Nebraska State Court Form REQUIRED ACCEPTANCE OF APPOINTMENT OF TEMPORARY GUARDIAN AND TEMPORARY CONSERVATOR BY THE PUBLIC GUARDIAN CC 16:2.227 New 11/15 Neb. Rev. Stat. §§ 30-2626(a), 30-2630.01(a); Neb. Ct. R. §§ 6-1433.02(G), 6-1443(A) IN THE COUNTY COURT OF COUNTY, NEBRASKA Case # IN THE MATTER OF Ward/Incapacitated Person/Protected Person ACCEPTANCE OF APPOINTMENT OF TEMPORARY GUARDIAN AND TEMPORARY CONSERVATOR BY THE PUBLIC GUARDIAN The Public Guardian accepts the appointment as temporary guardian and temporary conservator of the assets of, (ward/incapacitated person/protected person) and swears that they will perform, according to law, all duties for the ward/incapacitated person/protected person as temporary guardian and temporary conservator. Date Signature Print or Type Name Bar Number and Firm Name (attorneys only) Street Address/P.O. Box City/State/ZIP Code Phone of E-mail Address Page 1 of 3 Acceptance of Appointment of T e m p o r a r y Guardian and Temporary Conservator by the Public Guardian CC 16:2.227 New 11/15 American LegalNet, Inc. www.FormsWorkFlow.com