Page 1 of 2 Certificate of Mailing CC 16:2.49 Rev. Nebraska State Court Form REQUIRED CERTIFICATE OF MAILINGCC 16:2.49 IN THE COUNTY COURT OF COUNTY, NEBRASKA IN THE MATTER OF Ward/Incapacitated Person/Protected Person Case CERTIFICATE OF MAILING I, , swear or affirm, under the penalties of perjury, ; As well as: Notice of Right to Object form; andCertificate of Mailing. to all interested persons* and bondingNAME(S) OF INTERESTED PERSON(S) ADDRESS(ES) See attached (more names and addresses Date Signature(s) of Guardian(s) and/or Conservator(s) Print or Type Name of Guardian(s) and/or Conservator(s) Bar Number and Firm Name (attorneys only) Street Address/P.O. Box of Guardian(s) and/or Conservator(s)City/State/ZIP Code of Guardian(s) and/or Conservator(s)Phone E-mail Address American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 Certificate of Mailing CC 16:2.49 Rev. *Interested persons are defined as: children and spouses; future heirs if the ward/incapacitated person/protected person would die without leaving a valid will(brothers and sisters who are adults, grandparents, etc.); a trustee of any trust executed by the ward/incapacitated person/protected person; if there are no individuals defined as 223interested persons224 above, include any person or organizationnamed as a 223devisee224 in the ward222s/incapacitated person222s/protected person222s most recent will; after death of the ward/incapacitated person/protected person, interested person also includes thepersonal representative of a deceased ward222s/incapacitated person222s/protected person222s estate, thedeceased ward222s/incapacitated person222s/protected person222s heirs in an intestate estate, and thedeceased ward222s/incapacitated person222s/protected person222s devisees in a testate estate; any governmental agency paying benefits on behalf of the ward/incapacitated person/protectedperson; and any person designated by order of the court to be an interested person. If there are no interested persons identified for a ward/incapacitated person/protected person, the court shall appoint a guardian ad litem (Nebraska Supreme Court Rule 247 6-1449(B)). The cost of the guardian ad litem may be taken from the assets of the ward/incapacitated person/protected person. American LegalNet, Inc. www.FormsWorkFlow.com