CONFIDENTIAL ATTORNEY FOR PETITIONER/ PETITIONER (Name, State Bar Number, (FOR COURT USE ONLY) and Address) Telephone No.: Fax No.: Proposed General Limited PERSON ESTATE OF: CASE NUMBER: SPRHEARING DATE: CONSERVATORSHIP OF THE: (CONSERVATEE) CONFIDENTIAL CONTACT INFORMATION FOR USE BY COURT INVESTIGATORS IN ACCORDANCE WITH PROBATE CODE §§ 2250.6(a)(1); 1826(a) and (l), 1850 and 1851(a) and (b) TYPE OF PETITION OR REVIEW: Petition for Appointment of Temporary Conservator Petition for Appointment of Conservator Petition for Appointment of Successor Conservator(s) Petition for Appointment of Co-Conservator(s) Account and Review General Instructions This form (completed) must accompany all petitions for appointment of probate conservators, successor conservators, or co-conservators (Limited or General, Temporary or Permanent). All references to conservatee or conservator in this form include proposed conservatee(s) and conservator(s). Additionally, this form (completed) must accompany all accountings filed by conservators of an estate. Attachments should be added as necessary to provide complete information. Additionally, the Court must be notified immediately if the address of the conservator or conservatee changes. The new addresses should be reported on Sonoma Superior Court Form PR-3. The PR-3 is to be used for the conservator and for each accounting. Form GC-079, or GC-080 must be used for the conservatee when a change in placement occurs. Form Adopted for Mandatory Use Local Rule 6.4.B.4 CONFIDENTIAL PR- 12 [Rev. March 11, 2011] American LegalNet, Inc. www.FormsWorkFlow.com CONFIDENTIAL 1. Conservatee Contact Information: Residential Address: Mailing Address: Telephone Number: SPECIAL PROBLEMS RELATED TO INTERVIEWING THE CONSERVATEE: (For instance: language other than English, personal safety concerns, lack of ability to communicate) 2. Conservator Contact Information: Name of Conservator: Mailing Address: Telephone Numbers: (Home) Relationship to Conservatee: 3. Petitioner Contact Information: Same as Conservator (continue to part 4) Name of Petitioner: Mailing Address: Telephone Numbers: (Home) Relationship to Conservatee: (Work) (Mobile) Listed below: (Work) (Mobile) 4. Living Spouse or Registered Domestic Partner No Spouse or Registered Domestic Partner (continue to part 5) Spouse Registered Domestic Partner Name: Mailing Address: Telephone Numbers: (Home) Form Adopted for Mandatory Use (Work) (Mobile) Local Rule 6.4.B.4 CONFIDENTIAL PR- 12 [Rev. March 11, 2011] American LegalNet, Inc. www.FormsWorkFlow.com CONFIDENTIAL 5. Living Relatives Within the First Degree (Children and Parents of Conservatee): For each person list name, mailing address, telephone numbers (home, cell, work) and the relationship to the conservatee. None Listed on Attachment 5. 6. Living Relatives Within the Second Degree (Grandchildren, Grandparents, Sisters and Brothers of Conservatee): For each person list name, mailing address, telephone numbers (home, cell, work) and the relationship to the conservatee. None Listed on Attachment 6. 7. Living Relatives Described by Probate Code § 1821(b): For each person list name, mailing address, telephone numbers (home, cell, work) and the relationship to the conservatee. None Not applicable. Listed on Attachment 7. 8. Neighbors of Conservatee: For each person list name, mailing address, telephone numbers (home, cell, work) and the relationship to the conservatee. None Listed on Attachment 8. 9. Friends of Conservatee: For each person list name, mailing address, telephone numbers (home, cell, work) and the relationship to the conservatee. None Listed on Attachment 9. Form Adopted for Mandatory Use Local Rule 6.4.B.4 CONFIDENTIAL PR- 12 [Rev. March 11, 2011] American LegalNet, Inc. www.FormsWorkFlow.com CONFIDENTIAL Attachment 5 Living Relatives Within the First Degree (Adult Children and Parents of Conservatee): For each person list name, mailing address, telephone numbers (home, cell, work) and the relationship to the conservatee. Form Adopted for Mandatory Use Local Rule 6.4.B.4 CONFIDENTIAL PR- 12 [Rev. March 11, 2011] American LegalNet, Inc. www.FormsWorkFlow.com CONFIDENTIAL Attachment 6 Living Relatives Within the Second Degree (Adult Grandchildren, Grandparents, Sisters and Brothers of Conservatee): For each person list name, mailing address, telephone numbers (home, cell, work) and the relationship to the conservatee. Form Adopted for Mandatory Use Local Rule 6.4.B.4 CONFIDENTIAL PR- 12 [Rev. March 11, 2011] American LegalNet, Inc. www.FormsWorkFlow.com CONFIDENTIAL Attachment 7 Living Relatives Described by Probate Code § 1821(b): If no spouse or domestic partner of the (proposed) conservatee or relatives within the second degree are known to the petitioner, the following shall all be deemed to be relatives: a spouse or domestic partner of a predeceased parent of the conservatee; the children of a predeceased spouse or domestic partner of the proposed conservatee; the siblings of the conservatee's parents (the conservatee's aunts and uncles), if any (If none, then the natural and adoptive children of the conservatee's parents' siblings - the conservatee's first cousins); and the natural and adoptive children of the proposed conservatee's siblings. For each person list name, mailing address, telephone numbers (home, cell, work) and the relationship to the conservatee. Form Adopted for Mandatory Use Local Rule 6.4.B.4 CONFIDENTIAL PR- 12 [Rev. March 11, 2011] American LegalNet, Inc. www.FormsWorkFlow.com CONFIDENTIAL Attachment 8 Neighbors of Conservatee: For each person list name, mailing address, telephone numbers (home, cell, work) and the relationship to the conservatee. Form Adopted for Mandatory Use Local Rule 6.4.B.4 CONFIDENTIAL PR- 12 [Rev. March 11, 2011] American LegalNet, Inc. www.FormsWorkFlow.com CONFIDENTIAL Attachment 9 Friends of Conservatee: For each person list name, mailing address, telephone numbers (home, cell, work) and the relationship to the conservatee. Form Adopted for Mandatory Use Local Rule 6.4.B.4 CONFIDENTIAL PR- 12 [Rev. March 11, 2011] American LegalNet, Inc. www.FormsWorkFlow.com