Nevada Code § 159.0753

Requirements; form; Secretary of State to make form available; regulations
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1. Any person who wishes to request to
nominate another person to be appointed as his or her guardian may do so:
(a) If nominating a guardian of the estate,
pursuant to NRS 162A.250 ;
(b) If nominating a guardian of the person,
pursuant to NRS 162A.800 ; or
(c) By completing a form requesting to nominate a
guardian in accordance with this section.
2. A form requesting to nominate a guardian
pursuant to this section must be:
(a) Signed by the person requesting to nominate a
guardian;
(b) Signed by two impartial adult witnesses who
have no interest, financial or otherwise, in the estate of the person
requesting to nominate a guardian and who attest that the person has the mental
capacity to understand and execute the form; and
(c) Notarized.
3. A request to nominate a guardian
pursuant to this section may be in substantially the following form, and must
be witnessed and executed in the same manner as the following form:
REQUEST
TO NOMINATE GUARDIAN
I, ....................
(insert your name), residing at ................... (insert your address), am
executing this notarized document as my written declaration and request for the
person(s) designated below to be appointed as my guardian should it become
necessary. I am advising the court and all persons and entities as follows:
1. As of the
date I am executing this request to nominate a guardian, I have the mental
capacity to understand and execute this request.
2. This request
pertains to a (circle one): (guardian of the person)/(guardian of the
estate)/(guardian of the person and estate).
3. Should the
need arise, I request that the court give my preference to the person(s)
designated below to serve as my appointed guardian.
4. I request
that my .................... (insert relation), .................... (insert
name), serve as my appointed guardian.
5. If
.................... (insert name) is unable or unwilling to serve as my
appointed guardian, then I request that my .................... (insert
relation), .................... (insert name), serve as my appointed guardian.
6. I do not,
under any circumstances, desire to have any private, for-profit guardian serve
as my appointed guardian.
(YOU
MUST DATE AND SIGN THIS DOCUMENT)
I sign my name to this
document on ................. (date)
..........................................................................................
(Signature)
(YOU
MUST HAVE TWO QUALIFIED ADULT WITNESSES DATE AND SIGN THIS DOCUMENT)
I declare under penalty of
perjury that the principal is personally known to me, that the principal signed
this request to nominate a guardian in my presence, that the principal appears
to be of sound mind, has the mental capacity to understand and execute this
document and is under no duress, fraud or undue influence, and that I have no
interest, financial or otherwise, in the estate of the principal.
..........................................................
(Signature of first witness)
..........................................................
(Print name)
..........................................................
(Date)
..........................................................
(Signature of second witness)
..........................................................
(Print name)
..........................................................
(Date)
CERTIFICATE
OF ACKNOWLEDGMENT OF NOTARY PUBLIC
State of Nevada }
}
County of ........................... }
On this .......... day of ...............,
in the year ......., before me, .................... (insert name of notary
public), personally appeared .................... (insert name of principal), ....................
(insert name of first witness) and .................... (insert name of second
witness), personally known to me (or proved to me on the basis of satisfactory
evidence) to be the persons whose names are subscribed to this instrument, and
acknowledged that they have signed this instrument.
..........................................................
(Signature of notarial officer)
(Seal, if any)
4. The Secretary of State shall make the
form established in subsection 3 available on the Internet website of the
Secretary of State.
5. The Secretary of State may adopt any
regulations necessary to carry out the provisions of this section.

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