FORM #549GC (01/2019) SCRCP 4(j), 62-5-303A, 62-5-308, 62-5-403A, 62-5-408 STATE OF SOUTH CAROLINA ) ) COUNTY OF ) ) IN THE MATTER OF: ) PROBATE COURT USE ONLY , ) ) IN THE PROBATE COURT an alleged incapacitated individual. ) ) ) ) CASE NUMBER - GC - - ACCEPTANCE OF SERVICE; RENUNCIATION/NOMINATION ACCEPTANCE OF SERVICE I accept service of a copy of the Summons and Petition in this matter pursuant to Rule 4(j), SCRCP at the following location: on the following date: ; and/or RENUNCIATION/NOMINATION FOR CONSERVATORSHIP (Check only one of the following two boxes): I renounce my right to be considered for appointment as conservator; OR I renounce my right to be considered for appointment as conservator and nominate the following person: Name: Address: Preferred Telephone: Secondary Telephone: Email: Relationship to alleged incapacitated individual: RENUNCIATION/NOMINATION FOR GUARDIANSHIP (Check only one of the following two boxes): I renounce my right to be considered for appointment as guardian; OR I renounce my right to be considered for appointment as guardian and nominate the following person: Name: Address: Preferred Telephone: Secondary Telephone: Email: Relationship to alleged incapacitated individual: Executed this day of , 20. SWORN to before me this day of Signature: , 20 . Print Name: Address: Print Name: Preferred Telephone: Notary Public for: Secondary Telephone: (State) Email: My Commission Expires: (Date) Relationship to the alleged incapacitated individual : American LegalNet, Inc. www.FormsWorkFlow.com