Ffurflen Adroddiad (OPG102)

Ailosod / Reset
Argraffu / Print
OPG102
10.13
Ffurflen Adroddiad
Report Form
Cyfeirnod yr Achos / Case reference number
Datganiad y dirprwy
Deputy’s declaration
Gallaf gadarnhau fod yr wybodaeth rwyf wedi’i
rhoi yn yr adroddiad hwn yn gywir hyd eithaf fy
ngwybodaeth. Cadarnhaf fy mod wedi cyflawni fy
nyletswyddau fel Dirprwy’n unol â gofynion y Ddeddf
Galluedd Meddyliol a’r Cod Ymarfer.
I confirm that the information that I have given in this
report is true and correct to the best of my knowledge.
I confirm that I have carried out my duties as a Deputy
in accordance with the requirements of the Mental
Capacity Act and the Code of Practice.
Llofnod y Dirprwy
Deputy’s signature
Dyddiad
Date
Gweler y nodiadau cyfarwyddyd ar Dudalennau
11 a 12 cyn cwblhau’r ffurflen hon.
Please refer to the guidance notes on Pages 11
and 12 before completing this form.
Enw’r dirprwy
Deputy’s name
Cyfeiriad y dirprwy
Deputy’s address
Cod post
Postcode
Rhifau ffôn
Telephone numbers
cartref
home
gwaith
work
ffôn symudol
mobile
cyfeiriad e-bost
email address
1
Enw’r cleient
Client’s name
Cyfeiriad y cleient
Client’s address
Cod Post
Postcode
Rhif ffôn
Telephone number
Cyfnod yr Adroddiad
Reporting Period
O
From
Hyd
To
2
ADRAN A - i’w chwblhau gan
Ddirprwyon eiddo a materion a lles
personol
SECTION A - to be completed by
property and affairs and personal
welfare Deputies
Penderfyniadau rydych
wedi’u gwneud eleni yn eich
rôl fel Dirprwy
Decisions you have made
this year in your role as
Deputy
Mae gwneud penderfyniadau’n rhan bwysig o
Ddeddf Galluedd Meddyliol 2005. Bydd y Gorchymyn
a oedd yn eich penodi fel Dirprwy’n dangos pa
benderfyniadau y gallwch eu gwneud. Dim ond
sylwadau am y penderfyniadau hyn sy’n rhaid i chi eu
gwneud. Gweler rhan 3 y Cod Ymarfer os nad ydych
^
r pwy ddylai fod yn gwneud penderfyniadau.
yn siw
Os oes angen mwy o ofod arnoch i ateb y
cwestiynau hyn defnyddiwch ddalenni ychwanegol.
Decision making forms an important part of the
Mental Capacity Act 2005. The Order appointing you
as Deputy will show what decisions you may make.
You need only comment about these decisions.
Please see part 3 of the Code of Practice if you are
unsure who should be making decisions. If you need
more space to answer any of these questions please
continue on separate sheets.
^
Gwnewch yn siw
r bod pob rhan o’r adran hon wedi’u
cwblhau. Os nad oes dim i’w nodi yn achos un neu
fwy o rannau, rhowch “Dim”. Os gadewir rhan yn
wag gellir dychwelyd eich adroddiad atoch.
Please ensure that all parts of this section are
completed. If you have nothing to report for one or
more parts, please enter “N/A”. If a part is left blank
your report may be returned.
1. Rhestrwch y penderfyniad (au) arwyddocaol a
wnaethoch fel Dirprwy yn ystod y cyfnod adrodd.
1. List the significant decision(s) that you have
made as Deputy during the reporting period.
Nodyn
Note
Gallai enghreifftiau o benderfyniadau o’r fath gynnwys
newid llety neu drefniadau byw, newid trefniadau
ariannol
Examples of such decisions might include a change of
accommodation or living arrangements, or an alteration
in financial arrangements.
3
2. I ba raddau oeddech chi’n gallu cynnwys ein
client yn y broses benderfynu? Dim ond sylw
am benderfyniadau a wnaethpwyd fel rhan o’r
rôl fel Dirprwy sydd angen eu cynnwys.
Dylech gynnwys unrhyw wybodaeth am
benderfyniadau y gall y client eu gwneud e.e.
unrhyw arian y gallant ei reoli drostynt eu hunain.
2. To what extent were you able to involve our client
in the decision making process? You only need
comment on decisions taken as part of your role
as Deputy. Include here any information about
decisions the client is able to make e.g. any
funds they are able to manage themselves.
Nodyn
Note
Gweler Pennod 3 y Cod Ymarfer am ragor o wybodaeth.
Please see Chapter 3 of The Code of Practice for further
information.
4
3. Rhowch enw a chyfeiriad yr holl bobl
arwyddocaol yr ydych wedi cysylltu â hwy yn
eich rôl fel Dirprwy, yn ogystal â’u perthynas
â’r client (e.e. Teulu, Meddyg, Gwasanaethau
Cymdeithasol, Cyfreithiol). Os nad oeddech wedi
ymgynghori ag eraill, dywedwch pam wrthym yn
y gofod ar dudalen 10.
3. Please give the name and address of all the
significant people you have contacted in your
role as Deputy, as well as the relationship to the
client (e.g. Family, Doctor, Social Services, Legal).
If you did not consult others, please tell us why
using the space on page 10.
Nodyn
Note
Mae’r Cod Ymarfer yn enwi nifer o bobl y dylech
siarad â hwy, os yn ymarferol a phriodol. Gweler
Pennod 5 y Cod Ymarfer am ragor o wybodaeth.
The Code of Practice sets out a number of people
you should speak to, if practical and appropriate. See
Chapter 5 of the Code of Practice for further information.
Enw
Name
Cyfeiriad
Address
Cod post
Postcode
Rheswm dros y cyswllt
Reason for contact
Perthynas
Relationship
Enw
Name
Cyfeiriad
Address
Postcode
Postcode
Rheswm dros y cyswllt
Reason for contact
Perthynas
Relationship
5
I’w chwblhau gan Ddirprwyon Eiddo a
Materion
To be completed by Property and
Affairs Deputies
ADRAN B
SECTION B
Rhestrwch yma unrhyw asedau cyfalaf (e.e. arian
yn Swyddfa Cronfeydd y Llys, cynilion, eiddo,
buddsoddiadau, stociau, cyfranddaliadau a / neu
fondiau) sydd gan y Client, a’u gwerth. Os yw’r Client
yn byw yn eu heiddo, nid oes angen i chi ei gynnwys
fel ased.
List here any capital assets (e.g. monies in Court
Funds Office, savings, property, investments, stocks,
shares and/or bonds) held by the Client and their
values. If the Client is living in their property, you do
not need to include it as an asset.
Mae gwerth bras yn dderbyniol ar gyfer eiddo a
buddsoddiadau. Dangoswch hefyd unrhyw forgeisi
neu fenthyciadau heb eu talu sy’n gysylltiedig â’r
asedau hyn.
Approximate valuations are acceptable for property
and investment holdings. Please also show any
outstanding mortgages or loans in relation to these
assets.
SYLWER rydych chi’n gyfrifol am sicrhau bod
Swyddfa’r Gwarcheidwad Cyhoeddus yn cael ei
hysbysu am unrhyw newidiadau yn asedau’r Client,
oherwydd gall lefel yr asedau hynny effeithio ar lefel yr
oruchwyliaeth fydd ei hangen.
PLEASE NOTE it is your responsibility to ensure the
Office of the Public Guardian is kept up to date with
any changes to the assets of the Client, as the level
of these assets may affect the level of supervision
required.
Nodyn
Mae’r Cod Ymarfer yn nodi rôl a dyletswyddau Dirprwyon
Eiddo a Materion a benodir gan orchmynion y Llys
Gwarchod. Gweler Pennod 8 am ragor o wybodaeth
Note
The Code of Practice outlines the role and duties of
Property and Affairs Deputies appointed by Court of
Protection orders. See Chapter 8 for further information.
Rhestr o asedau ym meddiant y client
List of assets held by the client
^
Gwnewch yn siw
r bod pob rhan o’r adran hon
wedi’u cwblhau. Os nad oes gennych ddim i’w
adrodd yn achos un neu fwy o rannau, rhowch
“Dim”. Os bydd rhan wedi’i gadael yn wag gellir
dychwelyd eich adroddiad atoch.
Please ensure that all parts of this section are
completed. If you have nothing to report for one
or more parts, please enter “N/A”. If a part is left
blank your report may be returned.
6
CYFRIF 1
ACCOUNT 1
Enw’r Banc / Cymdeithas Adeiladu
Bank/Building Society name
Pedwar digid olaf rhif
cyfrif y Banc / Cymdeithas Adeiladu
Last four digits of the
Bank/Building Society
account number
Cod didoli’r gangen
Branch sort code
–
–
–
–
Datganiad cryno o
incwm a gwariant:
Summary statement of
income and expenditure:
Yn ôl telerau’r Gorchymyn sydd wedi eu penodi
mae’n ofynnol bod Dirprwyon Eiddo a Materion yn
cadw ac yn cyflwyno cyfrifon cywir i’r Gwarcheidwad
Cyhoeddus yn flynyddol o’r holl drafodion ar ran ein
client.
Property and Affairs Deputies are required under
the terms of the Order appointing them to keep
and annually submit to the Public Guardian correct
accounts of all dealings and transactions on our
client’s behalf.
Dylech gofnodi cyfanswm yr incwm a gafwyd a’r
gwariant a dalwyd o’r cyfrif banc yn ystod y cyfnod
adrodd.
Please record the total income received and
expenditure paid out of the bank account during
the reporting period.
PWYSIG – Os oes * wrth y pennawd rhaid i chi
roi rhagor o fanylion ar dudalen 9. Os na roddir
manylion pellach, bydd eich adroddiad yn cael ei
ddychwelyd atoch.
IMPORTANT - Where headings are noted with
* you must provide further details on page 9. If
further details are not provided, your report will be
returned to you.
Incwm (Talwyd i mewn/Credydau)
Math
1.
Income (Paid in/Credits)
Cyfanswm
Type
Taliadau budd-daliadau – ticiwch
bob un perthnasol a rhowch
gyfanswm cyfunol
Lwfans Byw i’r Anabl
1.
Total
amount
Benefit payments - please tick all
that apply and provide a combined
total
Disability Living Allowance
Lwfans Gweini
Attendance Allowance
Lwfans Cyflogaeth a Chymorth
Employment Support Allowance
Budd-dal Analluogrwydd
Incapacity Benefit
Lwfans Anabledd Difrifol
Severe Disablement Allowance
Cymhorthdal Incwm/
Credyd Pensiwn
Budd-dal Tai
Income Support/
Pension Credit
Housing Benefit
Pensiwn y Wladwriaeth
State Pension
Eraill (Rhowch Fanylion):
Others (Please State):
Is-gyfanswm
Sub-total
7
Incwm arall
Other income
2. Pensiwn/pensiynau galwedigaethol
2. Occupational pension(s)
3. Llog ar y cyfrif
3. Account interest
4. Incwm o fuddsoddiadau / eiddo
5. Gwerthu buddsoddiadau/eiddo/
asedau*
4. Income from investments/property
5. Sale of investments/property/
assets*
6. Trosglwyddo o gyfrifon eraill /
Cronfeydd y Llys
6. Transfers from other accounts/
Court Funds
7. Ad-daliadau treth / Ad-daliadau eraill
7. Tax rebates/other refunds
8. Cymynroddion (e.e. etifeddiaethau,
rhoddion a gafwyd)
8. Bequests
(e.g. inheritance, gifts received)
9.
9.
10.
10.
11.
11.
Total Income
Cyfanswm Gwariant
Gwariant (Talwyd/Debydau)
Math
Expenditure (Paid out/Debits)
Cyfanswm
Type
Total
amount
12. Costau llety (e.e. rhent, morgais)
12.
Accommodation costs (e.g. rent,
mortgage)
13.
Ffioedd gofal/Ffioedd gofal yr
Awdurdod Lleol
13.
Care fees/Local Authority charges for
care
14.
^
Biliau’r cartref (e.e. dw
r, nwy, trydan,
teledu, ffôn, rhyngrwyd)
14.
Household bills (e.g. water, gas,
electric, TV, Phone, Internet)
15. Treth
15. Tax
16. Yswiriant
16. Insurance
17.
Ffioedd Swyddfa’r Gwarcheidwad
Cyhoeddus
17. Office of the Public Guardian fees
18. Premiwm bond sicrwydd y Dirprwy
19.
18. Deputy’s security bond premium
Gwariant cyfalaf / pryniannau
mawr*
19.
Capital expenditure/major
purchases*
20. Cynnal a chadw / gwella eiddo*
20. Property maintenance/improvement*
21. Buddsoddiadau a brynwyd*
21. Investments purchased*
22.
Trosglwyddo i gyfrifon eraill/
Cronfeydd y Llys
22.
Transfers to other accounts/
Court Funds
23. Gwyliau / teithiau
23. Holidays/excursions
24. Ffioedd proffesiynol
24. Professional fees
25. Treuliau’r Dirprwy*
25. Deputy’s expenses*
26. Arian gwario a roddir i’r Client
26. Spending money provided for Client
27.
Costau byw o ddydd i ddydd
(e.e. Bwyd, Ymolchi, Manion)
27.
Day-to-day living costs
(e.g. Food, Toiletries, Sundries)
28. Rhoddion *
28. Gifts*
29.
29.
30.
30.
31.
31.
32.
32.
Total Expenditure
Cyfanswm Gwariant
8
Crynodeb o’r Cyfrif - Cyfrif 1
Balans agoriadol y
cyfnod adrodd (fel sydd
i’w weld ar y fantolen banc)
Account Summary - Account 1
Opening balance for
reporting period
(as shown on bank statement)
Blwch 1
Box 1
Blwch 2
Total Income (as previous
page)
Box 2
Blwch 3
Sub-Total 1 (box 1 and box 2
added together)
Box 3
Cyfanswm gwariant (fel y
dudalen flaenorol)
Blwch 4
Total expenditure (as
previous page)
Box 4
Is-gyfanswm 2 (blwch 3
minws blwch 4)
Blwch 5
Sub-total 2 (box 3 minus box
4)
Box 5
Blwch 6
Closing balance for
reporting period
(as shown on bank statement)
Cyfanswm Incwm
(fel y dudalen flaenorol)
Is-gyfanswm 1 (Adio blwch
1 a blwch 2)
Balans ar ddiwedd y
cyfnod adrodd (fel sydd i’w
weld ar y fantolen banc)
Dylai’r ffigur ym Mlwch 5 gyfateb i’r ffigur ym Mlwch
6. Os ydynt yn wahanol, a’ch bod yn gallu egluro’r
gwahaniaeth, gwnewch hynny yma.
Box 6
The figure in Box 5 should be the same as the
figure in Box 6. If they differ, but you can explain the
difference, then please do so here.
9
Os ydych chi wedi cymryd eich balans agoriadol a
chau ar ddyddiad sy’n wahanol i ddyddiau cyntaf ac
olaf eich cyfnod adrodd, nodwch hyn isod a rhowch
reswm a’r union ddyddiadau a ddefnyddiwyd.
If you have taken your opening or closing balances
from a different date to the first and last days of your
reporting period, please state this below and provide
a reason and the actual dates used.
10
CYFRIF
ACCOUNT
Enw’r Banc / Cymdeithas Adeiladu
Bank/Building Society name
Pedwar digid olaf
rhif cyfrif y Banc /
Cymdeithas Adeiladu
Last four digits of the
Bank/Building Society
account number
Cod didoli’r gangen
Branch sort code
–
–
–
–
Os oes gennych fwy nag un cyfrif, copïwch a
chwblhewch y tudalennau hyn gymaint o weithiau
ag sydd angen – gan eu rhifo’n briodol.
If you have more than one account, please copy
and complete these pages as many times as
required – numbering these as appropriate.
Datganiad cryno o
incwm a gwariant:
Summary statement of
income and expenditure:
Cofnodwch gyfanswm yr incwm a gafwyd a’r
gwariant a dalwyd o’r cyfrif banc yn ystod y cyfnod
adrodd.
Please record the total income received and
expenditure paid out of the bank account during
the reporting period.
PWYSIG – Os oes * wrth y pennawd rhaid i chi
roi rhagor o fanylion ar dudalen 9. Os na roddir
manylion pellach, bydd eich adroddiad yn cael ei
ddychwelyd atoch.
IMPORTANT - Where headings are noted with *
you must provide further details on page 9.
If further details are not provided, your report will be
returned to you.
Incwm (Talwyd i mewn/Credydan
Math
1.
Income (Paid in/Credits)
Cyfanswm
Type
Taliadau budd-daliadau – ticiwch bob un
perthnasol a rhowch gyfanswm cyfunol
1.
Total amount
Benefit payments - please tick all that apply
and provide a combined total
Lwfans Byw i’r Anabl
Disability Living Allowance
Lwfans Gweini
Attendance Allowance
Lwfans Cyflogaeth a Chymorth
Employment Support Allowance
Budd-dal Analluogrwydd
Incapacity Benefit
Lwfans Anabledd Difrifol
Severe Disablement Allowance
Cymhorthdal Incwm/Credyd Pensiwn
Income Support/Pension Credit
Budd-dal Tai
Housing Benefit
Pensiwn y Wladwriaeth
State Pension
Eraill (Rhowch Fanylion):
Others (Please State):
Sub-total
Is-gyfanswm
11
Other income
Incwm arall
2.
Pensiwn/pensiynau
galwedigaethol
2. Occupational pension(s)
3. Account interest
from investments/
4. Income
property
of investments/
5. Sale
property/assets*
from other accounts/
6. Transfers
Court Funds
3. Llog ar y cyfrif
o fuddsoddiadau /
4. Incwm
eiddo
buddsoddiadau /
5. Gwerthu
eiddo / asedau*
o gyfrifon eraill /
6. Trosglwyddo
Cronfeydd y Llys
7.
Ad-daliadau treth / Ad-daliadau
eraill
7. Tax rebates/other refunds
8. Cymynroddion
(e.e. etifeddiaethau, rhoddion
a gafwyd)
8.
9.
9.
10.
10.
11.
11.
Bequests
(e.g. inheritance, gifts received)
Total Income
Cyfanswm Gwariant
Gwariant (Talwyd allan/Debydan)
Math
Expenditure (Paid out/Debits)
Cyfanswm
Type
llety
12. Costau
(e.e. rhent, morgais)
costs
12. Accommodation
(e.g. rent, mortgage)
gofal/Ffioedd gofal yr
13. Ffioedd
Awdurdod Lleol
^
14. Biliau’r cartref (e.e. dwr, nwy,
fees/Local Authority
13. Care
charges for care
14. Household bills (e.g. water, gas,
15. Treth
15. Tax
16. Yswiriant
16. Insurance
Swyddfa’r
17. Ffioedd
Gwarcheidwad Cyhoeddus
of the Public Guardian
17. Office
fees
bond sicrwydd y
18. Premiwm
Dirprwy
security bond
18. Deputy’s
premium
cyfalaf/ pryniannau
19. Gwariant
mawr*
expenditure/major
19. Capital
purchases*
a chadw/
20. Cynnal
gwella eiddo*
maintenance/
20. Property
improvement*
21. Buddsoddiadau a brynwyd*
21. Investments purchased*
i gyfrifon eraill/
22. Trosglwyddo
Cronfeydd y Llys
to other accounts/
22. Transfers
Court Funds
23. Gwyliau / teithiau
23. Holidays/excursions
24. Ffioedd proffesiynol
24. Professional fees
25. Treuliau’r Dirprwy*
25. Deputy’s expenses*
gwario a roddir i’r
26. Arian
Client
money provided for
26. Spending
Client
byw o ddydd i ddydd
27. Costau
(e.e. Bwyd, Ymolchi, Manion)
living costs
27. Day-to-day
(e.g. Food, Toiletries, Sundries)
trydan, teledu, ffôn, rhyngrwyd)
electric, TV, Phone, Internet)
12
Total amount
28. Rhoddion*
28. Gifts*
29.
29.
30.
30.
31.
31.
32.
32.
Cyfanswm Gwariant
Total Expenditure
13
Crynodeb o’r Cyfrif - Cyfrif
Balans agoriadol y
cyfnod adrodd
(fel sydd i’w weld ar y
fantolen banc)
Cyfanswm Incwm (fel y
dudalen flaenorol)
Is-gyfanswm 1 (Adio
blwch 1 a blwch 2)
Account Summary - Account
Opening balance for
reporting period
(as shown on bank
statement)
Blwch 1
Box 1
Blwch 2
Total Income (as previous
page)
Box 2
Blwch 3
Sub-Total 1 (box 1 and box
2 added together)
Box 3
Cyfanswm gwariant (fel
y dudalen flaenorol)
Blwch 4
Total expenditure (as
previous page)
Box 4
Is-gyfanswm 2 (blwch 3
minws blwch 4)
Blwch 5
Sub-total 2 (box 3 minus
box 4)
Box 5
Balans ar ddiwedd y
cyfnod adrodd
(fel sydd i’w weld ar y
fantolen banc)
Closing balance for
reporting period
(as shown on bank
statement)
Blwch 6
Box 6
Dylai’r ffigur ym Mlwch 5 gyfateb â’r ffigur ym Mlwch
6. Os ydynt yn wahanol, a’ch bod yn gallu egluro’r
gwahaniaeth, gwnewch hynny yma.
The figure in Box 5 should be the same as the
figure in Box 6. If they differ, but you can explain the
difference, then please do so here.
Os ydych chi wedi cymryd eich balans agoriadol a
chau ar ddyddiad sy’n wahanol i ddyddiau cyntaf ac
olaf eich cyfnod adrodd, nodwch hyn isod a rhowch
reswm a’r union ddyddiadau a ddefnyddiwyd.
If you have taken your opening or closing balances
from a different date to the first and last days of your
reporting period, please state this below and provide
a reason and the actual dates used.
14
Manylion trafodion ariannol/
eiddo pwysig
Details of major financial/property
transactions
Rhowch fanylion am gostau / rhoddion pwysig yn
ystod y cyfnod adrodd. Os oes angen mwy o ofod
arnoch, defnyddiwch ddalen arall o bapur.
Please give details of major costs/gifts over the
reporting period. If you require more space, please
continue on a separate sheet.
5. Gwerthu buddsoddiad / eiddo / asedau
5. Sale of investment/property/assets
19. Gwariant cyfalaf / pryniannau mawr
19. Capital expenditure/major purchases
20. Cynnal a chadw/Gwelliannau
20. Property maintenance/improvement
21. Buddsoddiadau a brynwyd
21. Investments purchased
25. Treuliau’r Dirprwy
25. Deputy’s expenses
15
28.Rhoddion
28.Gifts
Manylion Pellach
Further Details
Defnyddiwch y dudalen hon ar gyfer unrhyw
wybodaeth arall yr hoffech ei rhoi.
Please use this page for any other information you
wish to provide.
16
OPG102
10.13
Canllaw
Guidance
Diben adroddiad y dirprwy yw rhoi gwybodaeth i’r
Gwarcheidwad Cyhoeddus am y penderfyniadau
rydych wedi’u cymryd yn ystod y cyfnod adrodd yn
eich rôl fel Dirprwy.
The purpose of the deputyship report is to provide the
Public Guardian with information about the decisions
that you have made over the reporting period in your
role as Deputy.
Mae cwblhau adroddiad blynyddol dirprwy yn un o
amodau’r Gorchymyn Llys sydd wedi’ch penodi fel
Dirprwy.
Completing an annual deputyship report is a condition
of the Court Order appointing you as Deputy.
Gall y Gwarcheidwad Cyhoeddus benderfynu edrych
ymhellach ar y penderfyniadau a wnaethpwyd gennych
fel Dirprwy. Gall y broses hon gynnwys gofyn i chi
am ragor o wybodaeth, neu ofyn i Ymwelydd y Llys
Gwarchod ymweld â chi a / neu eich client. Gall y
Gwarcheidwad Cyhoeddus ofyn am ddogfennau
fel mantolenni banc o dan reoliad 39 Rheoliadau
Atwrneiaeth Arhosol, Atwrneiaeth Barhaus a
Gwarcheidwad Cyhoeddus 2007. Mae’r rheoliad hwn
yn rhoi pw^er i’r Gwarcheidwad Cyhoeddus i ofyn
am wybodaeth neu ddogfennau penodol a all fod yn
rhesymol iddo fod eu hangen i gadarnhau gwybodaeth
a geir mewn adroddiadau a gyflwynir iddo o dan
orchymyn Dirprwy, i weinyddu ei swyddogaeth yn
briodol o dan Ddeddf Galluedd Meddyliol 2005.
The Public Guardian may decide to look further at the
decisions you have made as Deputy. This process
may include asking you for more information, or asking
a Court of Protection Visitor to visit you and/or our
client. Documents, such as bank statements, may be
requested by the Public Guardian under regulation 39
of the Lasting Powers of Attorney, Enduring Powers of
Attorney and Public Guardian Regulations 2007. This
regulation empowers the Public Guardian to request
specific information or documents he may reasonably
require to verify information in reports that are being
submitted to him under a deputyship order, to properly
discharge his function under the Mental Capacity Act
2005.
Os na fyddwch wedi cyflwyno’ch adroddiad
Dirprwy, neu os oes pryderon yn deillio ohono, gall
y Gwarcheidwad Cyhoeddus benderfynu adolygu a
newid lefel yr oruchwyliaeth. Neu, gall y Gwarcheidwad
Cyhoeddus wneud cais i’r Llys Gwarchod i newid lefel
y bond sicrwydd, neu yn y pen draw eich rhyddhau
chi o’ch dyletswyddau fel y Dirprwy a phenodi Dirprwy
newydd yn eich lle. Yn achos Dirprwy ariannol, os
bydd y Llys yn canfod colledion yn ystâd y client gall
y Llys gyfarwyddo’r Gwarcheidwad Cyhoeddus i ofyn
i’r cwmni yswiriant a gyhoeddodd y bond sicrwydd i
wneud iawn am y golled honno, ac i geisio cael addaliad oddi arnoch chi.
If you fail to submit your deputyship report, or if there
are concerns raised from it, the Public Guardian may
decide to review and change the level of supervision.
Alternatively, the Public Guardian may apply to the
Court of Protection, to change the level of the security
bond, or ultimately to discharge you as the Deputy and
to appoint a new Deputy in your place. In the case of
a financial Deputy, if the Court finds there has been a
loss to the client’s estate the Court can direct the Public
Guardian to ask the insurance company who issued
the security bond to make good that loss, and to seek
reimbursement from you.
Ar ôl i chi gwblhau’r ffurflen, dylech ei dychwelyd i
Public Guardian, PO Box 16185, Birmingham, B2 2WH
neu DX 744240 Birmingham 79.
Once completed, please return your form to Office of
the Public Guardian, PO Box 16185, Birmingham, B2
2WH or DX 744240 Birmingham 79.
Sylwer – Gwnewch yn siw^r bod pob rhan o’r
ffurflen wedi’u cwblhau. Os nad oes gennych ddim
i’w nodi am un neu ragor o’r rhannau, nodwch
“Dim”. Os oes rhan wedi’i gadael yn wag, gall eich
adroddiad gael ei ddychwelyd atoch.
Note – Please ensure that all parts of the form are
completed. If you have nothing to report for one
or more parts, please enter “N/A”. If a part is left
blank your report may be returned.
TUDALEN 1 - Datganiad Dirprwy
Dylai eich Cyfnod Adrodd ar gyfer eich adroddiad
cyntaf ddechrau ar ddyddiad y Gorchymyn Llys. Dylai’r
un dyddiad gael ei ddefnyddio ar gyfer yr adroddiadau
a fydd yn dilyn dros y blynyddoedd dilynol.
Nodwch gyfeirnod eich achos ar frig y dudalen.
PAGE 1 – Deputy’s Declaration
The Reporting Period for your first return should
be taken from the date of your Court Order. The
Anniversary of that date should be taken for
subsequent reports. Please note your case
reference number at the top of the page.
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TUDALEN 2 - (1.) rhai enghreifftiau o
benderfyniadau arwyddocaol
PAGE 2 – (1.) Some examples of significant
decisions
Cyfeiriad symud ein client h.y. symud i gartref
nyrsio neu ofal, newid cartref nyrsio neu ofal neu’n
dychwelyd adref
Our client moving address i.e. moving into a
nursing or care home, changing nursing or care
home, or returning home
Cyflogi gofalwyr neu newid y gofalwyr presennol
Employing carers or changing existing carers
Prynu neu werthu buddsoddiadau, cyfranddaliadau
neu eiddo
Buying or selling investments, shares or property
TUDALEN 2 – (2.) i ba raddau yr oeddech yn
gallu cynnwys ein cleient
Os oes gan ein client beth galluedd a’ch bod yn
gallu ymgynghori â hwy wrth wneud unrhyw rai o’r
penderfyniadau a nodwyd uchod, dylech gynnwys
manylion amdanynt yma.
PAGE 2 – (2.) To what extent were you able to
involve our client
If our client has some capacity and you were able
to consult them when making any of the decisions
detailed above, please include details of that here.
Os nad oes gan ein client alluedd nac
ymwybyddiaeth ac nad oedd modd i chi
ymgynghori â hwy, dylech ddangos hynny yma.
If our client has no capacity or awareness and you
were not able to consult them then again, please
indicate that here.
TUDALEN 3 -Rhai enghreifftiau o gysylltiadau
arwyddocaol
Cyfreithiwr / cyfrifydd i baratoi eich adroddiad
blynyddol
PAGE 3- (3.) some examples of significant
contacts
Solicitor/accountant to prepare your annual report
Banc / cynghorydd ariannol am gyngor ar
fuddsoddiadau
Bank/financial advisor for investment advice
Staff cartref gofal / gwasanaethau cymdeithasol
ynghylch lles ein client
Care home staff/social services regarding the
welfare of our client
TUDALEN 4 – Asedau
Sicrhau bod manylion yr holl asedau sydd ym
meddiant ein client wedi’u nodi yma; dylai hyn
gynnwys manylion am unrhyw eiddo (gydag
amcangyfrif o werth), arian a gedwir yng nghyfrifon
unrhyw fanc neu gymdeithas adeiladu (gan
gynnwys ISA), arian ym meddiant Swyddfa
Cronfeydd y Llys, ac unrhyw fuddsoddiadau eraill.
PAGE 4 – Assets
Ensure details of all assets held by our client are
detailed here, this should include details of any
properties (with approximate values), monies held
in any bank or building accounts (including ISAs),
monies held in the Court Funds Office, and any
other investments.
Joint Accounts – If you manage a joint account for
our client you may find it difficult to balance the report.
In these circumstances please make it very clear
on your report that the account is a joint account.
Attempt to separate our client’s income/expenditure
on the bank statements and transfer those figures to
your report. We understand that this might be difficult
and will not always be possible – please make the
circumstances/ arrangements clear on your report.
Cydgyfrifon – Os ydych chi’n rheoli cydgyfrif ar ran
ein client gall fod yn anodd i chi fantoli’r adroddiad.
Mewn amgylchiadau o’r fath dylech ddatgan yn
eglur yn eich adroddiad bod y cyfrif yn gydgyfrif.
Ceisiwch wahanu incwm / gwariant ein client ar y
mantolenni banc a throsglwyddwch y ffigurau hynny
i’ch adroddiad. Rydym yn sylweddoli y gall hyn fod
yn anodd ac na fydd yn bosibl bob amser – cofiwch
egluro’r amgylchiadau / trefniadau yn eich adroddiad.
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TUDALEN 5 – Incwm a Gwariant
PAGE 5 – Income and Expenditure
^ r eich bod yn
PWYSIG – Gwnewch yn siw
cynnwys holl incwm a gwariant y cyfrif, fel sy’n
cael ei ddangos ar y mantolenni banc, am yr holl
gyfnod adrodd. Defnyddiwch y blychau gwag
ar waelod pob colofn i nodi unrhyw incwm /
gwariant sydd heb eu cynnwys yn y rhestrau.
IMPORTANT – Please ensure that you include
all income and expenditure for the account, as
shown on the bank statements, for the entire
reporting period. Please use the empty boxes at
the bottom of each column to note any income/
expenditure not included in the lists.
Wrth gwblhau tudalen 5 yr adroddiad mae’n bwysig
eich bod yn defnyddio’r mantolenni banc ar gyfer y
cyfrif rydych yn adrodd arno. Rhowch enw’r banc
ble mae’r cyfrif a math y cyfrif (er enghraifft “cyfredol
Barclays”) yn y blychau ar frig y dudalen.
When completing page 5 of the report it is important
to use the bank statements for the account you
are reporting on. Insert the name of the bank the
account is with and what type of account (for
example “Barclays current”) in the boxes at the top
of the page.
Y golofn ar ochr chwith y dudalen yw ble dylech
gofnodi unrhyw incwm sydd wedi’i dalu i’r cyfrif
am yr holl gyfnod adrodd. Y golofn ar ochr dde’r
dudalen yw ble dylech gofnodi’r gwariant.
The column on the left hand side of the page
is where to record any income which has been
received into the account for the entire reporting
period. The column on the right hand side of the
page is where to record the expenditure.
Ar frig y golofn incwm byddwch yn sylwi ar restr o
fudd-daliadau. Ticiwch y blwch wrth ymyl unrhyw rai
o’r taliadau mae ein client yn eu cael. Defnyddiwch
eich mantolenni banc i adio’r holl daliadau hyn a
gafwyd drwy gydol y cyfnod adrodd a chofnodwch
y cyfanswm yn y blwch wrth ochr y rhestr.
At the top of the income column you will notice
there is a list of benefit payments. Tick the box next
to any of these payments that are received by our
client. Use your bank statements to add up all of
these payments received throughout the reporting
period and enter the total in the box next to the list.
Gwnewch yr un peth ar gyfer y categorïau incwm
eraill isod.
Do the same for the other income categories below.
Rhaid i’r holl ffigurau a roddir fod yn
gyfansymiau blynyddol yn hytrach na chyfrifon
wythnosol/misol.
All figures given must be annual totals rather
than weekly/monthly amounts.
Ar waelod y golofn rhowch gyfanswm yr incwm
rydych yn adrodd arno.
At the bottom of the column enter the total income
you have reported for.
Defnyddiwch yr un dull i gofnodi’r gwariant yn y
golofn ar yr ochr dde.
Follow the same method to record the expenditure
in the right hand column.
Mae’r symbol * i’w weld wrth ymyl rhai o’r
categorïau yn y golofn hon. Os ydych yn cofnodi
swm wrth ymyl unrhyw rai o’r categorïau hyn rhaid
i chi roi manylion pellach ar dudalen 9 y ffurflen
adrodd.
Some of the categories in this column have this
symbol * next to them. If you enter an amount next
to any of these categories you must provide further
details on page 9 of the report form.
AWGRYM – chwiliwch am ddiwrnod cyntaf eich
cyfnod adrodd ar y mantolenni banc a thynnwch
linell o dan y diwrnod hwnnw, a gwnewch yr un
peth o dan ddiwrnod olaf eich cyfnod adrodd. Rhaid
cynnwys unrhyw drafodion rhwng y llinellau hyn
yn eich adroddiad. Mae hyn yn cynnwys unrhyw
drosglwyddiadau ac ad-daliadau.
TIP – find the first day of your reporting period on
your bank statements and draw a line under that day,
and do the same for the last day of your reporting
period. Any transactions between these lines must
be included in your report. This includes any transfers
and refunds.
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TUDALEN 6 – Crynodeb o’r cyfrif
PAGE 6 – Account summary
Blwch 1: Balans agoriadol y cyfrif. Dylai hwn gyfateb
i’r balans a ddangosir ar y mantolenni banc ar gyfer
y cyfrif ar ddiwrnod cyntaf eich cyfnod adrodd. Os
ydych chi wedi dilyn yr awgrym bydd hwn wedi’i
danlinellu eisoes ar eich mantolenni banc.
Box 1: The opening balance of the account. This
should match the balance shown on the bank
statements for the account at the first day of your
reporting period. If you have followed the tip this will
already be underlined on your bank statements.
Blwch 2: Cyfanswm yr incwm i’r cyfrif yn y
cyfnod adrodd. Cymerwch y ffigur hwn o’r blwch
“Cyfanswm Incwm” ar dudalen 5.
Box 2: The total income into the account for the
reporting period. Take this figure from the “Total
Income” box on page 5.
Blwch 3: Adiwch y ffigurau ym Mlwch 1 a Blwch 2
at ei gilydd. Nodwch y ffigur hwn ym Mlwch 3.
Box 3: Add the figures in Box 1 and Box 2
together. Note this figure in Box 3.
Blwch 4: Cyfanswm y gwariant o’r cyfrif yn y
cyfnod adrodd. Cymerwch y ffigur hwn o’r blwch
“Cyfanswm Gwariant ar dudalen 5.
Box 4: The total expenditure from the account for
the reporting period. Take this figure from the “Total
Expenditure” box on page 5.
Blwch 5: Tynnwch y ffigur ym Mlwch 4 o’r ffigur ym
Mlwch 3. Nodwch y ffigur hwn ym Mlwch 5.
Box 5: Subtract the figure in Box 4 from the figure
in Box 3. Note this figure in Box 5.
Blwch 6: Balans cau’r cyfrif. Dylai hwn gyfateb i’r
balans a ddangosir ar y mantolenni banc ar gyfer
y cyfrif ar ddiwrnod olaf eich cyfnod adrodd. Os
ydych chi wedi dilyn yr AWGRYM bydd hwn wedi’i
danlinellu eisoes ar eich mantolenni banc.
Box 6: The closing balance of the account. This
should match the balance shown on the bank
statements for the account at the last day of your
reporting period. If you have followed the TIP this
will already be underlined on your bank statements.
Os yw’r ffigurau ym mlychau 5 a 6 yn wahanol,
rhaid i chi roi esboniad am y gwahaniaeth yn y
gofod a roddir.
If the figures in boxes 5 and 6 are not the same,
you must explain the difference in the space
provided.
Os ydych chi wedi cymryd eich balans agoriadol a
chau ar ddyddiadau sy’n wahanol i ddiwrnod cyntaf
ac olaf eich cyfnod adrodd, rhowch resymau am hyn
yn y blwch ar waelod y dudalen. Dylech gynnwys y
dyddiadau a ddefnyddiwyd i gymryd y balans.
If you have taken your opening and closing
balances from dates other than the first and last day
of your reporting period, give reasons for this in the
box at the bottom of the page. Include the dates
that you have taken the balances from.
TUDALEN 7 ac 8 – Crynodeb o gyfrif arall
Os ydych chi’n rheoli mwy nag un cyfrif banc ar ran
ein client, llungopïwch y dudalen nesaf gymaint o
weithiau ag sydd angen. Er enghraifft, os ydych chi’n
rheoli pedwar cyfrif ar ran ein client bydd angen tri
chopi o tudalennau 7 ac 8 arnoch. Dilynwch yr un
drefn ag a ddilynwyd ar gyfer y cyfrif cyntaf.
PAGE 7 and 8 – Other account summary
If you manage more than one bank account for our
client, please photocopy the next page as many
times as you need. For example, if you manage four
accounts for our client you will need three copies of
pages 7 and 8. Follow the same instructions as for
the first account.
TUDALEN 9 - Trafodion ariannol / eiddo pwysig
Mae’r symbol * i’w weld wrth ymyl rhai o’r
categorïau yn y golofn gwariant ar dudalen 5.
Os ydych yn cofnodi swm wrth ymyl unrhyw
rai o’r categorïau hyn rhaid i chi roi manylion
pellach ar dudalen hon
PAGE 9 – Major financial/property transactions
Some of the categories in the expenditure column
on page 5 have this symbol * next to them.
If you entered an amount next to any of these
categories you must provide further details on
this page.
TUDALEN 10 - Manylion pellach
Defnyddiwch y dudalen hon os oes gennych unrhyw
wybodaeth bellach yr hoffech ei chynnwys.
PAGE 10 – Further Details
Please use this page for any further information you
wish to provide.
Os oes angen mwy o ofod arnoch ar gyfer unrhyw
rai o’r adrannau blaenorol, gallwch ddefnyddio’r
dudalen hon
If you require any more space for any of the
previous sections, you can use this page.
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