ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, address and telephone #): FOR COURT USE ONLY STATE BAR NO: ATTORNEY FOR (Name): IN PRO PER YES NO MARIN COUNTY SUPERIOR COURT 3501 Civic Center Drive P.O. Box 4988 San Rafael, CA 94913-4988 CONSERVATORSHIP OF (NAME): CASE NUMBER: APPLICATION FOR ORDER TRANSFERRING VENUE PR HEARING DATE: TIME: COURTROOM: _______________________________________________, in pro per, hereby submits the within request for a transfer of the above-referenced matter from Marin County to County where the conservatee is located. The conservatee has resided in County for __________ years and it is likely that the place of residence will remain unchanged for the reasonably foreseeable future. The conservatee's estate is valued at $ _______________________ and includes monthly income of $ _______________________. Accountings to the court are not required because this is a conservatorship of the person only (or have been waived by the court pursuant to an order filed _______________________.) The conservatee does not own real property. In addition to the fact that the conservatee resides in __________________________ County and there is no plan to change the residence, it is in the conservatee's best interest to have this matter transferred from Marin County to __________________________ County due to the expense and delay of reviews by the Court Investigators' Office. There appear to be no matters requiring the court's immediate attention in this matter. The address of the conservatee is _______________________________________________. The name and address of the conservator(s) is _______________________________________________. The conservatee is not represented by legal counsel in this matter. The names and addresses of the spouse and relatives within the second degree are as follows: A. Spouse: B. Parents: PR030 (Rev. 7/13) APPLICATION FOR ORDER TRANSFERRING VENUE Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com C. Children: D. Siblings: WHEREFORE, the Petitioners, _____________________________________________________________, request that this matter be transferred to the county of residence of the conservatee. I certify under penalty of perjury that the foregoing is true and correct to the best of my knowledge. Dated: ___________________ at ________________________, California. PRINT NAME SIGNATURE PRINT NAME SIGNATURE PR030 (Rev. 7/13) APPLICATION FOR ORDER TRANSFERRING VENUE Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com