SDSC PR-149 (Rev. 9/15) ANNUAL DECLARATION RE WAIVER OF ACCOUNTINGS Prob. Code 247 2628 Mandatory Form SDSC Local Rule 4.15.11 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO.: FAX NO. (Optional): EMAIL ADDRESS (Optional):SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 CENTRAL DIVISION, MADGE BRADLEY, 1409 4TH AVE., SAN DIEGO, CA 92101 IN THE MATTER OF DEPT ANNUAL DECLARATION RE WAIVER OF ACCOUNTINGS CASE NUMBER INSTRUCTIONS: This form is to be used when the court has previously ordered that future accountings in this proceeding are waived pursuant to Prob. Code 247(1) The estate at the beginning and end of this accounting period consisted of property, exclusive of the residence of the ward or conservatee, of a total net value of less than fifteen thousand dollars ($15,000); (2) The income of the estate for each month of this accounting period, exclusive of public benefit payments, was less than two thousand dollars ($2,000); and (3) All income of the estate during this accounting period, if not retained, was spent for the benefit of the ward or conservatee. 1. I am the duly appointed conservator guardian of the estate in this proceeding. 2. The court entered an order on in this proceeding pursuant to Prob. Code 247 2628 that I need not present an account so long as all of the conditions set forth in Prob. Code 247 2628(a) are satisfied. 3. This accounting period is from to . 4. The beginning net value of the estate for this accounting period, exclusive of the ward or conservatee222s residence, 6. All income of the estate during the accounting period, if not retained, was spent for the benefit of the ward conservatee. 7. I understand that I must file an accounting as required by Prob. Code 247Date: Signature of Attorney I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Type or print name Signature of Conservator/Guardian American LegalNet, Inc. www.FormsWorkFlow.com