No filing fee is required. NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NUMBER FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES COURTHOUSE ADDRESS: IN THE MATTER OF: CASE NUMBER: REQUEST BY COURT-APPOINTED COUNSEL FOR AUTHORITY TO PERFORM ADDITIONAL HOURS OF SERVICE HEARING DATE: DEPT.: TIME: I, the undersigned, declare: 1. I was appointed as counsel for __________________________________ the (check one): Conservatee Ward Proposed conservatee Proposed ward by order dated __________________________________ to represent my client in connection with the follow petition(s)/matter(s): 2. As of _____________, I have spent _______ hours in representing my client regarding this (Date) Appointment. 3. I believe that the maximum number of hours authorized by General Order Re: Probate Volunteer Panel Appointments dated May 20, 2011 will be insufficient to adequately represent my client in this proceeding. I estimate that up to __________ additional hours of services will be necessary to resolve the petition(s)/issue(s) currently pending before the court. 4. Request by Court Appointed Counsel For Authority to Perform Additional Hours of Service PRO 037 02/12 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 5. The following explains why additional services are needed [include a description of services performed to date]: 6. A hearing is scheduled in this case on (Date) There is no hearing currently scheduled in this case. 7. A copy of this Request by Court Appointed Counsel for Authority to Perform Additional Hours of Services has been served by mail on all parties who have formally appeared in this matter. Proof of service by mail is attached hereto. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Dated: (Signature) 8. (Typed or Printed Name) (Address) Approved By: _________ FOR COURT USE ONLY Set for hearing on:_______________ Request by Court Appointed Counsel For Authority to Perform Additional Hours of Service PRO 0 02/12 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com