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Petition For Protective Order/appointment Of Conservator - State Of South Carolina Probate Court Page 2

6. The following is a general statement of the property, assets, and income of the above person, together with an

estimate of the value thereof: (A full inventory, Form #550PC, shall be completed and filed with the Court within

thirty days of appointment.)

Description

Value

7. The appointment of a conservator for the above person is necessary because (state reasons justifying

appointment):

8. I request the appointment of:

Name:

Address:

Telephone (O):

Telephone (H):

Email:

whose priority for appointment as conservator for the above person is as follows:

fiduciary appointed or recognized by the appropriate court of any other jurisdiction in which the

minor/alleged incapacitated person resides

individual or corporation nominated by the minor/alleged incapacitated person (if fourteen or more years of

age and deemed mentally capable of making such a choice)

attorney-in-fact appointed by protected person (Pursuant to S.C. Code Ann. Section 62-5-501)

spouse of protected person

adult child of protected person

parent of protected person or person nominated by Will of deceased parent

other relative of protected person

(specify):

person nominated by the person who is caring for protected person or paying benefits to him/her

nominated by one with priority to serve in his/her stead (specify):

other (specify):

9. The following persons are required by statute to be given notice of the time and place of hearing on this Petition:

Name

Address

Relationship

FORM #540PC (4/13)

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Petition For Protective Order/appointment Of Conservator - State Of South Carolina Probate Court Page 2