CITATION FOR LPS CONSERVATORSHIP LASC MH 037 NEW 01/19 For Mandatory Use Page 1 of 2 THE PEOPLE OF THE STATE OF CALIFORNIA, 1.TO: (name):2.You are hereby cited and required to appear at a hearing in this court on b.Address of court: (specify): 3.At this hearing the Public Guardian, according to their verified petition on file, will seek to haveyou found to be gravely disabled and to have the Public Guardian, or some other suitableperson, appointed Conservator of your person and estate. 223Gravely disabled224 means: acondition in which a person, as a result of a mental disorder, is unable to provide for their basicpersonal needs for food, clothing, or shelter. Grave disability must be proven beyond areasonable doubt.4.The Conservator must arrange for your care, food, clothing, and shelter. The Conservator mustinvestigate whether it is possible for you to return home or to the home of family or friends.5.The Conservator may detain you in a locked facility.6.The appointment of a Conservator over your person and estate may limit or prohibit your abilityto enter into contracts, to manage and control your property, to vote, to possess a driver222slicense or firearm, and to consent to or refuse medical treatment.7.You have the right to appear at the hearing and oppose the petition; you also have the right tobe represented by legal counsel who will be appointed by the Court if you are unable to retainan attorney.8.You have the right to demand a jury trial. Date: Clerk, by , Deputy (Seal) ATTORNEY OR PARTY WITHOUT ATTORNEY ( Name, Sate Bar number, and address): TELEPHONE NO.: FAX NO. (Optional) E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CONSERVATORHSIP OF THE PERSON ESTATE OF (name): PROPOSED CONSERVATEE CITATION FOR LPS CONSERVATORSHIP CASE NUMBER : a. Date: Time: Dept.: Room: Assisted listening systems, computer - assisted real - time caption ing, or sign language interpreter services are available upon request if at least 5 days222 notice is provided. Contact the clerk222s office for Request for Accommodations by Persons with Disabilities and Order (form MC-410). (Civil Code section 54.8.) American LegalNet, Inc. www.FormsWorkFlow.com CITATION FOR LPS CONSERVATORSHIP LASC MH 037 NEW 01/19 For Mandatory Use Page 2 of 2 PROOF OF SERVICE a. by personally delivering the copies (1) on (date):(2)at (time): At the time of service I was at least 18 years of age and not a party to this action, and I served copies of the Citationfor LPS Conservatorship and the Petition for Appointment Reappointment of Conservator.a. Person cited (name):specify name and title or relationship to the party named in item 2a): Address (specify):I served the party named in item 2by leaving the copies with or in the presence of (name, and title or relationship to person indicated in item 2b): (1) (business) a person at least 18 years of age apparently in charge at the office or usual place of business of theperson served. I informed him or her of the general nature of the papers.(2) (residence) a competent member of the household (at least 18 years of age) at the dwelling house or usualplace of abode of the person served. I informed him or her of the general nature of the papers.(3)On (date):(4)at (time):(5)a declaration of diligence is attached. (Substituted service on natural person, minor, Conservatee, or politicalcandidate.) c. by mailing the copies to the person served, addressed as shown in item 2c, by first-class mail, postage prepaid,(1)On (date):(2) from (city):(3)with two copies of the Notice and Acknowledgment of Receipt-Civil and a postage-paid return envelope addressed to me. (Attached completed Notice and Acknowledgment of Receipt-Civil (form POS-015.)) (4) to an address outside California with return receipt requested. (Attach completed return receipt.) d.other (specify other manner of service and authorizing code section): 5.a. Person serving (name, address, and telephone number): d. Business and Professions Code, 22350(b). e. Registered California process server.(1)(2)Registration no. (Specify): (3)County (specify): date):b.Fee for service: $c.not a registered California process server. 6.I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.7.I am a California sheriff or marshal and I certify that the foregoing is true and correct. Date:> (SIGNATURE OF PERSON SERVING) CONSERVATORSHIP OF THE PERSON ESTATE OF (NAME): PROPOSED CONSERATEE CASE NUMBER : American LegalNet, Inc. www.FormsWorkFlow.com