IN THE PROBATE DIVISION, CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI In the matter of __________________________________________ No._____________________ Respondent PETITION FOR APPOINTMENT OF A GUARDIAN AND CONSERVATOR Comes now _____________________________________ and states that the above named respondent, age _____, whose domicile is St. Louis County, Missouri, and whose present residence and post office address is ______________________________________________________________________________, is incapacitated and Street Address City State Zip disabled. The respondent owns property having an estimated value of: Real Property - $_________________________ Personal Property - $_____________________ Has the respondent executed a durable power of attorney? ____________________________________________ Petitioner is the _______________________________________ of the respondent and requests that letters (relationship) of guardianship be granted to ________________________________________________________, whose address is _______________________________________________________________ and who is not now guardian or Street Address City State Zip conservator for any wards or protectees (except as follows): _________________________________ _____________________________________________ Street Address (Name) _____________________________________________ City State Zip [For Guardianship of Person or Conservatorship of Estate – per 475.060(10) R.S.Mo. 1983]. The reasons why the appointment of a guardian is sought are: _____________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com [For Guardianship of Person Only – per 475.060(9) R.S.Mo. 1983]. The specific physical or mental conditions which prevent the respondent from being able to care for person are: _________________________________________ [For Conservatorship of Estate Only – per 475.061(1) R.S.Mo. 1983]. The specific physical or mental conditions which prevent the respondent from being able to manage financial resources are: ____________________________ ____________________________________________________________________________________________________________ __________________________________________________________________________________________________ 2 American LegalNet, Inc. www.FormsWorkFlow.com The following are listed pursuant to the provisions of 475.060 and 475.075 R.S.Mo. 1983: NAME & RELATIONSHIP AGE (if applicable) POST OFFICE ADDRESS (Include Zip Code) __________________________________ ____________________________________ Spouse (indicate if deceased) ____________________________________ __________________________________ ____________________________________ Mother (indicate if deceased) ____________________________________ __________________________________ ____________________________________ Father (if deceased) ____________________________________ __________________________________ Son/Daughter (Grandson/Granddaughter) __________________________________ Son/Daughter (Grandson/Granddaughter) __________________________________ Son/Daughter (Grandson/Granddaughter) __________________________________ Son/Daughter (Grandson/Granddaughter) _______________ ____________________________________ Age ____________________________________ _______________ ____________________________________ Age ____________________________________ _______________ ____________________________________ Age ____________________________________ _______________ ____________________________________ Age ____________________________________ Nearest Known Relative Relationship - __________________________________________ ____________________________________ ______________________________________________________ ____________________________________ NOTE: If the respondent has no spouse, mother, father or children, the names of the nearest known relatives who are over the age of eighteen must be listed above. _______________________________________ ____________________________________ Person having custody of respondent ____________________________________ _______________________________________ ____________________________________ Name of any guardian/conservator in this or any other State ____________________________________ 3 American LegalNet, Inc. www.FormsWorkFlow.com Petitioner prays that a hearing and inquiry be held and the court appoint __________________________ __________________________________________________________________________________________ Guardian of the Person and Conservator of the Estate for the respondent. Petitioner states that the foregoing is made on this _____ day of ____________, ______, under oath or affirmation, and its representations are true and correct to the best of petitioner’s knowledge and belief, subject to penalties of making a false affidavit or declaration. _______________________________________ __________________________________________ Attorney’s Signature Petitioner’s Signature _______________________________________ __________________________________________ Attorney’s Name (Typed) Petitioner’s Name (Typed) _______________________________________ __________________________________________ Street Address Street Address _______________________________________ __________________________________________ City City State Zip Code State Zip Code _______________________________________ __________________________________________ Phone Number With Area Code Phone Number with Area Code _______________________________________ Missouri Bar Number _______________________________________ __________________________________________ Attorney’s Signature Petitioner’s Signature _______________________________________ __________________________________________ Attorney’s Name (Typed) Petitioner’s Name (Typed) _______________________________________ __________________________________________ Street Address Street Address _______________________________________ __________________________________________ City City State Zip Code State Zip Code _______________________________________ __________________________________________ Phone Number With Area Code Phone Number with Area Code _______________________________________ Missouri Bar Number Serve notice on respondent at: _________________________________________________________________ __________________________________________________________________________________________ Send Fee Bills to: _______________________________ Publish Notice of Letters in _____________________ Minute Notices to: Attorney _____________________________________ Fiduciary____________________ 4 American LegalNet, Inc. www.FormsWorkFlow.com