1. I request to act as litigation guardian for _____________________ (name), a person who lacks the mental capacity to participate in this Application before the Landlord and Tenant Board.
2. I declare that I am at least 18 years of age and that I understand the nature of this proceeding.
3. I declare that:
My relationship with the person is as follows:
4. I declare that:
I do not have any existing substitute decision making authority for the person.
I am a court appointed litigation guardian or substitute decision-maker for the person and have the authority to conduct this proceeding. (Please attach a copy of the document(s) authorizing you to act in this capacity, i.e. a continuing power of attorney and related document(s), or appointment under the Substitute Decisions Act, 1992, or Court order).[IF THIS APPLIES, YOU NEED NOT COMPLETE SECTIONS 5 - 8 OF THIS FORM]
I am a substitute decision maker for the person with respect to matters other than this Application. Please attach a copy of the document authorizing you to act in this capacity (i.e. a continuing power of attorney, or appointment under the Substitute Decisions Act, 1992).
5. I declare that no other person has authority to be the litigation guardian for the person in this Board proceeding.
6.I declare that:
no other person has guardianship or substitute decision making powers for the person for any matters.
_____________________________________(name) holds power of attorney or guardianship for the person for other matters but this power does not apply to the conduct of this proceeding. I have provided that person or organization with a copy of all the materials related to this Application and a copy of the Social Justice Tribunals Ontario practice direction on litigation guardians.
7. I declare that I believe:
the person for whom I seek to be a litigation guardian does not have the mental capacity to make decisions about this Application on his or her own behalf;
the person cannot understand information relevant to making the decisions to commence an Application (if applicable), delegate the power to pursue or respond to an Application, or withdraw or settle an Application and is not able to appreciate the reasonably foreseeable consequences of making or not making such decisions.
8. I declare that the reasons for my belief that the person is not mentally capable of making decisions about this Application, and the nature and extent of the disability causing the mental incapacity, are as follows (attach additional pages as needed to explain the basis of the person’s incapacity and evidence in support) :
9. I declare that I have no interest that would conflict with the interests of the person I am representing.
10. I declare that I will diligently attend to the interests of the person represented and shall take all steps necessary for the protection of those interests including:
a. to the extent possible, informing and consulting with the person represented about the proceedings;
b. considering the impact of the proceeding upon the person represented;
c. deciding whether to retain a representative and providing instructions to the representative; and
d. assisting in gathering evidence to support the proceeding and putting forward the best possible case to the Board.