NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY: ATTORNEY FOR (Name): STATE BAR NUMBER Reserved for Clerk222s File Stamp SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES COURTHOUSE ADDRESS: Estate of: APPLICATION AND ORDER APPOINTING PROBATE REFEREE LANTERMAN-PETRIS SHORT ACT CONSERVATORSHIP CASE NUMBER: I am the court-appointed conservator of the above referenced estate. I am requesting that a Probate Referee be appointed to appraise the assets held in the above referenced estate for the following reason: 1. Appointment of a Probate Referee is mandatory in this case pursuant to Probate Code section 261(d)(2). 2. Appointment of a Probate Referee is discretionary and would assist in the resolution of this case for the reason(s) stated in the attached declaration. Dated: Signature of Applicant Absent an addendum attached to this document petitioning the court to appoint a specific Referee and the granting of that request, the court will appoint a Referee randomly selected from the list authorized by the State Controller. 3. Petition for appointment of Probate Referee is attached. The Application to Appoint a Probate Referee is GRANTED/DENIED. The court orders the appointment of Probate Referee who is authorized by the State Controller to be appointed in Los Angeles County. Dated: Judge of the Superior Court LASC MH 047 NEW 06/19 For Mandatory Use ORDER ON APPLICATION American LegalNet, Inc. www.FormsWorkFlow.com