JDF 861SC R6/19 PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR Page 1 of 7 District Court Denver Probate Court County, Colorado Court Address: In the Interest of: Minor COURT USE ONLY Attorney or Party Without Attorney (name and address): Phone Number: E-mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR 1. No court proceeding is pending in this state or elsewhere concerning the respondent. The following proceeding(s) concern(s) the respondent. Identify name of court, case number, state, date, and type of proceeding if any. Name of Court Case Number State Date of Proceeding Type of Proceeding 2. The petitioner is: a person who would be adversely affected by lack of effective management of the minor222s property and business. a person who is interested in the estate, financial affairs, or welfare of the minor. the minor and is 12 years of age or older. This is a petition for appointment of a: Conservator. (Note: the appointment will expire when the Minor reaches the age of 21, unless otherwise ordered by the court.) Special Conservator. While a petition to establish a conservatorship is pending, a special conservator is needed to preserve and apply the minor222s property as may be required for the support of the minor or individuals who are dependent upon the Minor. Special Conservator. A special conservator is necessary to assist in the accomplishment of the following protective arrangement or other single transaction. A permanent conservatorship is not requested. 3. Information about the petitioner: Name: List all names used (also known as, formerly known as, etc.): Relationship to Minor: Street Address: City: State: Zip Code: American LegalNet, Inc. www.FormsWorkFlow.com JDF 861SC R6/19 PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR Page 2 of 7 Mailing Address, if different: City: State: Zip Code: Primary Phone: Alternate Phone: Email Address: Does Petitioner need an interpreter? NoYes (Language:) 4. Information about the minor: Name: Age: Date of Birth: Street Address: City: State: Zip Code: Mailing Address, if different: City: State: Zip Code: Primary Phone: Alternate Phone: Email address: Does the minor need an interpreter? NoYes (Language:) 5. Information about the minor222s parents: Parent222s Name: Deceased Unknown (attach Birth Certificate) Street Address: City: State: Zip Code: Mailing Address, if different: City: State: Zip Code: Primary Phone: Alternate Phone: Email Address: Does this person need an interpreter? NoYes (Language:) Parent222s Name: Deceased Unknown (attach Birth Certificate) Street Address: City: State: Zip Code: Mailing Address, if different: City: State: Zip Code: Primary Phone: Alternate Phone: Email Address: Does this person need an interpreter? NoYes (Language:) 6. Venue for this proceeding is proper in this county because the minor resides in this county. does not reside in this state but has property in this county. American LegalNet, Inc. www.FormsWorkFlow.com JDF 861SC R6/19 PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR Page 3 of 7 7. A conservator is required because of the minor222s age. The minor owns or will receive money or property that requires management or protection that cannot otherwise be provided; and/or has or may have business affairs that may be put at risk or prevented because of his or her age; and/or needs money for support and education and protection is necessary or desirable to obtain or provide money. 8. A conservator is required for reasons other than the minor222s age. The minor is unable to manage property and business affairs because he or she is unable to effectively receive and evaluate information or both or to make or communicate decisions, even with the use of appropriate and reasonably available technological assistance due to the following disabilities or impairments: Physician222s letter attached. In addition: the Minor has property that will be wasted or dissipated unless proper management is provided. and/or the Minor, or persons entitled to the Minor222s support, require money for support, care, education, health, and welfare, and protection is necessary or desirable to obtain or provide money. 9. A conservator is required because the minor is missing, detained, or unable to return to the United States. The nature of the minor222s disappearance or detention and any efforts to locate the minor are as follows: 10. The petitioner requests the conservator222s powers and duties be unlimited/unrestricted or limited/with restrictions. The property to be placed under the conservator222s control and the requested limitations/restrictions on the conservator222s powers and duties, if any, are as follows: 11. The petitioner requests the special conservator222s powers and duties be unlimited or unrestricted or limited or with restrictions. The property to be placed under the special conservator222s control and the requested limitations/restrictions on the Special Conservator222s powers and duties, if any, are as follows: American LegalNet, Inc. www.FormsWorkFlow.com JDF 861SC R6/19 PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR Page 4 of 7 12. Petitioner is 21 years of age or older, nominates himself or herself and requests to be appointed as conservator or special conservator. or Petitioner nominates the following person, who is 21 years of age or older, to be appointed as conservator or special conservator. Name: List all names used (also known as, formerly known as, etc.): Relationship to Minor: Street Address: City: State: Zip Code: Mailing Address, if different: City: State: Zip Code: Primary phone: Alternate phone: Email Address: Does this person need an interpreter? NoYes (Language:) 13. The nominated conservator has priority for appointment because he or she is: nominated by the minor and the minor is 12 years of age or older. (Attach Consent or Nomination of Minor - JDF 826). an interested person. (State nature of interest.) 14. The conservator may receive compensation. The hourly rates to be charged, any amounts to be charged pursuant to a published fee schedule, including the rates and basis for charging fees for any extraordinary services, and any other bases upon which a fee charged to the estate will be calculated, are as stated below or in an attachment to this petition. * American LegalNet, Inc. www.FormsWorkFlow.com JDF 861SC R6/19 PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR Page 5 of 7 The basis of compensation has not yet been determined. * There is a continuing obligation to disclose any material changes to the basis for charging fees. (247 15-10-602 C.R.S.) 15. The conservator may compensate his, her, or its counsel. The hourly rates to be charged, any amounts to be charged pursuant to a published fee schedule, including the rates and basis for charging fees for any extraordinary services, and any other bases upon which a fee charged to the estate will be calculated, are as stated below or in an attachment to this petition. * The basis of compensation has not yet been determined. * There is a continuing obligation to disclose any material changes to the basis for charging fees. (247 15-10-602 C.R.S.) 16. Sections a and b below identify assets and the source and amount of estimated income (public benefits, real property, proceeds from insurance policy, proceeds from pension, etc.) of the minor, together with an estimate of the value. a. The minor222s assets are: Description of Assets (e.g. b ank a ccounts, p roperty) None. Estimated Value $ $ $ Total $ b. The Minor222s income is: Description of Income ( e.g. s ocial s ecurity, insurance or pension ) None. Estimated Amount of Income $ $ $ Total $ 17. The following person is currently acting as Guardian or Conservator for the Minor in Colorado or elsewhere: Name: Relationship to Minor: Street Address: City: State: Zip Code: Mailing Address, if different: City: State: Zip Code: American LegalNet, Inc. www.FormsWorkFlow.com JDF 861SC R6/19 PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR Page 6 of 7 Primary Phone: Alternate Phone: Email Address: Does this person need an interpreter? NoYes (Language:) 18. The minor222s parents are