UJS - 158 Petition to Terminate Guardianship & Conservatorship on Death ( Minor ) Rev. 05/2016 STATE OF SOUTH DAKOTA ) IN CIRCUIT COURT ) COUNTY OF ) JUDICIAL CIRCUIT ) ****************************************************************************** ****** In the Matter of the Guardianship and ) GDN ) Conservatorship of , ) PE TITION TO TERMINATE ) GUARD IANSHIP & CONSERVATORSHIP a Minor . ) ON DEATH OF MINOR ****************************************************************************** ****** I, , Guardian - Conservator for the above - mentioned Minor , being duly sworn upon oath, state and affirm the following: I was appointed guardian and conservator of the above - mentioned Minor on ( month ), ( day ), ( year ). This guardianship and conservatorship has since terminated when the Minor died at ( time ), on the day of ( month ), ( year ) , pursuant to SDCL 29A - 5 - 50 5 . Attached to this Petition is a Certified Copy of the Death Certificate as proof of death , pursuant to SDCL 29A - 1 - if ordered by the Court per SDCL 29A - 5 - 401 and - 403 (4). If not waived by the Court also attached per SDCL 29A - 5 - 408(4). I request the C ourt enter an Orde r Terminating the Guardianship/ Conservatorship and Order Accepting the Final Report and Final Accounting (if applicable), and that Letters of Guardianship/ Conservatorship be revoked (and any bond released). Dated , Guardian - (month) (day) (year) Mailing Address City, State, and Zip Code Phone Number Signed and sworn to before me on this day of , . Notary Public/Deputy Clerk of Courts (SE AL) Commission Expires: American LegalNet, Inc. www.FormsWorkFlow.com