Fill and Sign the Acceptance of Office Colorado Form

 District Court  Denver Probate Court ___________________ County, Colorado Court Address: COURT USE ONLY In the Interest of: Respondent Attorney or Party Without Attorney (Name and Address): Phone Number: Email: FAX Number: Atty Reg. #: Case Number: Division Courtroom ACCEPTANCE OF OFFICE - GUARDIANSHIPS AND CONSERVATORSHIPS 1. I, (name) accept appointment to, and agree to perform the duties and discharge the trust of, the office of: (Check all that apply.)  Guardian.  Emergency guardian.  Temporary guardian.  Conservator.  Special conservator. 2. I submit personally to the jurisdiction of this court in any proceeding relating to this matter. 3. A legible copy of my driver’s license, passport or other government-issued identification is filed/e-filed as a separate document. 4.  I request that the court waive required background information because I am: (If this paragraph applies, check all boxes below that apply, skip questions 5 through 9.)  a public administrator.  a trust company, bank, credit union, savings and loan, or other financial institution.  a state or county agency.  the respondent’s parent and I reside with the respondent.  a person or entity for whom good cause exists to waive such disclosures. State reasons: ____________________________________________________________________________________ The court may require a nominee to obtain additional background information that the court considers necessary to assist it in determining the fitness of the nominee for the appointment sought. Such information may include requiring a nominee to obtain fingerprint-based criminal history record checks through the Colorado Bureau of Investigation and the Federal Bureau of Investigation at the nominee’s expense. ( § 15-14-110(5), C.R.S.) 5. I  have been  have not been convicted of, pled no contest to, or received a deferred sentence for one or more felonies or misdemeanors. If so, describe all: Name of State and Court Issuing Order 6. I  have  have not had a temporary or permanent civil restraining/protection order issued against me. If so, describe all: JDF 805 ACCEPTANCE OF OFFICE R 8 17 © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 1 of 2 Name of State and Court Issuing Order 7. A civil judgment  has been  has not been entered against me. If so, describe all: Name of State and Court Entering Judgment 8. I  have been  have not been relieved from one or more court - appointed responsibilities. If so, describe all: Name of State and Court Relieving Nominee 9 . True copies of my name - based criminal history record check obtained through the Colorado Bureau of Investigation and my current credit report are filed/e-filed as separate documents. (See instructions below.) 10 . I  am  am not a “professional” which is defined as: An individual or entity engaged in the business of providing services as guardian or conservator, who is not related to the protected person/ward by blood, law, or marriage. A professional usually acts as guardian or conservator for two or more individuals. 11. The nominee acknowledges and understands that if the nominee fails to file required reports with the court or fails to respond to an order of the court to show cause why the nominee should not be held in contempt of court, Colorado law authorizes the court to access data and records of state agencies in order to obtain contact information, as defined in sections 15-14-317 (4) (c) and 15-14-420 (6) (c), C.R.S. Note: Social security numbers should not be attached to or written on this Acceptance of Office.  By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form.  By checking this box, I am acknowledging that I have made a change to the original content of this form. (Checking this box requires you to remove JDF number and copyright at the bottom of the form.) VERIFICATION AND ACKNOWLEDGMENT I verify that the statements set forth in this document and its attachments are accurate and complete to the best of my knowledge or belief. I understand that penalties for perjury follow deliberate falsification of the facts stated herein. (§15-10-310, C.R.S.) ____________________________________________ Signature of Proposed Guardian/Conservator Date The foregoing instrument was acknowledged before me in the County of ________________, State of Colorado, this ____day of ____________, 20___, by the Proposed Guardian/Conservator. My Commission Expires: ________________ _____________________________________________ Notary Public/Deputy Clerk _____________________________________________ Signature of Attorney Date JDF 805 ACCEPTANCE OF OFFICE R 8 17 © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 2 of 2 INSTRUCTIONS: 1. To obtain a name - based criminal history check from the Colorado Bureau of Investigation (CBI), contact CBI at 690 Kipling Street Denver, CO 80215, (303) 239 - 4300, or at www.cbi.state.co.us and click on CBI Records Check. 2. To obtain a current credit report, contact any of the following credit reporting agencies: a. Equifax, Inc., P.O. Box 740241, Atlanta, GA 30374, 1 - 800 - 685 - 1111, or at www.equifax.com b. Experian, P.O. Box 2002, Allen, TX 75013, 1 - 888 - 397 - 3742, or at www.experian.com c. TransUnion, P.O. Box 2000, Chester, PA 19022, 1 - 800 - 916 - 8800, or at www.transunion.com 3. §15 - 14 - 110, C.R.S., requires that the costs for all criminal history checks and credit reports be paid by the proposed guardian/conservator. JDF 805 ACCEPTANCE OF OFFICE R 8 17 © 2017 Colorado Judicial Department for use in the Courts of Colorado Instructions