ATTORNEY (Name, address and telephone #): FOR COURT USE ONLY STATE BAR NO: MARIN COUNTY SUPERIOR COURT 3501 Civic Center Drive P.O. Box 4988 San Rafael, CA 94913-4988 GUARDIANSHIP FOR: CONSERVATORSHIP TRUST CASE NUMBER: ATTORNEY FEE DECLARATION I, _______________________________________________, declare as follows: 1. I am the attorney for _______________________________________ . I have personal knowledge of the facts set forth in this declaration, and offer it in support of my request for payment of $_____________ to me as fees for services that I have provided (including time spent by associates and assistants). This request is for the period beginning ________________ and ending ________________. I am also requesting approval of reimbursement for out-of-pocket expenses in the amount of $______________, of which $______________ has already been reimbursed. Rates for Services Charged. Declarant's normal billing rate is $__________ /hour. Declarant has staff that assists with services related to declarant's representation of a fiduciary. Staff time is billed at $__________ /hour. Services provided by staff included: . 3. Summary of Time Categories / Fees. This declaration describes services provided by declarant (and any assistants). A total of _________ hours of services were provided, broken down as follows: Total Hours a. Declarant: b. Declarant's associate: c. Declarant's assistant: Hrs Hrs Hrs $ $ $ Hourly Rate $ $ $ Total Fees 2. TOTAL FEES: $ 4. Summary of Services Provided. The services for which I am now seeking compensation are summarized as follows (provide attachment, if needed): a. Initial petition: b. Temporary petition and powers: c. General administration (e.g., marshaling assets, preparation of the I&A, preparation of General Plan and required Judicial Council forms, general advice, investment decisions, accounting, fee declaration): PR035 (Rev. 1/1/14) ATTORNEY FEE DECLARATION Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com GUARDIANSHIP FOR: CONSERVATORSHIP TRUST CASE NUMBER: d. Sale of residence: e. Sale of real or personal property: f. Management of real property or business: g. Contested or complex issues: h. Substituted judgment / petition for instructions: i. Accounting and fee petition: 5. If a paralegal is used, give facts to show compliance with Probate Code section 2642(a) and California Rule of Court 7.754: 6. Reimbursement of Out-of-Pocket Expenses: 7. Conclusion/Further Explanation or Justification: I declare under penalty of perjury that the foregoing is true and correct and that this declaration was executed on _____________________ in _______________________________, California. DATE ATTORNEY'S SIGNATURE PR035 (Rev. 1/1/14) ATTORNEY FEE DECLARATION Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com