Nebraska State Court Form REQUIRED ACCEPTANCE OF APPOINTMENT OF TEMPORARY GUARDIAN AND TEMPORARY CONSERVATOR CC 16:2.225 New 11/15 Neb. Rev. Stat. §§ 30-2626(a), 30-2630.01(a); Neb. Ct. R. § 6-1443(A) IN THE COUNTY COURT OF COUNTY, NEBRASKA IN THE MATTER OF Case # Ward/Incapacitated Person/Protected Person ACCEPTANCE OF APPOINTMENT OF TEMPORARY GUARDIAN AND TEMPORARY CONSERVATOR I, , accept appointment as temporary guardian and temporary ( Name of guardian(s) and conservator(s)) conservator of the assets of , and swear that I will perform, ( Name of ward/incapacitated person/protected person) according to law, all duties for the ward/incapacitated person/protected person as temporary guardian and temporary conservator. Signature(s) of Guardian(s) and Conservator(s) Date Print or Type Name of Guardian(s) and Conservator(s) Bar Number and Firm Name (attorneys only) Street Address/P.O. Box of Guardian(s) and Conservator(s) City/State/ZIP Code of Guardian(s) and Conservator(s) Phone(s) E-mail Address(es) Page 1 of 1 Acceptance of Appointment of Temporary Guardian and Temporary Conservator CC 16:2.225 New 11/15 American LegalNet, Inc. www.FormsWorkFlow.com