Fill and Sign the Andor 15 14 4311 C Form

JDF 853SC R6/19 NOTICE OF DEATH Page 1 of 2  District Court  Denver Probate Court ___________________ County, Colorado Court Address: In the Interest of: Ward/ Protected Person COURT USE ONLY Attorney or Party W ithout Attorney (Name and Address): Phone Number: E -mail: FAX Number: Atty. Reg.#: Case Number: Division Courtroom NOTICE OF DEATH This notice is submitted pursuant to § §15- 14-314(2)(g), C.R.S. and/or 15- 14- 431(1), C.R.S. 1. (name) , who died on (date) was the subject of a  Guardianship and/or  Conservatorship . 2.  The guardian’s authority to act on behalf of the ward has terminated .  The conservator’s authority to act on behalf of the p rotected person is limited and the c onservator will conclude administration of the conservatorship estate pursuant to §§1 5-14- 428 and 15 -14- 431, C.R.S.  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. VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the ______ day of ___________, _________, (date) (month) (year) at ______________________________________ (city or other location, and state OR country) _______________________________ (printed name) _______________________________ (signature) CERTIFICATE OF SERVICE I certify that on ___________________ (date), a copy of this _______________ (name of document) was served as follows on each of the following: Name and Address Relationship to Decedent, Ward, or Protected Person Manner of Service* JDF 853SC R6/19 NOTICE OF DEATH Page 2 of 2 *Insert one of the following: hand delivery, first -class mail, certified mail, e -service, or fax. __________________________________________ Signature