PROBATE COURT OF WOOD COUNTY, OHIO David E. Woessner, Judge In the Matter of the CONSERVATORSHIP of : ______________________________________________________ Case No.______________________ Date:__________________________ LETTERS OF CONSERVATORSHIP ________________________________________ is appointed Conservator of As Conservator, his/her powers are: 1. All powers conferred by the Guardianship laws of Ohio and the Rules of this Court over the conservatee's: Person and Estate Person only Estate only 2. Those guardianship powers, until revoked, are for an: Indefinite time period Definite time period to_______________________________________________, 20___ 3. The Conservator's powers are limited to: __________________________________________________________ ___________________________________________________________________________________________ ____________________________________________________________________________________________ 4. The following property of the conservatee is subject to the above power of the conservator: All property Only the property listed as follows _____________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ The above-named Conservator has the power conferred by law to do and perform all the duties of Conservator as described. _______________________________ Date Journalized _______________________________________ Probate Judge, David E. Woessner NOTE TO FINANCIAL INSTITUTIONS Funds being held in the name of the within-named Conservatee shall not be released to Conservator without a Court Order directing release of a specific fund and amounts thereof. FORM 20.2 - LETTERS OF CONSERVATORSHIP American LegalNet, Inc. www.USCourtForms.com Crensch$\forms\20.2 7/26/01 CERTIFICATE OF APPOINTMENT AND INCUMBENCY This document is a true copy of the original kept by me as custodian of the records of this Court. It constitutes the appointment and letters of authority of the named Conservator, who is qualified and acting in such capacity. DAVID E. WOESSNER, PROBATE JUDGE (Seal) By: Deputy Clerk Date American LegalNet, Inc. www.USCourtForms.com