SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE 4 RI-PR057 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address) FOR COURT USE ONLY TELEPHONE NO.: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): CONSERVATORSHIP OF (Name): ,Conservatee CASE NUMBER: CITATION FOR CONSERVATORSHIP (LPS) (W & I CODE 247 5350 et. seq.) To: You are hereby cited and required to appear at a hearing in this court On (date): at (time) Department 8 of the Historic Courthouse located at 4050 Main Street, Riverside, California 92501 Department 42 of the Hall of Justice located at 4100 Main Street, Riverside, California 92501 other address: and give any legal reason why, according to the verified petition filed with this court, you should not be found to be gravely disabled as a result of mental disorder impairment by chronic alcoholism, and why should not be appointed conservator of your person estate. A conservator of the person and/or the estate may be created for a person who, as a result of a mental disorder, is unable to provide for his or her basic personal needs for food, clothing, and shelter. At the hearing, a conservator may be appointed for your personal and/or estate. The conservatorship can last up to one year. The conservator must arrange for your care, food, clothing, and shelter. The conservator must investigate whether it is possible for you to return home or to the home of family or friends. The conservator may detain you in a locked facility. The appointment of the conservator may also take away some or all of the following rights: The right to refuse treatment related to your being gravely disabled; The right to refuse routine medical treatment; The ability to possess a driver222s license or to operate a motor vehicle; The right to enter into contracts; The right to vote; The right to possess a firearm. You have a right to appear at the hearing and oppose the petition. You have the right to hire an attorney of your choice to represent you. The court will appoint an attorney to represent you if you are unable to retain one. You must pay the cost of that attorney if you are able. You have the right to a jury trial if you wish. Dated: Clerk, by, , Deputy (Seal) Page 1 of 2 Approved for Optional Use Riverside Superior Court RI-PR057 [Rev. 05/2/17] CITATION FOR CONSERVATORSHIP (W & I CODE 247 5350 et seq.) W & I CODE 247 5350 et seq. riverside.courts.ca.gov/localfrms/localfrms.shtml American LegalNet, Inc. www.FormsWorkFlow.com IN THE MATTER OF: CASE NUMBER: PROOF OF SERVICE 1. At the time of service I was at least 18 years of age and not a party to this proceeding. I served copies of the Citation for Conservatorship and the Petition for Appointment Reappointment of Conservator. 2. a. Person cited (name): b. Person served: (1) person in item 2a (2) other (specify name and title of relationship to the person named in item 2a): c. Address (specify): 3. I served the person named in item 2 a. by personally delivering the copies (1) On (date): (2) at (time): b. by mailing the copies to the person served, addressed as shown in item 2c, by first-class mail, postage prepaid (1) on (date): (2) from (city): (3) with two copies of the Notice and Acknowledgement of Receipt227Civil and a postage-paid return envelope addressed to me. (Attach completed Notice and Acknowledgment of Receipt227Civil (form POS-015).) (4) to an address outside California with return receipt requested. (Attach completed return receipt.) c. other (specify other manner of service, and the authorizing code section and order of the court): 4. a. Person serving (name, address, and telephone number): b. Fee for service: $ c. Not a registered California process server. d. Exempt from registration under Business and Professions Code section 22350(b). e. Registered California process server. (1) Employee or independent contractor. (2) Registration no. (specify): (3) County (specify): (4) Expiration (date): 5. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 6. I am a California sheriff or marshal and I certify that the foregoing is true and correct. Date: (SIGNATURE OF PERSON SERVING) Page 2 of 2 Approved for Optional Use Riverside Superior Court RI-PR057 [Rev. 05/2/17] CITATION FOR CONSERVATORSHIP (W & I CODE 247 5350 et seq.) W & I Code 247 5350 et seq. riverside.courts.ca.gov/localfrms/localfrms.shtml American LegalNet, Inc. www.FormsWorkFlow.com