FOR CLERK’S USE ONLY Name of Person Filing: _______________________________________ Mailing Address: _______________________________________ City, State, Zip Code: _______________________________________ Day/Evening Telephone: _______________________________________ Attorney Bar Number (if applicable): _________________________________ Licensed Fiduciary Number (if applicable): __________________________ Self or Representing: Attorney for: __________________________ SUPERIOR COURT OF ARIZONA MOHAVE COUNTY In the Matter of the Conservatorship for Case Number ________________________ ORDER TO CONSERVATOR AND ACKNOWLEDGMENT __________________________________ (Protected Person’s Name) A Minor An Adult The welfare and best interest of the person named above (“your protected person”) are matters of great concern to this Court. By accepting appointment as conservator, you have subjected yourself to the power and supervision of the Court. Therefore, to assist you in the performance of your duties, this order is entered. You must be guided by it and comply with its provisions as it relates to your duties as conservator of your protected person. As conservator, you must: 1. Immediately locate, identify secure and inventory all of the assets of the protected person and make proper arrangements for their protection, such as changing the locks on the house, renting a safe deposit box for important documents, etc. 2. Immediately begin to take title to all of the protected person’s property. The property should be titled in the name of the conservatorship: “(Your name), as Conservator(s) of the estate of (protected person’s name)” or “(protected person’s name), by (your name), Conservator.” Do not put the protected person’s funds into joint accounts, trust accounts (“in trust for”), or payable on death (POD) accounts. Do not list yourself as beneficiary on any bank accounts or other assets belonging to the protected person. 3. If the Court has ordered you to place funds in a restricted account, you must immediately file a receipt from the bank or financial institution showing that you have deposited the money in an account which the bank has restricted in accordance with the Court order. The receipt should include the name and address of the financial institution, the type of account, the account number and the amount deposited. 4. Record certified copies of your letters of conservatorship in each county in Arizona where the protected person owns property in order to protect title to Revised: 1/1/2011 Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Case No.______________________________ those properties. If the protected person owns property in another state, record letters in the county in that state in which the property is located as well. 5. File your formal inventory with the Court no more than 90 days after your letters of permanent conservator have been issued. If you are filing it without an attorney, be sure to put the case name and number on all papers you file with the Court. 6. Keep detailed records of all receipts and expenditures you make on behalf of the protected person, including bills, receipts, bank statements, tax returns, bills of sale, promissory notes, etc. Open a separate conservatorship checking account for deposit of your protected person’s income and other receipts and payment of all bills and expenses. Avoid dealing in cash and do not write checks to “cash.” 7. Establish a budget, pay the protected person’s debts when they become due, and properly invest the protected person’s assets. You may hire accountants, attorneys and other advisors to help you carry out your duties as the size and the extent of the conservatorship estate may dictate. 8. Keep detailed records of the time you are spending in identifying, managing and protecting the conservatorship estate in case you later decide to ask the Court to be paid for your time from the conservatorship estate. 9. File annual accountings with the Court. Unless otherwise ordered by the Court, your first accounting must reflect all activity relating to the conservatorship from the date your letters of conservator, whether temporary or permanent, were first issued through and including the last day of the ninth month after the date your letters of permanent conservator were issued and must be filed with the Court on or before the first anniversary date of the issuance of your letters of permanent conservator. Unless otherwise ordered by the Court, all subsequent accounting shall reflect all activity relating to the conservatorship estate from the ending date of the most recent previously filed accounting through and including the last date of the twelfth month thereafter and must be filed with the Court on or before the anniversary date of the issuance of your letters of permanent conservator. Each accounting must list all conservatorship property at the beginning of the accounting period and the conservatorship property at the end of the accounting period, and must describe all money and property received or disbursed by you during the accounting period. As to money and property received, you must provide the date of each receipt, the source of the receipt, the purpose of the receipt, and the amount of the receipt. As to money and property disbursed, you must provide the date of each disbursement, the payee/distributee, the purpose of the disbursement, and the amount of the disbursement. With each accounting, you also must submit a bank statement or financial account statement that supports the ending balances of each account shown on the accounting. Revised: 1/1/2011 Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Case No.______________________________ 10. NEVER use any of the protected person’s money or property for any reason other than the protected person’s direct benefit. You may not profit in any way from access to the protected person’s assets. You have a legal duty of undivided loyalty to the protected person. Neither you, your friends, nor other family members may profit by dealing in the assets of the conservatorship estate. You must be cautious and prudent in investing the protected person’s assets. 11. You must not make speculative investments. Do not purchase merchandise or services which the protected person would have considered extravagant or inappropriate for his/her lifestyle prior to your appointment. Use the assets to maintain the safety, health and comfort of the protected person, bearing in mind that the protected person may have no additional sources of income for the remainder of his/her life. 12. The conservatorship terminates only upon the entry of a Court order terminating the conservatorship. The Court will enter such an order only after you, the protected person, or another interested person files a petition requesting that the conservatorship be terminated. If the protected person is a minor, such a petition should be filed after the minor becomes 18 years of age, after the conservatorship estate has been exhausted, or after the death of the protected person, whichever occurs first. If the protected person is an adult, such a petition should be filed if the protected person no longer needs a conservator (either because the protected person’s disability has ceased or because the conservatorship estate has been exhausted) or after the protected person dies. Unless otherwise ordered by the Court or unless, in the case of the protected person’s death, you comply with A.R.S. 14-5419(F), you will need to file a final accounting with the Court before you can be discharged of liability in connection with the conservatorship and before your bond is exonerated. 13. If you have any questions as to your duties as conservator, contact an attorney who handles conservatorships before taking any action. 14. If you are not a licensed fiduciary and are not related by blood or marriage to the protected person, you are not entitled to compensation for your services as the ward’s conservator. See A.R.S. 14-5651(J)(I). 15. The Conservator shall immediately notify the Court in writing of any change in the physical or mailing address of himself or herself or the protected person and shall be responsible for all costs resulting from failure to do so. § § This is an outline of some of your duties as conservator. It is your responsibility to obtain proper legal advice about your duties. Failure to do so may result in personal financial liability for any losses. Revised: 1/1/2011 Page 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Case No.______________________________ WARNING: FAILURE TO OBEY THE ORDERS OF THIS COURT AND THE STATUTORY PROVISIONS RELATING TO CONSERVATORS, MAY RESULT IN YOUR REMOVAL FROM OFFICE AND OTHER PENALTIES. IN SOME CIRCUMSTANCES, YOU MAY BE HELD IN CONTEMPT OF COURT, AND YOUR CONTEMPT MAY BE PUNISHED BY CONFINEMENT IN JAIL, FINE, OR BOTH. DATED this day of , 20 ____ Judge/Commissioner ACKNOWLEDGEMENT I, the undersigned acknowledge receiving a copy of this order and agree to be bound by its provisions, whether or not I read it before signing, as long as I am conservator. ______________________________________ ______________________ Signature of Conservator Revised: 1/1/2011 Date Page 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com