IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI PROBATE DIVISION AT In the Matter of Estate Number , Respondent PETITION FOR APPOINTMENT OF SUCCESSOR FIDUCIARY Comes now the undersigned petitioner and states: 1. The former *(guardian - conservator) has *(died -resigned - been removed.) 2. Respondent remains in need of a *(limited) guardian and *(limited) conservator. 3. The nature, extent and estimated value of respondents asses so far as is known to petitioner is set forth in Exhibit A attached hereto and incorporated herein by this reference. 4. The name and address of respondentsparents, spouse and child and the childrens ages are set forth in Exhibit B attached hereto and incorporated herein by this reference. 5. , is a suitable personto serve as *(limited) guardian - *(limited) conservator for respondent and said persons consent to act is attached hereto and incorporated herein by this reference as Exhibit C. 6. If the proposed successor fiduciary is a non-residentof Missouri, attachedhereto and incorporatedherein by this reference as Exhibit D is the proposed successors designation of resident agent and the resident agents consent to act. WHEREFORE, petitioner prays that a hearing be held and that the above named person be appointed successor fiduciary and that letters issue accordingly. The under signed swears that the matters set forth in theforegoing petition are true and correct to the best knowledge and belief of the und ersigned subject to the penalties of making a false affidavit or declaration. PetitionerAttorney for Petitioner: MO BAR No Address: Telephone:( ) Fax Number:( ) E-Mail Address: *Strike inapplicable. Form 10192