REQUEST TO REGISTER OUT-OF- STATE CONSERVATORSHIP PC-306 NEW 10/12 TO: Court of Probate, IN THE MATTER OF: STATE OF CONNECTICUT COURT OF PROBATE [Type or Print in Black Ink.] District No. Hereinafter referred to as the conserved person. Conservator of the Person [Name, address and telephone number] ________________________________________________________________________________________________ Conservator of the Estate [Name, address and telephone number] ________________________________________________________________________________________________ Conserved Person's Residence Address Conserved Person's Domicile Address [If different] Conserved Person's Present Address [If different] ________________________________________________________________________________________________ The petitioner(s) represents that: There is no petition pending for the appointment of a conservator of the person or conservator of the estate in Connecticut. _________________________ was appointed conservator of the person by ______________________________ [Court] in the State of__________________________. A certified copy of the decree of appointment is attached. _______________________________ was appointed conservator of the estate by ________________________ [Court] in the State of__________________________. A certified copy of the decree of appointment is attached. A notice of intent to register the conservatorship in Connecticut has been filed with the court in the other state. The petitioner(s) requests that the court register the order of appointment of the petitioner as conservator as a foreign judgment pursuant to C.G.S. sections 45a-667r, 45a-667s and 45a-667t. DATE: SIGNED: _______________________________ Petitioner ­ Conservator of the Person ______________________________ Petitioner ­ Conservator of the Estate REQUEST TO REGISTER OUT-OF-STATE CONSERVATORSHIP PC-306 American LegalNet, Inc. www.FormsWorkFlow.com