SUPERIOR COURT OF CALIFORNIA COUNTY OF YUBA 215 FIFTH STREET, SUITE 200 MARYSVILLE CA 95901 (530) 749-7600 CONFIDENTIAL CLETS/CJIS INFORMATION SHEET [Conservatorship] In the Matter of the Conservatorship of: Case Number: ALL PROPOSED CONSERVATORS MUST COMPLETE THIS INFORMATION SHEET, WHICH MUST BE RETURNED TO THE COURT WITH THE PETITION. LETTERS WILL NOT BE ISSUED UNTIL THIS FORM IS PROVIDED TO THE COURT. Name: Last Address: Street Address Date of Birth: Driver's License No: SSN: State of Issuance: City State Zip Code First Middle Yuba County Superior Court 6/11/07 _________________________________________________________________________________________________ G04050C CONFIDENTIAL CLETS/CJIS INFORMATION SHEET [Conservatorship] American LegalNet, Inc. www.FormsWorkflow.com