JDF 800 SC R 7 /1 9 ACKNOWLEDGMENT OF RESPONSIBLITIES Page 1 of 2 District Court Denver Probate Court County, Colorado Court Address: I n the Interest of: Protected Person COURT USE ONLY Case Number: Division: Courtroom: ACKNOWLEDGMENT OF RESPONSIBILITIES CONSERVATOR AND/OR GUARDIAN I, (name) , acknowledge that I was appointed as the c onservator and/or g uardian for ( ward or protected person) on (date) a nd I understand that Letters of Guardianship/Conservatorship will not be issued until this form is signed and provided to the c ourt. I agree to comply with statutory and court requirements and understand that I am responsible for preparing and filing reports a nd /or plans with the c ourt and providing copies to all i nterested p ersons as identified in the Order of Appointment . I have received the following information to review regarding my responsibilities. Conservators Viewed DVD/Video Pamphlets Attendance at mandatory training session on (date). Other: Acknowledgment of Re sponsibilities : 1. I am responsible for promptly providing the court with any changes to my mailing address, email address, and telephone number by filing a Notice of Change Regarding Contact Information (JDF 725) . 2. I am responsible for maintaining supporting documentation for all receipts into the accounts and all disbursements out of the accounts under my control during the duration of my appointment . Supporting documentation includes bank statements and check copies , credit card statements and receipts, sales receipts, and other such forms of proof that support my r eports . I understand that the c ourt or any i nterested p erson s may request copies at any time. 3. If funds must be placed in a restricted account, I understand that any withdrawals require a court order. The A cknowledgment of D eposit of Funds to Restricted Account ( JDF 86 7) must be return ed to the c ourt as documentation that the funds were deposited , within 45 days or by (date). All requests for withdrawal must be in writing by submitting a Motion to Withdraw Funds ( JDF 86 8) . 4. I understand that the following reports and/o r plans are due on (date). Initial Guardian Report /Care Plan - Adult (JDF 850) Financial Plan with Inventory and Motion for Approval ( JDF 88 2 ) 5. I understand that the following reports are due on (date) and every year there after on s uch day and month , unless I am notified by the c o urt : - Minor (JDF 834) Guardian Report - Adult ( JDF 850 ) JDF 8 85 ) 6. I understand that as a court - appointed guardian and/or conservator, I am required by law to report any known or suspected abuse, neglect , or exploitation of an y at - risk elder (a person 70 years of age or older) to law enforcement. I understand that criminal penalties may result from failure to comply with this law. Please refer to 247 18 - 6.5 - 108, C.R.S. for additional information. American LegalNet, Inc. www.FormsWorkFlow.com JDF 800 SC R 7 /1 9 ACKNOWLEDGMENT OF RESPONSIBLITIES Page 2 of 2 7. I understand that all reports must be filed on the most current version of the form and that the forms are available on the state court website: http://www.courts. state.co.us By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form. My signature below indicates that I have read and understand m y responsibilities as a newly appoint ed g uardian and/or c onservator. VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Execut ed on the day of Executed on the day of (date) (date) , , , , (month) (year) (month) (year) at at (city or other location, and state OR country) (city or other location, and state OR country) (printed name) (printed name) (Signature of Guardian/Conservator/Successor) (Signature of Co - Guardian/Co - Conservator/Successor, if any) American LegalNet, Inc. www.FormsWorkFlow.com