SDSC PR-096 (Rev. 9/15) FEE DECLARATION: CONSERVATOR Page 1 of 3 Person - Estate ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO.: FAX NO. (Optional): EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): FOR COURT USE ONLY 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 CONSERVATORSHIP OF FEE DECLARATION: CONSERVATOR Person Estate CASE NUMBER Instructions: A fee declaration is required when fees are requested by a Conservator of the Person and/or Estate. The declaration must be filled out completely and attachments should be used where additional space is needed. This form should not be used for Guardianships, Decedent222s Estates or Trust matters.a. Conservatee: b. Conservator: c. Conservator222s relationship to conservatee: Registered Private Professional Conservator Family Member/Relative Other: d. If filing as a Private Professional Conservator, state your years of experience: e. Description of your experience, specialized training, and education that contributes to your expertise as a fiduciary: Continued on Attachment 1e. f. Reporting period for this fee request: g. Number of months in this reporting period: 2. CONSERVATOR OF THE PERSON Own home or apartment Retirement facility Assisted living facility Board and care Skilled nursing facility Other: b. Ambulation Transferring (bed to chair) Personal hygiene Dressing Feeding American LegalNet, Inc. www.FormsWorkFlow.com IN THE CONSERVATORSHIP OF CASE NUMBER SDSC PR-096 (Rev. 9/15) FEE DECLARATION: CONSERVATOR Page 2 of 3 Optional Form Person 226 Estate c. With respect to services provided during the accounting period for which the conservator of the person is requesting compensation, complete the following table: Category Nature of Services & Results Achieved Level of Difficulty (High, Medium, Low) Total Hours Hourly Rate Total Fee Communication with Legal Counsel Comm unication with Family/Friends Arrangements for Living Situation / Residency (Including meals, clothing, personal care, housekeeping, and recreation) Health Care Transportation Recreation Other Totals d. Previous Reporting Period: Current Reporting Period: 1. Fees for services approved and paid: 1. Fees for services: 2. Hours for services approved and paid: 2. Hours for services: 3. Average monthly fee for services: 3. Average monthly fee for services: Total fees: Total fees: Total hours: Total hours: e. If, during the accounting period, a person or company assisted in monitoring the care of the conservatee, complete the following: Name of Hired Agent (s) Function (s) Continued on Attachment 2e. 3. CONSERVATOR OF THE ESTATE This section must be completed if you are seeking compensation as conservator of the estate. a. With respect to services provided during the accounting period for which the conservator of the estate is requesting compensation, complete the following table: Category Nature of Services & Results Achieved Level of Difficulty (High, Medium, Low) Total Hours Hourly Rate Total Fee Estate Administration (collecting income, paying bills, reconciling bank statements, etc.) C ommunication with Legal Counsel Asset Management Preparation of Court Accounting Preparation of Fee Declaration American LegalNet, Inc. www.FormsWorkFlow.com IN THE CONSERVATORSHIP OF CASE NUMBER SDSC PR-096 (Rev. 9/15) FEE DECLARATION: CONSERVATOR Page 3 of 3 Optional Form Person 226 Estate Category Nature of Services & Results Achieved Level of Difficulty (High, Medium, Low) Total Hours Hourly Rate Total Fee Income Tax Return Co mpilation Management of Caregivers Health Care Issues Marshalling Assets Termination of Proceedings Participation in Appointment Proceeding Sale of Assets Income Tax Return Preparation Litigation Tenanc y Issues Other Totals Total Fee Request for Conservator of Estate b. Previous Reporting Period: Current Reporting Period: 1. Fees for services approved and paid: 1. Fees for servic es: 2. Hours for services approved and paid: 2. Hours for services: 3. Average monthly fee for services: 3. Average monthly fee for services: Total fees: Total fees: Total hours: Total hours: c. If, during the accounting period, a person or company performed routine accounting services other than income tax preparation and was compensated by the estate, complete the following: Name of Hired Agent (s) Function (s) Continued on Attachment 3c. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Type or Print Name of Conservator Signature of Conservator American LegalNet, Inc. www.FormsWorkFlow.com