‰District Court ‰Denver Probate Court _________________________________ County, Colorado Court Address: In the Interests of: COURT USE ONLY Case Number: Protected Person/Minor Division: Courtroom: ORDER APPOINTING SPECIAL CONSERVATOR ‰PROTECTED PERSON ‰MINOR Upon consideration of the Petition for Appointment of Conservator for the above Protected Person/Minor and hearing on ________________________ (date), The Court finds: 1. Venue is proper and that the required notices have been given or waived 2. An interested person seeks appointment. 3. The Protected Person’s/Minor’s best interest will be served by the appointment of a Special Conservator. The Court finds by clear and convincing evidence that: ‰ It is necessary to appoint a Special Conservator for the Minor as may be required for the support of the Minor or individuals who are in fact dependent upon the Minor pursuant to §15-14-405(2), C.R.S., until a hearing can be held on the Petition for the following reasons: _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ ‰ It is necessary to appoint a Special Conservator to preserve and apply the property of the Respondent/Protected Person as may be required for the support of the Respondent/Protected Person or individuals who are in fact dependent upon the Respondent/Protected Person pursuant to §15-14-406(7), C.R.S., until a hearing can be held on the Petition for the following reasons: _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ ‰ It is necessary to appoint a Special Conservator to assist in the accomplishment of the following protective arrangement or other authorized single transaction pursuant to §15-14-412(3), C.R.S. _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ JDF 877 6/08 ORDER APPOINTING SPECIAL CONSERVATOR - MINOR OR ADULT Page 1 of 3 American LegalNet, Inc. www.FormsWorkflow.com The Court appoints the following person as Special Conservator of the Protected Person/Minor: Name: ___________________________________________________________________________________ Address: _________________________________________________________________________________ City: ____________________ State: ___ Zip Code: ________ Email Address: __________________________ Home Phone #: ______________________________ Work Phone #: _________________________________ The Court directs the issuance of Letters of Conservatorship as follows: The Letters shall expire on ______________________ (date), unless otherwise ordered by the Court. The Special Conservator is only authorized to assist with the following: _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ The Court orders the following: 1. The Special Conservator shall notify the Court within 30 days if his/her home address, email address, or phone number changes and/or any change of address for the Protected Person/Minor. 2. The appointment of a Special Conservator is not a determination of incapacity of the Protected Person/Minor. 3. ‰This appointment is pursuant to §15-14-412(3), C.R.S., for single transactions and protective arrangements. The Special Conservator shall report to the Court by _______________________ (date). The report shall include the following information: ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ 4. ‰The Special Conservator shall serve without bond, as bond is not required pursuant to §15-14-415, C.R.S., for the following reason(s). ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ JDF 877 6/08 ORDER APPOINTING SPECIAL CONSERVATOR - MINOR OR ADULT Page 2 of 3 American LegalNet, Inc. www.FormsWorkflow.com 5. ‰The Special Conservator shall serve with bond in the amount of $ _______________ pursuant to §1514-415, C.R.S. The bond must be posted with the Court by ______________________ (date). If bond is posted by a surety, notice of any proceeding must be provided to the surety. 6. Copies of all future filings with the Court shall be provided to the following identified as interested persons in this matter, by the one filing such documents. Relationship to Protected Person/Minor Name of Interested Person Protected Person/Minor Spouse Adult Children Parents Special Conservator 7. The Special Conservator shall provide a copy of this Order Appointing Special Conservator to the Protected Person/Minor, if 12 years of age or older, and interested persons within 30 days of appointment. 8. The Court further orders: __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Date: __________________________ ______________________________________ ‰Judge ‰Magistrate Notice to Interested Persons You have the right to request termination or modification of the special conservatorship pursuant to §15-14409(3), C.R.S. JDF 877 6/08 ORDER APPOINTING SPECIAL CONSERVATOR - MINOR OR ADULT Page 3 of 3 American LegalNet, Inc. www.FormsWorkflow.com