IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION AT IN THE ESTATE OF ESTATE NUMBER , Adult Protectee. PETITION FOR APPROVAL OF SETTLEMENT AND ORDER FOR NO FURTHER PROCESS Now comes the conservator of the estate of the above named protectee, and states that the real property of the protectee does not exceed the value prescribed by Chapter 208 for welfare eligibility and is the residence of the protectee and that the conservator has filed settlement which shows that: ! The value of the assets of the protectees estate does not exceed the value prescribed by Chapter 208 RSMO for welfare eligibility and the protectee is eligible for and receiving public assistance. ! The value of the assets of the protectees estate does not exceed the value prescribed by Chapter 208 RSMO but the protectee is ineligible for public assistance and that all income of the protectee is needed for the support and maintenance of the protectee. WHEREFORE, petitioner prays for an order approving said settlement, for waiver of costs, for waiver or reduction of petitioners bond and for an order of no further process. The undersigned swears that the matters set forth 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: * Strike inapplicable Conservator: Address: zip Attorney: MO BAR No Address: zipTelephone Number: ( ) Fax Number: ( ) E-Mail Address: Form 10212