Fillable Confidential Conservator Screening Form printable pdf download

CONFIDENTIAL (DO NOT ATTACH TO PETITION)

GC-314

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

FOR COURT USE ONLY

To keep other people from

seeing what you entered on

your form, please press the

Clear This Form button at the

TELEPHONE NO.:

FAX NO. (Optional):

end of the form when finished.

E-MAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

CONSERVATORSHIP OF

CASE NUMBER:

(Name):

PROPOSED CONSERVATEE

HEARING DATE AND TIME:

DEPT.:

CONFIDENTIAL CONSERVATOR SCREENING FORM

Person

Estate

Limited Conservatorship

Conservatorship of

The proposed conservator must complete and sign this form. The person requesting appointment of a

conservator must submit the completed and signed form to the court with the conservatorship petition.

This form must remain confidential.

How This Form Will Be Used

This form is confidential and will not be a part of the public file in this case. Each proposed conservator must complete and sign a

separate copy of this form under rule 7.1050 of the California Rules of Court. The information provided in this form will be used by

the court and by the persons and agencies designated by the court to assist the court in determining whether to appoint the

proposed conservator as conservator. The proposed conservator must respond to each item.

Proposed conservator (name):

Date of birth:

Social security number:

d. Driver's license number:

State:

Telephone numbers: Home:

Work:

Other:

2. a.

I am related to the proposed conservatee as (specify relationship):

I have personally known the proposed conservatee for:

years,

months.

I was

I was not

nominated as conservator of the

person

estate of the proposed conservatee,

the proposed conservatee.

the spouse or registered domestic partner of the proposed conservatee.

a parent of the proposed conservatee.

(If you checked "I was," provide documentation in Attachment 3.)

I am the spouse of the proposed conservatee.

I have

I have not

filed for legal separation,

dissolution of marriage, annulment, or adjudication of nullity of the marriage. (If you checked "I have,"

explain in Attachment 4.)

I am not the spouse of the proposed conservatee.

5. a.

I am the registered domestic partner of the proposed conservatee.

I do not

I do

intend to

terminate my domestic partnership with the proposed conservatee. (If you checked "I do," explain in Attachment 5.)

I am a former domestic partner of the proposed conservatee. My domestic partnership with the proposed

conservatee was terminated on (date):

. (Explain circumstances in Attachment 5.)

I am neither a current nor former domestic partner of the proposed conservatee.

I do

I do not

owe money or have a financial obligation to the proposed conservatee.

(If you checked "I do," explain in Attachment 6.)

The proposed conservatee

does

does not

owe money or have a financial obligation to me.

(If you checked "does," explain in Attachment 6.)

I am

I am not

an agent for a creditor of the proposed conservatee.

If you checked "I am," explain in Attachment 6.)

Page 1 of 2

Form Adopted for Mandatory Use

Probate Code, §§ 1810, 1811,

CONFIDENTIAL CONSERVATOR SCREENING FORM

Judicial Council of California

2104, 2346;

GC-314 [Rev. July 1, 2009]

Cal. Rules of Court, rule 7.1050

(Probate—Guardianships and Conservatorships)

Confidential Conservator Screening Form

Related Articles

Related forms

Related Categories