CONFIDENTIAL (DO NOT ATTACH TO PETITION) CONSERVATORSHIP OF (Name): (Proposed) CASE NUMBER: CONSERVATEE'S INFORMATION & LIST OF RELATIVES/FRIENDS (Attach to Form PR-1) Please list spouse or registered domestic partner, conservatee's 1st degree relatives (parents and children) and 2nd degree relatives (brothers, sisters, grandparents & grandchildren). If there is a close friend or neighbor who is involved, please list. Name: Address: Home Phone No: Email: Name: Address: Home Phone No: Email: Name: Address: Home Phone No: Email: Name: Address: Home Phone No: Email: Name: Address: Home Phone No: Email: PAGE: of Relationship: Zip: Work Phone No: Relationship: Zip: Work Phone No: Relationship: Zip: Work Phone No: Relationship: Zip: Work Phone No: Relationship: Zip: Work Phone No: Form Adopted for Mandatory Use Superior Court of California, County of San Mateo PR-1A [Revised and effective August 2009] CONSERVATEE'S INFORMATION AND LIST OF RELATIVES/FRIENDS ­ CONFIDENTIAL (ADDITIONAL PAGE) American LegalNet, Inc. www.FormsWorkFlow.com