Nebraska State Court Form CC 16:2.124 New 10/2015 ACCEPTANCE OF INTRASTATE TRANSFER REQUIRED Neb. Ct. R. § 6-1443.02(F) IN THE COUNTY COURT OF ________________COUNTY, NEBRASKA IN THE MATTER OF Court Case # ____________________ ____________________________________ Ward/Incapacitated Person/Protected Person ACCEPTANCE OF INTRASTATE TRANSFER This matter comes before the court upon receipt of a provisional order for transfer of this guardianship/conservatorship from ______________________ County Court to _____________________ County Court. Good cause having been shown to the court of original jurisdiction and venue existing for the transfer, this court accepts the transfer of this guardianship/conservatorship. A status review hearing will be set within 30 days of receipt of the record from the originating court. It is so ordered. DATED __________________, 20_____. BY THE COURT: __________________________________ County Judge Page 1 of 1 Acceptance of Intrastate Transfer CC 16:2.124 New 10/2015 American LegalNet, Inc. www.FormsWorkFlow.com