Page 1 of 3 Motion to Terminate Guardianship/Conservatorship CC 16:3.20 Rev. 04/16 Nebraska State Court Form REQUIRED MOTION TO TERMINATE GUARDIANSHIP/ IN THE IN THE MATTER OF Ward/Incapacitated Person/Protected Person Case MOTION TO TERMINATE GUARDIANSHIP/CONSERVATORSHIP , uardian/onservator for moves the court for an Order to terminate the guardianship/conservatorship because: the ward/incapacitated person/protected person has died. (A copy of the certified death certificate with the date of birth and social security numberthe guardianship/conservatorship is not needed for the following reason(s): I DO NOT HAVE possession or control o the ward222s/incapacitated person222s/protected person222s money assets, possessions or income (including social security or other benefits). I HAVE possession or control of the ward222s/incapacitated person222s/protected person222s money, assets, possessions or income (including American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 3 Motion to Terminate Guardianship/Conservatorship CC 16:3.20 Rev. 04/16 I acknowledge that I will receive a Notice of Hearing when I file my Motion to Terminate Guardianship/Conservatorship, and all required documents (if applicable). After I receive the Notice of Hearing from the County Court, it is my responsibility to send a copy of this Motion and all required documents (if applicable), the Notice of Hearing and the Notice of Right to Object form to all interested persons*. I also acknowledge that I shall file a Certificate of Mailing with the court showing I mailed copies of all required documents by first class mail, postage prepaid to all interested persons. I, swear and affirm under penalty of perjury that the (guardian(s)/conservator(s) above marked statement is true and correct. Signature(s) of Guardian(s) and/or Conservator(s) Date Print or Type Name of Guardian(s) and/or Conservator(s) Street Address/P.O. Box of Guardian(s) and/or Conservator(s) Bar Number and Firm Name (attorneys only) City/State/ZIP Code of Guardian(s) and/or Conservator(s) Phone(s) E-mail Address(es) American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 3 Motion to Terminate Guardianship/Conservatorship CC 16:3.20 Rev. 04/16 *Interested persons are defined as:children and spouses;future heirs if the ward/incapacitated person/protected person would die without leaving a validwill (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 ororganization named as a 223devisee224 in the ward222s/incapacitated person222s/protected person222smost recent will;after death of the ward/incapacitated person/protected person, interested person also includesthe personal representative of a deceased ward222s/incapacitated person222s/protected person222sestate, the deceased ward222s/incapacitated person222s/protected person222s heirs in an intestateestate, and the deceased ward222s/incapacitated person222s/protected person222s devisees in atestate estate;any governmental agency paying benefits on behalf of the ward/incapacitatedperson/protected person; andany 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 (Neb247 6-1449(B)). The cost of the guardian ad litem may be taken from the assets of the ward/incapacitated person/protected person. TO THE GUARDIAN AND/OR CONSERVATOR: This form is to be filed only with the Court. Do not send this form to the interested parties. Fill out one form for each ward, incapacitated person or protected person. American LegalNet, Inc. www.FormsWorkFlow.com