ATTORNEY APPLICATION FOR APPOINTMENT TO PROBATE VOLUNTEER PANEL Page 1 of 5 PRO 057 (Rev. 06/18) CONFIDENTIAL 226 FOR COURT USE ONLY LOS ANGELES SUPERIOR COURT PROBATE DEPARTMENT ATTORNEY APPLICATION FOR APPOINTMENT TO PROBATE VOLUNTEER PANEL I, , apply for appointment to the Probate (Print Name) Volunteer Panel and declare as follows: 1. State Bar Membership A. I was admitted to the California State Bar on . (Date) I am currently an active member. My Bar number is . (Initial) B. As of the date of this Application, I have no disciplinary proceedings pending with the California State Bar, and I have had no discipline imposed on me within the 12-month period immediately preceding that date. (Initial) Check one: I have previously been subject to State Bar disciplinary proceedings. I have not ever been subject to any State Bar disciplinary proceedings. (Initial) If applicable, please explain any prior State Bar disciplinary proceedings in a separate attachment. C. If, at any time that I am a member of this panel and my status as a member of the State Bar changes, I agree to notify the Court, in writing, within 10 days of that change. (Initial) 2. Professional Liability Insurance A. I carry professional liability insurance with policy limits consistent with the values of the matters to be handled, at a minimum amount of $100,000 per claim and $300,000 per year. (Initial) B. If, at any time that I am a member of this panel, I am no longer covered by professional liability insurance in the amounts specified above, I agree to notify the Court, in writing, within 10 days of that change. (Initial) 3. California Rules of Court A. Requirements for appointment as counsel in conservatorship cases: I am qualified to accept appointments by the Court to represent conservatees or American LegalNet, Inc. www.FormsWorkFlow.com ATTORNEY APPLICATION FOR APPOINTMENT TO PROBATE VOLUNTEER PANEL Page 2 of 5 PRO 057 (Rev. 06/18) proposed conservatees under Probate Code 247247 1470 and 1471. Pursuant to Rule 7.1101(b)(2) of the California Rules of Court, I have filed or am filing herewith mandatory Judicial Council form GC-010, Certification of Attorney Concerning Qualifications for Court Appointment in Conservatorships and Guardianships. (Initial) B. Requirements for appointment as counsel in guardianship cases: I am qualified to accept appointments by the Court to represent wards or proposed wards under Probate Code 247 1470. Pursuant to Rule 7.1101(b)(1) of the California Rules of Court, I have filed or am filing herewith mandatory Judicial Council form GC-010, Certification of Attorney Concerning Qualifications for Court Appointment in Conservatorships and Guardianships. (Initial) 4. Los Angeles Superior Court A. I have read California Rules of Court Rule 7.1101 and Los Angeles Superior Court Rules 4.123 through 4.124 regarding eligibility requirements for Probate Volunteer Panel members. (Initial) B. I comply with the educational requirements as follows: i. Check one: I have completed the mandatory PVP training program. I have NOT yet completed the mandatory PVP training program. I agree to complete the mandatory PVP training program within one year from submission of my initial application. (Initial) ii. I have completed at least 12 hours of MCLE during my State Bar reporting period in the areas of decedents222 estates, conservatorships, guardianships, or trust administration as required. (Initial) C. I request appointment to the Probate Volunteer Panel in the following area(s): Decedents222 estates and trust administration Conservatorships and guardianships of the estate * Guardianships of the person (minor222s counsel 226 custody only) * Conservatorships of the person * Limited conservatorships for developmentally disabled adults *--- Completion date of last Limited Conservatorship Program Capacity determinations and health care decisions for adults without conservators (Probate Code 247 3200) Estate planning and taxation American LegalNet, Inc. www.FormsWorkFlow.com ATTORNEY APPLICATION FOR APPOINTMENT TO PROBATE VOLUNTEER PANEL Page 3 of 5 PRO 057 (Rev. 06/18) Medi-Cal planning (Probate Code 247247 3100 and 3600) Compromises/judgments, special needs trusts, minors222 trusts (probate) Compromises/judgments, special needs trusts, minors222 trusts (civil) Tuberculosis detention proceedings Fiduciary appointments Guardian ad litem Completion date of last Guardian ad litem Program: Yes No 226 Ten (10) Years of Practice Give specific court information, type of case served as GAL; Fiduciary case name; case number; and date: LASC Probate Cases LASC Civil Cases U.S. Federal District Court Cases, Central District of California I authorize Los Angeles Superior Court to provide a copy of this application to the Federal District Court, Central District of California. (Initial) Evidence Code 247 730 experts/referees/special masters Other (specify): * Attorneys accepting appointments as counsel in conservatorship and guardianship proceedings must meet the qualifications and continuing education requirements set forth in California Rules of Court Rule 7.1101. D. I certify that I meet the requirements specified in Los Angeles Superior Court Rules, Rule 4.124, for each area of interest marked above. (Initial) E. I am willing to accept appointments in the following Los Angeles Superior Court districts: Central (Los Angeles) North (Antelope Valley) F. I understand and agree that an Annual Compliance Certification must be filed as required by Los Angeles Superior Court Rules, Rule 4.123. In addition, if my areas of interest include appointments in guardianship or conservatorship proceedings, I will submit each year the mandatory Judicial Council form GC-011, Annual Certification of Court-Appointed Attorney. (Initial) G. I am a Certified Specialist in: Estate planning, probate, and trust law American LegalNet, Inc. www.FormsWorkFlow.com ATTORNEY APPLICATION FOR APPOINTMENT TO PROBATE VOLUNTEER PANEL Page 4 of 5 PRO 057 (Rev. 06/18) Taxation Family law Other (specify): H. Approximately % of my current practice consists of estate planning, estate administration, trusts, guardianships, or conservatorships. I. Private Professional Fiduciary Representation I am or have been the attorney of record for the following private professional fiduciaries: Name: Estimate Number of Cases: (Attach additional pages if needed.) J. I have the following special skills, training, and/or experience relating to decedents222 estates, trust administration, conservatorships, or guardianships: K. I speak the following languages (other than English) and may accept appointments requiring the translation/communication skills of language(s): L. Check one: I am willing to accept appointments for ex parte and other urgent matters. I am NOT willing to accept appointments for ex parte and other urgent matters. 5. Compensation Attorney Compensation in Los Angeles Superior Court Proceedings I have reviewed and agreed to be bound by the terms of Los Angeles Superior Court General Order Re: Probate Volunteer Panel Appointments dated February 27, 2017 concerning the court222s policies of accepting (or continuing) any PVP American LegalNet, Inc. www.FormsWorkFlow.com ATTORNEY APPLICATION FOR APPOINTMENT TO PROBATE VOLUNTEER PANEL Page 5 of 5 PRO 057 (Rev. 06/18) appointments to represent proposed conservatees, conservatees, proposed wards or wards or any other individual in Los Angeles Superior Court Proceedings. (Initial) Compensation for services as fiduciaries, guardians ad litem (including appointments in U.S. Federal District Court, Central District of California), and Evidence Code 730 experts will be determined on a case-by-case basis. By accepting such appointments, I agree that, except in cases involving unusual problems requiring extraordinary expertise, the hourly rates shall not exceed $250.00. (Initial) 6. Conflicts I understand that I may not represent any other party in cases in which I have been appointed as counsel or in cases that are related to cases in which I was appointed as counsel (for example, representation of an executor after the death of a conservatee whom I was appointed to represent).