ATTACHMENT PB-4051 SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA COURT ADDRESS: CITY AND ZIP CODE: PHONE NUMBER: FAX NUMBER: BRANCH NAME: 191 North First Street San José, California 95113 (408) 882-2651 (408) 882-2693 Downtown Courthouse FOR COURT USE ONLY In the Matter of Conservatorship of the Estate of: Conservatee LPS NUMBER: ORDER RE: ACCOUNTING IT IS ORDERED, that the Conservator either execute the enclosed "Declaration of Waiver of Accounting," if all three of the value and the income criteria are met, or complete and execute the enclosed "Final Accounting" (and accompanying schedules) for the period of the one-year Conservatorship, and to file the executed document(s) with the Probate Clerk. Failure to do so on or before , will result in an Order to Show Cause in this matter being issued requiring you to personally appear before the Court to show cause why you should not be held in contempt for failure to file such accounting, which may result in the Court ordering punishment pursuant to Probate Code sections 11050 ­ 11052. Date: Judicial Officer PB-4051 REV 07/01/12 ORDER RE: ACCOUNTING Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com