IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION AT IN THE MATTER OF ESTATE NUMBER , Minor(s) PETITION FOR APPOINTMENT OF GUARDIAN AND CONSERVATOR 1. Comes now petitioner and states that the minor(s) named below requires the appointment of a guardian of the person and/or a conservator of the estate because: (the parents are deceased or unfit, or unwilling or unable to assume the duties of guardianship) and/or (the estate requires supervision.) 2. The minor(s) (is) (are) domiciled in County, . 3. The nature, extent and estimated value of the minor(s) assets so far as is known to petitioner (the major part of which is located in County, Missouri) is set forth in Exhibit A attached hereto andincorporated herein by this reference. 4. The name and address of the minor(s) parents, spouse, if any, and children, if any, are set forth in ExhibitB attached hereto and incorporated herein by this reference. 5. The name and address of the person having custody of the minor(s) is: 6. The name and address of the guardian or conservator of the minor(s), if any, is: 7. The proposed guardian and/or conservator is not guardian or conservator for any other person except: Form 10320 Page 1 of 2 7/26/96>>>> 2 8. Attached hereto and incorporated herein by this reference as Exhibit C is the consent of the proposed guardian and/or conservator to act if appointed. 9. Attached hereto and incorporated herein by this reference as Exhibit D is the proposed guardians and/or conservators designation of resident agent and the resident agents consent to act if the proposed guardian and/or conservator is a non-resident of the State of Missouri. WHEREFORE, petitioner prays that letters of guardianship and/or conservatorship issue to: The undersigned swears that the answers set forth above are true and correct to the best knowledge and belief of the undersigned subject to the penalties of making a false affidavit or declaration. Dated: . Petitioner Address ( ) Telephone Attorney for Petitioner: MO BAR No Address: Telephone: ( ) Fax Number: ( ) E-Mail Address: SELECTION OF FIDUCIARY BY MINOR The undersigned minor acknowledges receipt of a copy of the above petition and waives service thereof and hereby requests that be appointed guardian and/or conservator. Witness Minor Witness Minor Witness Minor Form 10320 Page 2 of 2 7/26/96