Page 1 of 3 Acceptance of Appointment of Conservator by the Public Guardian226 Restricted CC 16:2.218 Nebraska State Court Form REQUIRED ACCEPTANCE OF APPOINTMENT OF CONSERVATOR BY THE PUBLIC GUARDIAN 226RESTRICTED CC 16:2.218 IN THE COUNTY COURT OF COUNTY, NEBRASKA IN THE MATTER OF Case Protected Person ACCEPTANCE OF APPOINTMENT OF CONSERVATOR BY THE PUBLIC GUARDIAN 226RESTRICTED Name of protected personprotected person, and swears they will perform, according to law, all duties as conservator. The Public Guardian acknowledges the responsibilities as conservator by initialing all of the following: AcknowledgementsThe Public Guardian shall file with the court an Address Information for Guardianships Conservatorships form (CC 16:2.5). The General Information Form, unless waived by the court for good cause shown. The Public Guardian shall file with the court the Notice of Designation of Deputy Public Guardian and Associate Public Guardians form (CC 16:2.96). The Public Guardian shall file with the court an updated Notice of Designation of Deputy Public Guardian and Associate Public Guardians form (CC 16:2.96) if the designation changes after the initial filing. Within ten days of appointmenthe Public Guardian shall file with the court a Proof of Restricted Account formWithin 30 days of appointment he Public Guardian shall file with the court an Acknowledgement of Financial Institution form (CC 16:2.6) showing he American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 3 Acceptance of Appointment of Conservator by the Public Guardian226 Restricted CC 16:2.218 Within 30 days of appointment, he Public Guardian shall file with the court a Budget that pursuant to Neb. Ct. R247 6-1433.02(D) is for informational purposes only, and the Inventory, Affidavit of Due Diligence, and Certificate of Mailing form (CC 16:2.9) of the ward222s/incapacitated person222s assets. Acknowledgements after Letters are issued: The Public Guardian shall file with the court an Acknowledgement of Financial Institution form (CC 16:2.6) showing that a copy of the Letters was given to all financial institutions where the protected person has accounts. The Public Guardian shall also file a (confidential) Personal and Financial Information for Guardianships and Conservatorships form (CC 16:2.23) with full account numbers and printouts of all assets and account numbers. The Public Guardian shall file The Letters of Conservatorship with the Register of Deeds in any county where the protected person has real property or an interest in real property. One year after appointment and every year thereafter, he Public Guardian shall file with the court: 1.Updated Inventory form (CC16:2.45)2.Annual Accounting3.Certificate of Proof of Possession (CC16:2.13). The bank or depository must indicate arestriction to the account on the certificate: 223No withdrawals without court order.224 4. Copies of all statements and/or brokerage statements for the datescoveredby the accounting. If full account numbers, social security numbers, dates ofbirth orother personal information appear on the accounting statements and/orbrokeragestatements, all but the last four digits shall be blacked out before sendingthem to theinterested persons. 5.Personal and Financial Information for Guardianships and Conservatorships form (CC16:2.23) showing complete account numbers, etc. listed on inventory and certificate ofproof of possession. This form contains confidential information and is not shared withthe parties except by court order. The Public Guardian acknowledges all of the above documents, except the confidential Personal and Financial Information for Guardianships and Conservatorships form, shall be sent to all interested persons along with Notice of Right to Object Form (CC 16:2.16). The Public Guardian acknowledges a Certificate of Mailing (CC 16:2.24) shall be filed with the court showing all of the above documents have been mailed to all interested persons by first class mail, American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 3 The Public Guardian shall notify the court of the change of address of the protected person within three days of the change. The Public Guardian shall not move the protected person to a location outside of the State of Nebraska without court permission. The Public Guardian shall notify the court of the protected person222s death within three days. The Public Guardian shall file with the court a Notice of Newly Discovered Assets form, (CC 16:2.18) within 30 days after becoming aware of any additional assets, gifts, awards, settlements or inheritances over $500.00, not disclosed in the most current inventory. The Office of Public Guardian is prohibited from making ATM withdrawals or receiving cash back on debit transactions. Signature Date Print or Type Name Bar Number and Firm Name (attorneys only) Street Address/P.O. Box City/State/ZIP Code Phone E-mail Address American LegalNet, Inc. www.FormsWorkFlow.com