District Court Denver Probate Court _________________________________ County, Colorado Court Address: __________________________________ In the Interests of: __________________________________ Minor Attorney or Party Without Attorney (Name and Address): COURT USE ONLY Case Number: __________________ ____________________________________________ ____________________________________________ Phone Number:______________ E-mail:___________________ FAX Number:________________ Atty. Reg. #:_______________ Division ________Courtroom_______ AFFIDAVIT OF ACCEPTANCE OF APPOINTMENT BY WRITTEN INSTRUMENT AS GUARDIAN FOR MINOR PURSUANT TO §15-14-202, C.R.S. I, ______________________________________ (name of Guardian), accept the appointment of Guardian for the above named unmarried Minor who is _____ years of age and born on _______________________ (date). 1. Information about the Appointed Guardian: Name: _________________________________________ Relationship to Minor: _____________________ Address: _______________________________________________________________________________ City: ____________________ State: _____ Zip Code: _________ Home Phone #: ____________________ Email Address: _______________________________Work Phone #: ______________________________ 2. The appointment was made by ‰Will or ‰other signed writing by ___________________________(the Minor’s parent) on ___________________ (date): Appointment by Will: Certified copy of will is attached. or ‰ Filed in this Court on ______________________ (date) in the following case number: ___________________________. or ‰ Filed in _________________________ (County) in ____________________ (State) in the following case number: ______________________. Appointment by other signed writing: Original signed writing is attached and is signed by the parent or guardian with at least two witnesses and all signatures must be notarized. 3. The parents of the Minor are ____________________________ and _____________________________. ‰ ‰ both parents are deceased. ______________________________ (name) was the last parent to die and at that time was a resident of ______________________________________ (name of County/State). ‰ JDF 821 ______________________________ (name) is deceased and _________________________ (name) survives, but has been adjudicated incapacitated and order is attached. 9/08 AFFIDAVIT OF ACCEPTANCE OF APPOINTMENT BY WRITTEN INSTRUMENT AS GUARDIAN FOR MINOR Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com ‰ both parents are alive and have been adjudicated incapacitated. Attach orders adjudicating incapacity. 4. No other Guardian for the Minor has been appointed. 5. I submit personally to the jurisdiction of this Court in any proceeding relating to this guardianship that may be instituted by any interested person. Notice of any such proceeding may be mailed to me by ordinary mail at my address stated above, or at such other address as I may later report to the Court. VERIFICATION AND ACKNOWLEDGMENT I swear/affirm under oath that I have read the foregoing Affidavit and that the statements set forth therein are true and correct to the best of my knowledge. Date: _________________________________ ______________________________________ Signature of Guardian Subscribed and affirmed, or sworn to before me in the County of ______________________, State of ___________________, this ___________ day of _______________, 20 ______. My Commission Expires: ____________________ ______________________________________ Notary Public/Deputy Clerk Certificate of Service I certify that on _________________ (date) a copy of this Affidavit was served on each of the following: Name of Person You are Sending this Document To (Interested Persons) Relationship to Minor Address Manner of Service* *Insert hand delivery, first class U.S. Mail, certified U.S. Mail, E-filed, or Fax. Date: ________________________________ ______________________________________ Signature of Person Certifying Service Note: Š Š Š Notice of this Affidavit of Acceptance of Appointment must be given to the appointing parent or Guardian, if living, the Minor, if he/she is 12 years of age or older, and a person other than the parent or Guardian having care and custody of the Minor. Any person receiving this Affidavit may cause this appointment to terminate by filing a written objection to this appointment within 30 days after receipt of the Affidavit. However, filing of an objection will not preclude the appointment of this or another suitable guardian by the Court in a proper proceeding. The minor, if 12 years of age or older, can consent or refuse to consent to the appointment of the Guardian within 30 days after receipt of the Affidavit. The Verified Consent of Minor (JDF 826) must be filed with the Court. JDF 821 9/08 AFFIDAVIT OF ACCEPTANCE OF APPOINTMENT BY WRITTEN INSTRUMENT AS GUARDIAN FOR MINOR Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com