State of Minnesota County of ______________________ District Court Probate Division ________ Judicial District Court File No.____________________________ Case Type: 14, Conservatorship In Re: Conservatorship of ____________________________, Protected Person Ex Parte Petition to Expend Funds TO THE HONORABLE JUDGE OF THE DISTRICT COURT: The conservator states that the personal property current value is $________________. The conservator states that it is necessary to expend up to $__________________ for: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _________________________________________________________________________ (Note to Conservator: Attach supporting documentation for the expenditure to this form.) The conservator requests that the above expenditures be authorized. Dated: ________________________ Signature of Conservator Name: Address: City/State/Zip: Telephone: E-mail address: GAC113 State ENG Rev 7/15 www.mncourts.gov/forms Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com