AOC-852 Rev. 7-99 Page 1 of 2 Doc. Code: PGM or PCM Commonwealth of Kentucky Court of Justice KRS 387.025, KRS 395.016 Case No._______________________ Court___________________________ PETITION FOR APPOINTMENT OF GUARDIAN/CONSERVATOR FOR MINOR County_________________________ 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): u guardian (individual, agency, or corporation having care, custody, and control of minor and managing minor's financial resources); or u limited guardian (individual, agency, or corporation having care, custody, and control of minor without managing minor's financial resources); or u 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. Minor's address is _________________________________________________________________________________. 2. Minor's date of birth is _____________________________________________________________________________. 3. Name and address of minor's spouse is ____________________________________________________________ ___________________________________________________________________________________________________________. 4. Name(s) and address(es) of minor's living parent(s) is (are) __________________________________________ ____________________________________________________________________________________________________________. 5. If no living parent(s), name(s) and address(es) of minor's adult next of kin is (are) _____________________ ___________________________________________________________________________________________________________. 6. Name and address of individual or facility having custody of minor is ________________________________ ____________________________________________________________________________________________________________. 7. Facts and reasons supporting need for appointment are: __________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________. 8. Description and value of estate: Description Value a. Real Property ______________________________________ $ ____________________ b. Personal Property ______________________________________ $ ____________________ c. Other Financial Resources: (1) Government Benefits ______________________________________ $ ____________________ (2) Insurance Entitlement ______________________________________ $ ____________________ 2000 © American LegalNet, Inc. AOC-852 Rev. 7-99 Page 2 of 2 (3) (4) Doc. Code PGM or PCM Anticipated Yearly Income ______________________________________ $ ____________________ Other ______________________________________ $ ____________________ 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 u guardian, u limited guardian, or u 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, __________________________________________, ________. __________________________________________________ Name/Title ____________________________________________________________________________________________________________ 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 u guardian, u limited guardian, or u conservator: __________________________________________________ Name __________________________________________________ Address __________________________________________________ Minor Copy Distribution: Minor (If 14 or older) Each person / Entity Named in Petition Inheritance Tax Section, Revenue Cabinet, Frankfort, Kentucky 40620 2000 © American LegalNet, Inc.