District Court Denver Probate Court __________________________________ County, Colorado Court Address: In the Interests of: COURT USE ONLY Minor Attorney or Party Without Attorney (name and address): Case Number: Phone Number: FAX Number: Division E-mail: Atty. Reg. #: Courtroom VERIFIED PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR 1. The Petitioner is: an adult 21 years of age or older who would be adversely affected by lack of effective management of the Minor’s property and business. an adult 21 years of age or older who is interested in the estate, financial affairs, or welfare of the Minor. the Minor and is 12 years of age or older. This is a Petition for: Conservator (expires when the Minor reaches the age of 21, unless otherwise ordered by the Court.) If you are seeking a Special Conservator, select one of the two boxes below: Special Conservator (to preserve and apply the property of the Minor as may be required for the support of the Minor or individuals who are in fact dependent upon the minor), pursuant to §15-14405(2), C.R.S.) Special Conservator (to assist in the accomplishment of a protective arrangement or other authorized single transaction), pursuant to §15-14-412(3), C.R.S.) 2. Information about the Petitioner: Name: __________________________________________ Relationship to Minor: _____________________ Address: _______________________________________________________________________________ City: ____________________ State: _____ Zip Code: _________ Home Phone #: ____________________ Email Address: _______________________________Work Phone #: ______________________________ 3. Information about the Minor: Name: __________________________________________ Age: _____ Date of Birth: __________________ Address: _______________________________________________________________________________ City: ____________________ State: _____ Zip Code: _________County of Residence: _________________ 4. Information about the biological Mother and Father: Mother’s Name: __________________________________ Deceased Address: _______________________________________________________________________________ City: ____________________ State: ___ Zip Code: ________ JDF 861 4/08 VERIFIED PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR Page 1 of 4 American LegalNet, Inc. www.FormsWorkflow.com Father’s Name: __________________________________ Deceased Unknown (attach Birth Certificate) Address: _______________________________________________________________________________ City: ____________________ State: ___ Zip Code: ________ 5. Venue for this proceeding is proper in this county because the Minor resides in this county. does not reside in this state, but has property in this county. 6. A conservator is required because the Minor owns money or property that requires management or protection that cannot otherwise be provided; or has or may have business affairs that may be put at risk or prevented because of his or her age; or needs money for support and education and that protection is necessary or desirable to obtain or provide money. Petitioner is requesting to be appointed as Conservator or Special Conservator. 7. or Petitioner is requesting the following person to act as the Conservator or Special Conservator. Name: ______________________________________ Relationship to Minor: _____________________ Address: ____________________________________________________________________________ City: __________________ State: ___ Zip Code: _______ Email Address: ________________________ Home Phone #: ____________________________ Work Phone #: ______________________________ He/She has priority for appointment as Conservator/Special Conservator pursuant to §15-14-413, C.R.S. because the proposed: Conservator/Special Conservator is nominated by the Minor and the Minor is 12 years of age or older. Attach Verified Consent or Nomination by Minor (JDF 825). Conservator/Special Conservator is an interested person. (State nature of interest.) ____________________________________________________________________________________ 8. Sections a and b identify assets and the source and amount of anticipated income or receipts (public benefits, houses, real property, proceeds from insurance policy as beneficiary, proceeds from pension as beneficiary, etc.) of the minor, together with an estimate of the value, including any insurance or pension pursuant to §15-14-403(2)(g), C.R.S. a. Does the Minor have any assets, e.g. bank accounts, property? Yes No If Yes, identify: Description of Assets, e.g. Bank Accounts, Property Bank Account Balance or Estimated Value of Property $ Total $ JDF 861 4/08 VERIFIED PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR Page 2 of 4 American LegalNet, Inc. www.FormsWorkflow.com b. Does the Minor have any anticipated income, e.g. Social Security, interest? Yes No If Yes, identify: Description of Income e.g. Social Security, interest, insurance proceeds Amount Anticipated or Receipts $ Total of Income $ 9. Is any person currently acting as a Guardian or Conservator for the Minor in Colorado or elsewhere? Yes No If Yes, identify: Name: ________________________________________ Relationship to Minor: _______________________ Address: _______________________________________________________________________________ City: ____________________ State: ___ Zip Code: ________ Email Address: ________________________ Home Phone #: ______________________________ Work Phone #: _______________________________ 10. If mother and father are deceased, list adult relative, for example aunt, uncle, grandparent, that can be found: Name: __________________________________________ Relationship to Minor: ____________________ Address: _______________________________________________________________________________ City: ____________________ State: ___ Zip Code: ________ Email Address: ________________________ Home Phone #: _____________________________ Work Phone #: ________________________________ 11. Information on each person who had primary care and custody of the Minor during the 60 days prior to filing this Petition: Name: ________________________________________ Relationship to Minor: _______________________ Address: _______________________________________________________________________________ City: ____________________ State: ___ Zip Code: ________ Email Address: ________________________ Home Phone #: ______________________________ Work Phone #: _______________________________ 12. Does the Minor have any legal representative(s) pursuant to §15-14-102(6), C.R.S. identify: Yes No If Yes, Name: __________________________________________ Phone #: ______________________________ Current Residence: _______________________________________________________________________ City: ____________________ State: ___ Zip Code: ________ Email Address: ________________________ Name: __________________________________________ Phone #: ______________________________ Current Residence: _______________________________________________________________________ City: ____________________ State: ___ Zip Code: ________ Email Address: ________________________ JDF 861 4/08 VERIFIED PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR Page 3 of 4 American LegalNet, Inc. www.FormsWorkflow.com The Petitioner shall provide notice to the parents, Minor if 12 years of age or older, and the persons listed in paragraphs 7 and 9 – 12 (the nominee, current guardian or conservator, parents or an adult relative, person who had primary care and control of the minor and any legal representatives, if applicable) of the time and place for a hearing on this Petition in accordance with Colorado Rules of Probate Procedures and pursuant to §15-14-404, C.R.S. In addition, I request that the Court: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ VERIFICATION AND ACKNOWLEDGMENT I swear/affirm under oath that I have read the foregoing Petition and that the statements set forth therein are true and correct to the best of my knowledge. Date: __________________________ ___________________________________________ Signature of Petitioner Subscribed and affirmed, or sworn to before me in the County of _________________________, State of ________________, this ___________ day of _______________, 20 _______. My Commission Expires: ____________________ JDF 861 4/08 _____________________________________ Notary Public/Clerk VERIFIED PETITION FOR APPOINTMENT OF CONSERVATOR FOR MINOR Page 4 of 4 American LegalNet, Inc. www.FormsWorkflow.com