Order Appointing Conservator - Nebraska State Court
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3Revised 03/16
Nebraska State Court Form
CC 16:2.1.3
ORDER APPOINTING
REQUIRED
CONSERVATOR
IN THE COUNTY COURT OF ________________COUNTY, NEBRASKA
IN THE MATTER OF
Case #____________________
___________________________
ORDER APPOINTING
Protected Person
CONSERVATOR
The Petition for Appointment of Conservator having come before the court, the court finds as follows:
1. Petitioner(s) is/are entitled to file the Petition pursuant to Neb. Rev. Stat. § 30-2633.
2. Notice has been given or waived as required by law.
3. Venue in this county is proper.
4. Upon clear and convincing evidence presented to the court, there is a sufficient basis for the
appointment of the conservator for ______________________________and there are no less
restrictive alternatives than the appointment of a conservator for the above-named protected
person.
5. Appointment of a conservator is necessary because __________________________________
____________________________________________________________________________.
6. ___________________________is entitled to appointment pursuant to Neb. Rev. Stat. § 30-
2639 and should be appointed as conservator. The above named person is authorized and
ordered to obtain an Acknowledgement of Financial Institution Form completed by each financial
institution holding any assets or accounts titled in any manner in the name of the ward/protected
person along with a printout of all assets and account numbers in each financial institution,
which shall be filed in these proceedings.
7. If any funds are ordered restricted, the above named person is further authorized and ordered to
open an account at a financial institution with the restriction that no withdrawals can be made
without a court order. To show the court that the conservator has complied with this restriction
the conservator shall file with the court a Proof of Restricted account form within 10 days of this
order.
Page 1 of 3
Order Appointing Conservator
CC 16:2.1.3 Rev 03/16
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