AOC-852 Rev. 2-17 Page 1 of 2 COM M Doc. Code: PGM or PCM O NW E A LT H O F K E lex et justitia Case No. ____________________ Court County Division ____________________ ____________________ ____________________ NT U C KY CO Commonwealth of Kentucky Court of Justice www.courts.ky.gov KRS 387.025, KRS 395.016 U RT OF JUS TI PETITION FOR APPOINTMENT OF GUARDIAN/CONSERVATOR FOR MINOR C E SS# or EIN# (If any) ____________________________ Voluntary NOTE TO PETITIONER: A verified application for appointment as guardian/limited guardian/conservator must accompany this form. AOC 853 may be used. In re estate of ________________________________________________________, a minor under the age of 18. Petitioner, ________________________________________, petitions this Court for appointment of a (choose one): q q q guardian (individual, agency, or corporation having care, custody, and control of minor and managing minor's financial resources); or limited guardian (individual, agency, or corporation having care, custody, and control of minor without managing minor's financial resources); or conservator (individual, agency, or corporation managing minor's financial resources) for the above named minor. In support of this petition, petitioner states as follows: 1. 2. 3. 4. 5. 6. 7. Minor's address is ____________________________________________________________________________. Minor's date of birth is _________________________________________________________________________. Name and address of minor's spouse is ___________________________________________________________ Name(s) and address(es) of minor's living parent(s) is (are) ____________________________________________ If no living parent(s), name(s) and address(es) of minor's adult next of kin is (are) ___________________________ Name and address of individual or facility having custody of minor is ____________________________________ Facts and reasons supporting need for appointment are: ______________________________________________ _______________________________________________________________________________________________. _______________________________________________________________________________________________. _______________________________________________________________________________________________. _______________________________________________________________________________________________. _______________________________________________________________________________________________ _______________________________________________________________________________________________. 8. Description and value of estate: Description a. b. c. Real Property Personal Property Other Financial Resources: (1) (2) (3) (4) Government Benefits Insurance Entitlement Anticipated Yearly Income Other _________________________________ _________________________________ _________________________________ _________________________________ $ _________________ $ _________________ $ _________________ $ _________________ American LegalNet, Inc. www.FormsWorkFlow.com Value $ _________________ $ _________________ _________________________________ _________________________________ AOC-852 Rev. 2-17 Page 2 of 2 9. Petitioner's address is _________________________________________________________________________. 10. Name and address of petitioner's attorney is __________________________________________ _____________________________________________________________________________________________. 11. Name and address of person/entity desiring appointment is ____________________________________________ _______________________________________________________________________________________________. Based on the above, petitioner prays that the above named person/entity be appointed as q guardian, q limited guardian, or q conservator. A verified application for appointment as guardian/limited guardian/conservator for minor completed by the above named person/entity is attached. _____________________________________________ Petitioner SUBSCRIBED AND SWORN to before me on this date, __________________________________, 2______. _____________________________________________ Name/Title NOTE TO PETITIONER: At least five (5) days before the hearing, Petitioner is required to give written notice of the time, place, and purpose of the hearing to each person/entity named in the Petition (unless notice has been waived in writing) by either: Certified mail, return receipt requested. Proof of receipt must be filed in the court record at the time of the hearing; OR First class mail in a sealed envelope, postage prepaid. Proof that notice was mailed must be made by Affidavit, including the date when posted, filed in the court record at the time of the hearing. _______________________________________________________________________________________________ Attorney Name & Address (If any) Choice of Guardian by Minor age 14 or older (This choice must be made in the presence of the Court.) The undersigned, being a minor aged 14 or older, nominates as q guardian, q limited guardian, or q conservator: ____________________________________________ Name ____________________________________________ Address ____________________________________________ Minor Copy Distribution: Minor (If 14 or older) Each Person / Entity Named in Petition American LegalNet, Inc. www.FormsWorkFlow.com