Form 1: Application for Appointment of Co-Decision-Maker - Alberta Human Services - Government of Alberta

Form 1: Application for Appointment of Co-Decision-Maker

Download as PDF (79.2 K)

Instructions

Court File Number: Leave blank. A court file number will be assigned when the documents are filed. Do not write anything in the court stamp box.

Judicial Centre: The application will be made in the appropriate judicial centre having regard to where the assisted adult (hereafter called the adult) resides.

Adult’s Full Name: Fill in full legal name of the proposed assisted adult. Do not use nicknames or abbreviations. Use the same name all the way through the documents.

Applicant’s Name: Fill in full legal name of the person making the application; do not use nicknames or abbreviations. Use the same name throughout the documents.

Applicant’s Address for Service: If you are a lawyer or an assistant completing this form, fill in the firm name and add address information etc. If you are not a lawyer, leave the top three lines that reference a lawyer blank and add your own address, phone number etc.

1. Information About the Application and Applicant
2. Information About the Adult
3. Information About Current Decision-Making Arrangements for the Adult
4. Information About Family Members and Other Interested Parties
5. Information About Proposed Co-Decision-Maker(s)
6. Information About Proposed Co-Decision Making Order
7. Other Documents Submitted with Application
8. Request to Dispense with Service or Notice
9. Costs and Other Matters


1. Information About the Application and Applicant

1.1 If you are completing this form electronically, this area will be entered automatically. If you are completing the Application by hand on printed application forms then fill in the full legal name of the adult for which this application is for. Do not use nicknames or abbreviations

1.2 Most straightforward applications proceed by way of a “desk application”. This means that you do not need to attend a hearing or appear in front of a judge. Please see below for additional information that may assist you in deciding which type of application suits your situation. Once you have made your decision select “desk application” or “hearing”.

Additional Information:

  • Desk Application: A desk application is made when the applicant wishes the Court to review the documents filed and grant the orders but there is no public court hearing.
  • Hearing: “hearing for an application” means that the application is heard in a public court room and the Court will listen to verbal submissions in addition to having the application materials. An applicant may speak to the Court or have a lawyer represent them. Other interested parties may also speak to the Court at the hearing.

1.3 If you are the proposed assisted adult and applying to appoint a co-decision maker for yourself, select yes. Otherwise, select no.

1.4 Select the appropriate relationship. If you are selecting “other” please describe your relationship, e.g. Maternal Aunt. Please note that adult interdependent partner is a term that describes a variety of personal relationships that fall outside of marriage, including committed platonic relationships, where two people agree to share emotional and economic responsibilities.

1.5 If your address is different from the address provided for service then provide your address and contact information here.

Top

2. Information About the Adult

2.1 Complete all information.

2.2 Complete all information. If the proposed assisted adult lives permanently in a residential facility (see below for a definition of a residential facility) then provide the name of the facility or the name of the Agency operating the facility.

  • “Permanent Residence” means the address where the adult lives the majority of the time.
  • A “Residential Facility” means a nursing home, a place of care for adults who are aged or infirm or who require special care, a hospital or auxiliary hospital and/or 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, e.g. a group home.

2.3 If the proposed assisted adult is temporarily living away from their permanent address, e.g. in hospital, provide the address to the current living situation; include the name of the facility (if any).

Top

3. Information About Current Decision-Making Arrangements for the Adult

3.1 If the proposed assisted adult already has a supporter, co-decision-maker, guardian and/or trustee, provide the information here. If there is an existing supported decision making agreement refer to the written document, as there may or may not be a review date. If a co-decision-maker, guardian and/or trustee have already been appointed there will be a court order – refer to this document for the review date.

3.2 Only complete this section if you have identified other forms of decision making support in 3.1. If you are completing the Application by hand on printed application forms then you can add separate pages to provide the information required. If you are completing the application electronically you can add more space between sections and put your additional information there. This is applicable to any description field.

3.3 and 3.4 If the adult made a personal directive and/or an enduring power of attorney prior to losing capacity, provide information about the documents here.

Top

4. Information About Family Members and Other Interested Parties

Provide as much information as you have about all indicated family members, treaty status (if First Nation) and other interested parties. Please make sure that addresses and phone numbers are current to the best of your knowledge.

5. Information About Proposed Co-Decision-Maker(s)

Complete all information; please make sure that all addresses and phone numbers are current.

6. Information About Proposed Co-Decision Making Order

6.1 Please refer to the capacity assessment report when completing this list as the assessor will have identified areas in which he/she believes that the adult needs a co-decision-maker. The Court can only grant authority in areas where it considers a co-decision-maker necessary. If you are selecting the last box (“any other personal matters”) you will need to write in the decision that you feel needs to be made and make sure that it does not fit in an area already identified, e.g. attending church services would not need to go into this section because it would be covered under social activities.

6.2 Section 16(1) of the Adult Guardianship and Trusteeship Act states that the Court may appoint one or more co-decision-makers for an adult. This section also states that where the Court appoints two or more co-decision-makers for an adult, the Court may provide that the co-decision-makers are to act jointly, separately or successively in respect of specified personal matters of the adult. Check the box that pertains to your application, if you choose separately or successively, provide a description.

6.3 The Court may specify in a co-decision-making order that a contract respecting a personal matter is voidable if it is not in writing and signed by the assisted adult and the co-decision-maker. If you are requesting this, select yes.

6.4 The assessor who completed the capacity assessment form may have suggested a review period. If the assessor has not mentioned a review period but you feel that a review is needed then identify a review period, e.g., 6 years. If you do not feel that a review is necessary then check off the last box and ensure that your affidavit explains why a review isn’t needed. The Court will review the information and determine if a review is necessary and if so, in what time period.

Top

7. Other Documents Submitted with Application

7.1 You must include with your application the documents that apply. If the matter is going to a hearing include the notice of application and hearing document. Also include any other documents related to the proposed dependent adult’s current decision making arrangements.

7.2 Check off the box that indicates you are, or will be, submitting the names of two personal references for each co-decision-maker.

8. Request to Dispense with Service or Notice

8.1 You may request to dispense with notice upon any person (other than the adult); however you must provide reasons why you are making the request. For example, the Court will consider requests such as the whereabouts of this person cannot be established with ordinary diligence (you will need to prove to the Court that you have attempted to locate this person), or the person has had no contact with the applicant for many years, or the person is incapacitated themselves.

Top

9. Costs and Other Matters

9.1 Costs associated with a straightforward application include (but are not limited to):

  • Court Filing fee: $250 filing fee in the form of a cheque or money order payable to “Government of Alberta”.
  • Capacity Assessment Report charge: Maximum $500 if the capacity assessment is related exclusively to the adult’s capacity to make decisions about personal matters. If you are applying for a Co-decision-making and Trusteeship order jointly a maximum fee of $700 may be charged.
  • Legal fees: If you choose to use a lawyer to do your application it is important that you thoroughly discuss and understand the likely costs including legal fees and disbursements before you hire the lawyer. You should also understand who will be responsible for paying the legal fees and disbursements. Disbursements are items such as photocopying, courier, mail. Legal fees may vary between lawyers and depending on the complexity of the application.

Costs may be managed by using this kit (with or without the assistance of an Agency who provides Assistance for Personal Decision Makers; formerly CIP Agencies). There will still be the filing fee and some out of pocket expenses but you may not have to pay a legal fee. You may still have to pay for the capacity assessment report.

In hardship situations the Crown may agree to a costs contribution. If the adult’s estate is less than $7,000 in liquid assets and it would be a hardship to the applicant(s) to pay the costs the Crown may pay for all or some of the costs. The applicant does not have to disclose their specific financial circumstances but if you are requesting costs from the Crown you must make a written statement of hardship in the sworn affidavit.

If the Crown agrees to a cost contribution the filing fee will be waived. If the Crown agrees to a cost contribution and you choose to go to a lawyer then you will need to inform the lawyer that it is a hardship for you and the estate to pay the costs. It is important that you provide this information to the lawyer right away.

9.2 Click either no or yes, not both. If you check yes, please provide a detailed explanation of your request. If you are completing the application on line you have the ability to add more boxes to provide the information required. If you are completing the application on paper then you can add separate pages or put in more space to provide the information required.

Created:
Modified: 2016-03-30
PID: 16378

Contact this service

1-877-427-4525 (toll-free)

8:15 am - 4:30 pm (Monday to Friday, closed statutory holidays)