State of Minnesota County of ____________________ In Re: Conservatorship of ____________________________, Protected Person District Court Probate Division Judicial District: __________________ Court File No. _____________________ Case Type: 14, Conservatorship County Assessor's Market Evaluation Address of Property: ________________________________________________________ ___________________________________________________________________________; Property Identification Number (if known): _______________________________________; Legal Description:____________________________________________________________ ___________________________________________________________________________; On _______________________, 20___, the Assessor's Market Value of the above described Date Assessed property was $ ______________________. COUNTY ASSESSOR Dated:_____________________ By:___________________________________ American LegalNet, Inc. www.FormsWorkFlow.com GAC 21-UV State ENG Rev 12/03 www.mncourts.gov/forms Page 1 of 1