State of Minnesota County of _________________________ District Court Probate Division Judicial District: ______________ Court File No. ______________ Case Type: 14, ___________________ In Re: Guardianship Conservatorship of Acceptance of Appointment and Oath Professional Individual Corporation Individual ________________________________ By Individual: As a condition to receiving letters, I, __________________________________(name), the appointed Guardian, Conservator, of the above named ward and/or protected person, verify that I understand the duties and responsibilities required of me in this role. I hereby accept my appointment and will fully and faithfully perform all of my duties according to law and submit to the jurisdiction of the Court in any proceeding relating to this ward or protected person that may be brought by the court or any person interested in the affairs of the ward or protected person. I have watched the Guardianship/Conservatorship Educational Video. _________ (initial here) I am a professional conservator as defined by M.S. 524.5-102 Subd. 13a. I declare under penalty of perjury that everything I have stated in this document is true and correct. Minn. Stat. � 358.116. Dated: , 20___ Signature Name: Date of Birth: Address: City/State/Zip: Telephone: E-mail address: By Corporation: ("Corporation") is a corporation under the Laws of the State of Minnesota. As a condition to receiving letters as Guardian, Conservator, the Corporation (1) accepts the duties of such appointment, (2) agrees to be bound by Minnesota law relating to guardians and conservators, (3) submits to the jurisdiction of the Court in any proceeding relating to this ward or protected person that may be brought by the court or any person interested in the affairs of the ward or protected person, and (4) employees of the corporation directly responsible for carrying out the duties and responsibilities of a guardian GAC 1-U State ENG Rev 5/16 www.mncourts.gov/forms Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com and/or conservator have watched the Guardianship/Conservatorship Educational Video and understand the duties and responsibilities of the role of guardian and/or conservator. The Corporation has authorized this acceptance to be signed in the corporate name. I declare under penalty of perjury that everything I have stated in this document is true and correct. Minn. Stat. � 358.116. Dated: , 20___ Signature Name: Title: Address: City/State/Zip: Telephone: E-mail address: GAC 1-U State ENG Rev 9/09 www.mncourts.gov/forms Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com