<p> Section 10, Protection of Personal and Property Rights Act 1988 In the Family Court at [place closest to subject persons address – Auckland, North Shore, Waitakere, Manukau, Papakura] FAM[file no. if known]</p><p>[full name, address (‘Auckland’ is sufficient), and occupation of applicant] Applicant [full name, address, and occupation of person in respect of whom this application is made] Person the application is about</p><p>APPLICATION FOR ORDER TO ADMINISTER PROPERTY</p><p>This document is filed by [name of applicant or their lawyer and address for service, including phone and fax]. 2</p><p>APPLICATION FOR ORDER TO ADMINISTER PROPERTY</p><p>I, [full name of applicant], apply for an order appointing a person to administer, on behalf of [Full name of the person in respect of whom the application is made], the following [property OR income OR benefit] belonging to that person or to which they may become entitled.: [specify property, income or benefit] I make this application in my capacity as: [delete and amend as appropriate – ADHB staff usually apply under 4, 5 or 7] 1. A [Specified relative, e.g. sister] of [Full name of the person in respect of whom the application is made]. 2. The attorney of [Full name of the person in respect of whom the application is made]. 3. A social worker within the meaning of the Protection of Personal and Property Rights Act 1988. 4. A medical practitioner. 5. A representative of Auckland District Health Board being a group that is engaged, otherwise than for commercial gain, in the provision of services and facilities for the welfare of persons in relation to whom the Court has jurisdiction in accordance with section 6 of the Act. 6. The [superintendent OR licensee OR supervisor OR person in charge] of [Name of institution], being the [hospital OR home OR {specify other institution}] in which [Full name of the person in respect of whom the application is made] is a [patient OR resident.] 7. A person granted leave of the Court to make this application. I say: 1. [Full name of the person in respect of whom the application is made] is of or over the age of 18 years. [or is under or 18 but is (or has been) married, in a civil union or living in a de facto relationship] 2 [Full name of the person in respect of whom the application is made] is ordinarily resident in New Zealand 3. [Full name of the person in respect of whom the application is made] wholly or partly lacks the capacity to understand the nature, and to foresee the consequences, of decisions relating to [his OR her] personal care and welfare, or wholly lacks the capacity to communicate decisions in respect of such matters. 3</p><p>4. [Full name of the person in respect of whom the application is made] is not subject to a property order. 5. No item of property in respect of which an order is sought exceeds $2,000 in value. 6. No income or benefit in respect of which an order is sought exceeds $20,000 in any 1 year. 7. The proposed appointee is [Full name of proposed appointee], of [Address of proposed appointee], [Occupation of proposed appointee.] 8. The proposed appointee is [of or over the age of 20 years OR a trustee corporation]. 9. The proposed appointee is not the superintendent, licensee, supervisor, or other person in charge of a hospital, home, or other institution in which [Full name of the person in respect of whom the application is made] is a patient or resident . 10. Further grounds are contained in my affidavit sworn [or affirmed] and filed herein in support of this application.</p><p>Signature of Applicant Date:</p>