JDF 853SC R6/19 NOTICE OF DEATH Page 1 of 2 District Court Denver Probate Court County, Colorado Court Address: In the Interest of: Ward/ Protected Person COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail: FAX Number: Atty. Reg.#: Case Number: Division Courtroom NOTICE OF DEATH This notice is submitted pursuant to 24724715-14-314(2)(g), C.R.S. and/or 15-14-431(1), C.R.S. 1. (name), who died on (date) was the subject of a Guardianship and/or Conservatorship. 2. The guardian222s authority to act on behalf of the ward has terminated. The conservator222s authority to act on behalf of the protected person is limited and the conservator will conclude administration of the conservatorship estate pursuant to 24724715-14-428 and 15-14-431, C.R.S. 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. VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the day of , , (date) (month) (year) at (city or other location, and state OR country) (printed name) (signature) CERTIFICATE OF SERVICE I certify that on (date), a copy of this (name of document) was served as follows on each of the following: Name and Address Relationship to Decedent, Ward, or Protected Person Manner of Service* American LegalNet, Inc. www.FormsWorkFlow.com JDF 853SC R6/19 NOTICE OF DEATH Page 2 of 2 *Insert one of the following: hand delivery, first-class mail, certified mail, e-service, or fax. Signature American LegalNet, Inc. www.FormsWorkFlow.com