Fill and Sign the 6 144302 Intrastate Transfer of Guardianship and Conservatorship Form

Nebraska State Court Form REQUIRED CC 16:2.125 New 10/2015 Neb. Ct. R. § 6-1443.02(F) DENIAL OF INTRASTATE TRANSFER AND CERTIFICATE OF MAILING IN THE COUNTY COURT OF ________________COUNTY, NEBRASKA IN THE MATTER OF Case No. ____________________ ______________________________ Ward/Incapacitated Person/Protected Person DENIAL OF INTRASTATE TRANSFER AND CERTIFICATE OF MAILING This matter comes before the court upon receipt of a provisional order for transfer of this guardianship/conservatorship from ______________________ County Court to _____________________ County Court. This court has reviewed the order submitted regarding provisional transfer, and finds that insufficient information has been provided to determine that this court has venue over this matter or that the information provided does not support venue existing for transfer of this matter to this court. Transfer of this matter is hereby denied. DATED ________________________. BY THE COURT: __________________________________ County Judge Page 1 of 3 Denial of Intrastate Transfer and Certificate of Service CC 16:2.125 New 10/2015 CERTIFICATE OF MAILING I certify that on ________________________, I mailed a copy of this order to the originating court and to all interested persons listed below: NAME(S) OF INTERESTED PERSON(S) ADDRESS(ES) See attached (more names and addresses than above) Date:__________________ Page 2 of 3 Denial of Intrastate Transfer and Certificate of Service CC 16:2.125 New 10/2015 BY THE COURT: ______________________________ *Interested persons are defined as: • children and spouses; • future heirs if the ward/incapacitated person/protected person would die without leaving a valid will (brothers and sisters who are adults, grandparents, etc.); • a trustee of any trust executed by the ward/incapacitated person/protected person; • if there are no individuals defined as “interested persons” above, include any person or organization named as a “devisee” in the ward’s/incapacitated person’s/protected person’s most recent will; • after death of the ward/incapacitated person/protected person, interested person also includes the personal representative of a deceased ward’s/incapacitated person’s/protected person’s estate, the deceased ward’s/incapacitated person’s/protected person’s heirs in an intestate estate, and the deceased ward’s/incapacitated person’s/protected person’s devisees in a testate estate; • any governmental agency paying benefits on behalf of the ward/incapacitated person/protected person; and • any person designated by order of the court to be an interested person. If there are no interested persons identified for a ward/incapacitated person/protected person, the court shall appoint a guardian ad litem (Nebraska Supreme Court Rule § 6-1449(B)). The cost of the guardian ad litem may be taken from the assets of the ward/incapacitated person/protected person. Page 3 of 3 Denial of Intrastate Transfer and Certificate of Service CC 16:2.125 New 10/2015