ATTORNEY OR PARTY WITHOUT AN 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 SANTA CRUZ Santa Cruz Branch 701 Ocean Street, Room 110 Santa Cruz, CA 95060 CONSERVATORSHIP OF: CONSERVATEE PETITION FOR REAPPOINTMENT OF CONSERVATORSHIP OF THE PERSON AND ESTATE WELFARE & INSTITUTIONS CODE 2475361 CASE NUMBER: Form Adopted for OPT IONAL USE Superior Court of Santa Cruz County SUP CV 410 11 / 02 / 18 PETITION FOR REAPPOINTMENT OF CONSERVATOR Page 1 of 3 Welfare & Institutions Code 2475361 SUP CV 0410 PETITIONER (name) : ALLEGES THAT: 1. This Court appointed Petitioner the conservator of the person and estate of the conservatee (name) : on (date) : 2. Letters of conservatorship were issued to Petitioner on (date) : 3. Petitioner is the duly appointed, qualified, and acting conservator of the person and estate of the conservatee and has been since the date of issuance of the letters. 4. Petitioner has determined that the conservatorship is still required because the conservatee is still gravely disabled as a result of mental disorder or chronic alcoholism. 5. Petitioner's determination is supported by the written opinions of the following duly licensed physician(s) and/or clinical psychologist(s). These opinions state, in effect, that the conservatee is still gravely disabled as a result of mental impairment a nd/or chronic alcoholism. The names and addresses of the physician(s) and/or clinical psychologist(s) are: Physician Clinical Psychologist Physician Clinical Psychologist These opinions are attached as Exhibits and made a part of this petition. 6. Petitioner is unable to obtain the opinion of two physicians or licensed psychologists that the conservatee is still gravely disabled as a result of mental impairment and/or chronic alcoholism. Petitioner therefore requests that th is Court appoint two physicians or licensed clinical psychologists for this purpose, under the provisions of Welfare and Institutions code 247 5361. 7. Under the provisions of Welfare and Inst itutions code 247247 5361 and 5368, if Petitioner is not reappointed conservator, the conservatorship will automatically terminate on (date): American LegalNet, Inc. www.FormsWorkFlow.com CONSERVATORSHIP OF : CONSERVATEE CASE NUMBER : Form Adopted for OPT IONAL USE Superior Court of Santa Cruz County SUP CV 410 11 / 02 / 18 PETITION FOR REAPPOINTMENT OF CONSERVATOR Page 2 of 3 Welfare & Institutions Code 2475361 8. On reestablishment of the conservatorship, the following rights and privileges enumerated in Welfare and Institutions Code 2475357 should be denied to the conservatee: a. the privilege of possessing a lic ense to operate a motor vehicle; b. the right to enter into a contract; c. the right to vote; d. the right to enter into the following types of transactions (specify): e. the right to enter into transactions that are in excess of (specify): $ f. the right to refuse g. disability; h. the right to possess a firearm. WHEREFORE, PETITIONER REQUESTS THAT: 1. Petitioner (name): be reappointed as conservator of the person and estate of the conservatee for a succeeding on e - year period beginning (date): and ending (date): 2. This Court appoint two physicians or licensed clinical psychologists pursuant to Welfare and Institutions Code 2475361 for the purpose of determining if the conservatee is still gravely disabled. 3. Conservator shall have the same powers that are /were granted to the conservator on the previous appointment by the Court. 4. The conservatee shall be denied: a. the privilege of possessing a license to operate a motor vehicle; b. the right to enter into a contract; c. the right to vote; d. the right to enter int o the following types of transactions (specify): e. the right to enter into transactions that are in excess of (specify): $ f. g. the right to refuse routine medical treatm disability; h. the right to possess a firearm. 5. Other relief be granted that the Court considers proper. Date: ( TYPE OR PRINT NAME ) (SIGNATURE OF PETITIONER) American LegalNet, Inc. www.FormsWorkFlow.com CONSERVATORSHIP OF : CONSERVATEE CASE NUMBER : Form Adopted for OPT IONAL USE Superior Court of Santa Cruz County SUP CV 410 11 / 02 / 18 PETITION FOR REAPPOINTMENT OF CONSERVATOR Page 3 of 3 Welfare & Institutions Code 2475361 VERIFICATION I am the petitioner in this action. I have read the foregoing Petition for Reappointment of Conservator of the Person and Estate and know the contents thereof. I certify that the same is true of my own knowledge. I declare under penal ty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on (date): , at (city): , California. ( TYPE OR PRINT NAME ) (SIGNATURE OF PETITIONER) American LegalNet, Inc. www.FormsWorkFlow.com