GC-112(A-2) TEMPORARY CONSERVATORSHIP OF (Name): CONSERVATEE CASE NUMBER: DECLARATION CONTINUATION PAGE * I (name): declare as follows: Date and signature are on the last page of this declaration. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME OF DECLARANT) (SIGNATURE OF DECLARANT) * For use with form GC-112(A-1). Page Form Approved for Optional Use Judicial Council of California GC-112(A-2) [New January 1, 2009] of DECLARATION CONTINUATION PAGE (Probate--Guardianships and Conservatorships) Probate Code, § 2250; Cal. Rules of Court, rule 7.1062 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com