IN THE CIRCUIT COURT OF JEFFERSON COUNTY, MISSOURI No. Matter of , Minor. APPLICATION FOR APPOINTMENT OF *GUARDIAN *AND * CONSERVATOR The applicant, states to the Court that: 1. whose birth date is , and whose domicile is , needs a *Guardian *And *Conservator, and is the owner of property with the estimated value of: , and Personal Property $ Real Property $ . 2. The appointment of a *Guardian *And *Conservator is sought because 3. The names and addresses of the parents and grandparents are: FATHER: MOTHER: PATERNAL GRANDPARENTS: MATERNAL GRANDPARENTS: 4. The name and address of the spouse of the Minor, if any, is: 5. The above Minor is in the custody of address is: whose 6. The above person has no guardian or conservator except as follows: Name and Address: 7. There are no other custody proceedings relating to the Minor, except *Give style of case WHEREFORE, the applicant requests that Letters of *Guardianship *And *Conservatorship of the Estate of be issued to , and that the matter be supervised by the Court. Page 1 of 2 *strike if inapplicable American LegalNet, Inc. www.FormsWorkflow.com THE STATEMENTS AND REPRESENTATIONS IN THIS DOCUMENT ARE MADE UNDER OATH AND ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THEY ARE MADE SUBJECT TO THE PENALTIES OF MAKING A FALSE AFFIDAVIT OR DECLARATION. Applicant’s Signature Address Date Phone: Relationship to the Minor: SELECTION OF *GUARDIAN * AND *CONSERVATOR BY MINOR , the within named Minor, over 14 years of age, hereby request that be appointed as *his *her *Guardian *And * Conservator. Signature Age Address WAIVER OF RIGHT TO BE APPOINTED *GUARDIAN *AND *CONSERVATOR I, _____________________________________ , the Mother _________________________ Minor, hereby waive any rights that I may have, to be appointed *Guardian *And *Conservator of said Minor, and request the appointment of ______ Signature of Mother Address Subscribed and sworn to before me this ______ day of ____________________________, 20_____. Notary Public Notary commission expires: WAIVER OF RIGHT TO BE APPOINTED *GUARDIAN *AND *CONSERVATOR I, , the Father of _______________________________________________ , Minor, hereby waive any rights that I may have, to be appointed *Guardian *And *Conservator of said Minor, and request the appointment of _________________________________________________________________ Signature of Father Address Subscribed and sworn to before me this _____ day of _____________________________, 20_____. _______________________________________________ Notary Public Notary commission expires: ______________ Attorney____________________________________________ Register No.___________________ ( SIGNATURE REQUIRED ) Address _________________________________________________Phone No. _______________ Page 2 of 2 *strike if inapplicable American LegalNet, Inc. www.FormsWorkflow.com