CONFIDENTIAL--FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: GC-011 (Do not file or lodge in case file) CERTIFYING ATTORNEY (Name): State Bar No.: ANNUAL CERTIFICATION OF COURT-APPOINTED ATTORNEY NOTICE TO ATTORNEYS APPOINTED BY THE COURT IN PROBATE CONSERVATORSHIPS OR GUARDIANSHIPS 1. Beginning in 2008, you must complete three hours of continuing education each calendar year that qualifies for Minimum Continuing Legal Education (MCLE) credit for California State Bar­certified specialists in estate planning, trust, and probate law. (See Cal. Rules of Court, rule 7.1101(f).) 2. Beginning in 2009, you must certify to the court before the end of March of each year that (1) you completed the required continuing education during the previous calendar year, and (2) your State Bar disciplinary history and professional liability insurance or self-insurance coverage either have or have not changed since your qualification certification or last annual certification was filed. You must also describe any changes in your disciplinary history and insurance or self-insurance coverage. (See rule 7.1101(h)(4) and (5).) I certify as follows (check all boxes that apply): 1. a. b. 2. a. I have had no State Bar discipline imposed since the date of my qualification certification or my last annual certification. I have had State Bar discipline imposed since the date of my qualification certification or my last annual certification. The circumstances are described in Attachment 1b. My professional liability insurance coverage (rule 7.1101(b)(3)), adequacy of self-insurance (rule 7.1101(e)(2)), or self-insurance program coverage (rule 7.1101(c)(2)) has not changed since the date of my qualification certification or my last annual certification. My professional liability insurance, adequacy of self-insurance, or self-insurance program coverage has changed since the date of my qualification certification or my last continuing education certification. My current circumstances are described in Attachment 2b. as stated in my qualification certification or last annual certification. as follows: b. 3. My contact information is a. Firm or employer name: b. Address: c. Telephone number: e. E-mail address: 4. During calendar year d. Fax number: , I completed a total of (specify): hours of continuing education that qualifies for MCLE Hours credit for State Bar-certified specialists in estate planning, trust, and probate law, as follows: Provider Subject I certify that the foregoing is true and correct. Dated: Total hours: (TYPE OR PRINT NAME OF CERTIFYING ATTORNEY ) Form Adopted for Mandatory Use Judicial Council of California GC-011 [New January 1, 2009] (SIGNATURE) Page 1 of 1 Probate Code, §§ 1456, 1470, 1471; Cal. Rules of Court, rule 7.1101 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com ANNUAL CERTIFICATION OF COURT-APPOINTED ATTORNEY (Probate--Guardianships and Conservatorships)