District Court Denver Probate Court __________________________________ County, Colorado Court Address: ____________________________________________________ In the Interests of: ___________________________________________ Ward/Protected Person Attorney or Party Without Attorney (Name and Address): ___________________________________________ ___________________________________________ Phone Number:_______________E-mail:______________________ FAX Number:_________________Atty. Reg. #:__________________ COURT USE ONLY Case Number:___________________ Division ___________Courtroom_______ PETITION REQUESTING COLORADO TO ACCEPT GUARDIANSHIP CONSERVATORSHIP FROM SENDING STATE PURSUANT TO §15-14.5-302, C.R.S. The Petitioner hereby submits certified copies of any documents evidencing authority to act (Order of Appointment, Letters) and the Provisional Order of Transfer from the sending state relating to a Guardianship Conservatorship, as identified below: Sending State: _______________________Sending Court: ________________________________________ Sending Court Case #: ___________________ 1. Information about the Guardian and/or Conservator: Name: _________________________________________ Address: _______________________________________________________________________________ City: ____________________ State: _____ Zip Code: _________ Home Phone #: ____________________ Email Address: _______________________________Work Phone #: ______________________________ 2. Information about the Ward/Protected Person: Name: ____________________________________ Current age: _____ Date of Birth: __________________ Address (Include name of facility): ___________________________________________________________ _______________________________________________________________________________________ City: ____________________ State: ___ Zip Code: ________ Telephone Number: ____________________ Type of Residence: Private Nursing Home Assisted Living Home Other: ____________________ 3. The Guardian and/or Conservator shall provide the Ward/Protected Person, Ward/Protected Person’s spouse, parents, adult children or an adult relative, person who had primary care and control of the Ward/Protected Person, and/or their property, any legal representatives and any interested person with notice of this Petition and JDF 712 – Notice of Non-Appearance Hearing. JDF 783 9/08 PETITION REQUESTING COLORADO TO ACCEPT GUARDIANSHIP/CONSERVATORSHIP Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com 4. The interested persons receiving notice are as follows: Name of Interested Person Requiring Notice in Sending State Relationship to Ward/Protected Person Name of Interested Person Requiring Notice in Colorado, not listed above Relationship to Ward/Protected Person Date: _________________________ ____________________________________________ Signature of Guardian and/or Conservator CERTIFICATE OF SERVICE I certify that on ________________________ (date) a copy of this Petition Requesting Colorado to Accept Guardianship/ Conservatorship from Sending State was served on each of the following: Name Relationship to Ward/Protected Person *Insert one of the following: Address Manner of Service* Hand Delivery, First-Class Mail, Certified Mail, E-Served or Faxed. ______________________________________ Signature Note: ‹ ‹ ‹ It is the responsibility of the Guardian and/or Conservator to file the Provisional Order to Accept Transfer issued by the Colorado Court and to file the appropriate documents to terminate the guardianship and/or conservatorship with the sending state to obtain a Final Order Confirming the Transfer to Colorado. Once the Colorado Court receives a Final Order Confirming the Transfer to Colorado and a completed Acceptance of Office (JDF 805), the Colorado Court may issue a Final Order Accepting Transfer. Any interested person may request an evidentiary hearing or the Court may require one. JDF 783 9/08 PETITION REQUESTING COLORADO TO ACCEPT GUARDIANSHIP/CONSERVATORSHIP Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com