children living, provide the above information with respect
to each on an additional page.
Parent Parent
[name] [name]
Taddress] laddress}
[eityAtate/zip] [eity/state/7ip]
[telephone] ~ [email] [iclephone] [email]
Adult Brother or Sister Adult Brother or Sister
Marcus D. Grey Carol Williams
Tname| Thame]
530 East 102nd Street 0210 Linksland Drive
jaddress] [address]
Chicago, Mlinois 60628 Huntersville, N.C 28038
[eitystate/vip] [city/state/7ip|
773/620-9696 773/575-9520
[telephone] Temail] [telephone] jen it]
If the Respondent has one or more additional adult brothers and sisters living, provide the above information
with respect to cach on an additional page.
B. Ifthe Respondent has no spouse, no adult child, no pa ent and no adult brother or sister, provide the fol-
lowing information with respect to cach nearest adult relative:
Janice W.G. Williams
[name] [rekutionship] [namie] [relationship]
530 East 102nd Street
[alr {address}
Chicago, Illinois 60628
[city/stute/zip] [eity/state/zip]
~ [telephone] Tema) [iclephone] le ail]
IRIS Y. MARTINEZ, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
ed of 5
2023P 004012
CCP 0200 E (12/01/20) File No.
Thame] [relationship] Tame] [relationship
a
[address] [address]
Sa
[eitytate/sip] [eity/state/zip]
[telephone] ~Temail] [Iclephor jemail]
Ifthe Respondent has one or more additional adult relatives living, provide the above information with respect
to cach on an additional page.
V.Mimor(s) and Adult(s) Dependent Upon the Respondent
Does the Respondent have one or more minors or adults who are dependent upon the Respondent?
(gl Yes (_]No (_J Unknown
IrYes”, provide the following information with respect to each:
Dependent C1] Minor (m) Adult Dependent {_] Minor (Adult
G
cle Smith daughter
[name] [relationship] [name} [relationship]
19030 John Avenue
—
{address} [address]
c untry Club Hills, IL 60478
[eity/state/*ip] [city/state:
TO8I897-6612 2
[ielephone] [email] [telephone] {email
Ifthe Respondent has one or more additional adult relatives living, provide the above information with respect
to each on an additional page.
IRIS Y. MARTINEZ, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
Page 5 of §
Preview
Hearing Date: 7/6/2023 11:00 AM Location: Court Room 1810 Judge: MacCarthy, Aicha P0200 (12/01/20) FILED IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS 6/6/2023 10:57 AM COUNTY DEPARTM! — PROBATE DIVISION IRIS Y. MARTINEZ CIRCUIT CLERK File No COOK COUNTY, IL ZUZ5P UU4ULZ 2023P 004012 te of Calendar, 10 THEODA SMITII 23019942 Alleged Person with a Disability PETITION FOR APPOINTMENT OF GUARDIAN OF A PERSON WITH A DISABILITY Does the Petitioner expect the Alleged Person With A Disability to appear in court? (_]) Yes [No In accordance with §11a-8 of the Probate Act of 1975 (“Probate Act”) [755 ILCS 5/11a-8] and §§201 - 204 of the Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act (SUAGPPJA”) [755 ILCS 8/201 - 204], the Petitioner, Gisele Smith [printed name of the Petitioner], states under the penaltics of perjury: 1 Theoda Smith (the “Respondent”), [printed name of the alleged person with a disability] whose year of birth is 1940 , who is 18 years or older, who resides in Cook County, and whose place of residence is 19030 John Avenue, Country Club Hills, Iinois 60478 in Cook County , is a person with a disability; Jaddress/city/county/state/sip code] The relationship to and interest in the Respondent of the Petitioner is Father 3 The asons for the guardianship are that the Respondent is a person with a disability due to Cerebrovascular accident with resulting Aphasia and because of that disability [description of disability] Im) (a) lac sufficient understanding or capacity to make or communicate responsible decisions concerning the care of the R pondent’s person; (i) (b) is unable to manage the Respondent's estate or financial affairs; (a) The approximate value of the Respondent's estate is: Person: al $500.00 Real $180,000.00 (b) The amount of the Respondent’s anticipated annual gross income and other receipts are: 568,000.00 _ The names and post office addres: s of the Respondent’s Guardian, if ny, or of the Respondent weni(s) appointed under any Power of Attorney Act, if any, and of the Respondent's nearest relatives entitled lo notic listed on Exhibit A attached to this Petition “Nea relativ means, in the following order, (a) the spou (including a party to a civil union) and adult children, the parents and adult brothers and s 1s or, if none, (b) the nearest adult kindred known to the Petitione! 6 The names and post offic addr of any minor or adult who is dependent upon the Respondent are also listed on Exhibit A attached to this Pe ion The name and addi of the person with whom, or the facility in which, the Respondent is residing is {@) (a) No Petition for the appointment of a Guardian of the Respondent is pending in any other jurisdiction; LJ (b) A Petition for the appointment of a Guardian of the Respondent is pending in 40), {i (a) Illinois is the Respondent’s “home state” as defined in §201(a)(2) of the UAGPPJA. 0 &) is the Respondent’s “home stat but Iinois ignificant-connection state” as defined in §201(a)(3) of the UAGPPJA, and one of the additional requirements specified in $203(2)(A)-(B) of UAGPPJA applies. Check the appropriate box or boxes Check the appropriate basis for jurisdiction IRIS Y. MARTINEZ, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Pape | of S 2023P 004012 CCP 0200 B (12/01/20) File No. {] (c) Minois is not the Respondent’s “home state” or a “significant-connection state” as defined in §201(a)(2)-(3) of the UAGPPJA, but the “home state” and every “significant-connection state” have declined to exer jurisdiction because Mlinois is the most appropriate forum. (1 (d) Mlinois is not the Respondent’s “home state” or a “significant-connection state” as defined in §201(a)(2)-(3) of the UAGPPJA, but the circumstances involved constitute an “emergency” as detined in §20](a)(J) of the UAGPPJA, and, as a result, the Court has “special jurisdiction” under §204(a) of the UAGPPIA. ‘The Petitioner asks that Theoda Smith be adjudged a person with a disability, and that [printed name of the Respondent] A Gisele Smith and Marcus Grey [printed name of the proposed Guardian] 19030 John Avenue, Country Club Hills, IL 60478/Marcus Grey, 530 E. 102nd St, Chg, IL 60628 [post office address/city/state/zip cade] age 23/62 £2 years, daughter and brother , customer service representative/retiree [relationship to the Respondent] [occupation] who is qualified and willing fo act and who have not been convicted of a felony, be (has) (h not) appointed as Guardian of the estate and person of the Respondent. (estate and person) (estate only) wr 2 [printed name of the proposed Guardian] [post office address/eity/state/zip code] age years, [relationship to the Respondent] Joceupation) who is qua fied and willing to act and who been convicted of a felony, be (has) (has not) appointed as Guardian of the person only of the Respondent. RIC [printed name of the proposed Guardian] be appointed even though has been convicted of a felony because: (he) (she) (i) the appointment is in the Respondent's be: inte after considering the nature and date of the offense and the evidence of the proposed Guardian’s rehabilitation, and (ii) the offense is not one which, under §11a-5(5) of the Probate Act, would prohibit the appointment. Strike if not applicable. [signature of the Petitioner} Attorney Number 17042 a 19030 John Avenue Name Byron L.Mason address of the Petitioner] Firm Name Byron L. Mason, Attorney at Law Country Club HIlls, 1160478 Attorneys for Petitioners {city/state/zip code] Service via mail will be accepted at: Address 1525 East 53rd Street-Suite 453 Masonlaw3 | @sbeglobal.net City/State/Zip Chicago, IL 60615 by consent pursuant to TI. Sup. Court Rules (1 and 131. Telephone 773/955-7457 a 2 Attorney Certification Email Masonlaw31@sbeglobal.net IRIS Y. MARTINEZ, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Page 2 of 5 2023P 004012 CCP 0200 C (12/01/20) File No. Exuisir A Attached to and made a part of a PETITION FOR APPOINTMENT OF GUARDIAN OF A PERSON WITH A DISABILITY List the names and post office addr s (i) of the persons entitled to receive notice under pi ph 5, and (ii) of the minors or adults who are dependent upon the Respondent under paragraph 6, of the Petition to which this Exhibit A is attached, I Respondent’s Guardian(s) or agent(s) appointed under the Illinois Power of Attorney Act Has a Court appointed a Guardian for the Respondent? C1Yes []No (] Unknown Has the Respondent executed a Power of Attorney for Property? (1 Yes [i] No [] Unknown Has the Respondent executed a Power of Attorney for Health Care? {) Yes l@)No [J] Unknown Provide the following information with respect to cach Guardian and agent: [name] jname] - ~ [address] Taddress] [eityistate/sip] Teity/state/zip] — —_ relationship to the Respondent] [relationship to the Respondent] ~ [telephone] fenvail] {ielephone] Temail| ‘Type of guardianship: ‘Type of Power of Attorney: ‘Type of guardianship: ‘Type of Power of Attorney: |_JAdutt LJ Minor {_] Property LJAdult {| Minor [J] Property {J Person LJ estate () Health Care C]Person Lh LJtlealth Care If the Respondent has one or more additional Guardian(s) or agent(s), provide the above information with respect to cach on an additional page. Il. Respondent’s Nearest Relatives Entitled to Notice A. Does the Respondent have a spouse (by marriage or civil union) and adult children, parents and adult brothers and sisters living’? If “No” or “Unknown”, proceed to paragraph B below. If “Yes”, provide the following information with respect to each: Spouse Adult Child Cleofe Smith ss Gisele Smith Frame] Tname] 19030 John Avenue 19030 John Avenue [address] [address] Country Club Hills, IL 60478 Country Club Hils, TL 60478 [city/state/zip] [eity/state/zip} 708/897-6612 a Trelephone] femaily [telephone] — Jemail] IRIS Y. MARTINEZ, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS p. age 3 of § 2023P 004012 CCP 0200 D (12/01/20) File No. Adult Child Adult Child Christpher Smith _ Tanya Cu is [name] Trae] 403 North Wabash Ave,, Unit 6C Unknown . address] $8 Chicago, IL 60611 Unknown jeity/tate/7ip| [city/state/7ip] [iciephone] [email] [telephone] Temail] If the Respondent has one or more additional adult children living, provide the above information with respect to each on an additional page. Parent Parent [name] [name] Taddress] laddress} [eityAtate/zip] [eity/state/7ip] [telephone] ~ [email] [iclephone] [email] Adult Brother or Sister Adult Brother or Sister Marcus D. Grey Carol Williams Tname| Thame] 530 East 102nd Street 0210 Linksland Drive jaddress] [address] Chicago, Mlinois 60628 Huntersville, N.C 28038 [eitystate/vip] [city/state/7ip| 773/620-9696 773/575-9520 [telephone] Temail] [telephone] jen it] If the Respondent has one or more additional adult brothers and sisters living, provide the above information with respect to cach on an additional page. B. Ifthe Respondent has no spouse, no adult child, no pa ent and no adult brother or sister, provide the fol- lowing information with respect to cach nearest adult relative: Janice W.G. Williams [name] [rekutionship] [namie] [relationship] 530 East 102nd Street [alr {address} Chicago, Illinois 60628 [city/stute/zip] [eity/state/zip] ~ [telephone] Tema) [iclephone] le ail] IRIS Y. MARTINEZ, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS ed of 5 2023P 004012 CCP 0200 E (12/01/20) File No. Thame] [relationship] Tame] [relationship a [address] [address] Sa [eitytate/sip] [eity/state/zip] [telephone] ~Temail] [Iclephor jemail] Ifthe Respondent has one or more additional adult relatives living, provide the above information with respect to cach on an additional page. V.Mimor(s) and Adult(s) Dependent Upon the Respondent Does the Respondent have one or more minors or adults who are dependent upon the Respondent? (gl Yes (_]No (_J Unknown IrYes”, provide the following information with respect to each: Dependent C1] Minor (m) Adult Dependent {_] Minor (Adult G cle Smith daughter [name] [relationship] [name} [relationship] 19030 John Avenue — {address} [address] c untry Club Hills, IL 60478 [eity/state/*ip] [city/state: TO8I897-6612 2 [ielephone] [email] [telephone] {email Ifthe Respondent has one or more additional adult relatives living, provide the above information with respect to each on an additional page. IRIS Y. MARTINEZ, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Page 5 of §