Fill and Sign the Case 15 10751 DOC 1 Filed 040815 Page 1 of 4 Cases Prime Clerk Form

JDF 879 SC R6/19 PETITION FOR APPOINTMENT OF CO -CONSERVATOR OR SUCCESSOR CONSERVATOR Page 1 of 3 ❑ District Court ❑ Denver Probate Court ___________________ County, Colorado Court Address: In the Interest of : Protected Person COURT USE ONLY Attor ney or Party W ithout Attorney (n ame and ad dress): Phone Number: E-mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom PETITION FOR APPOINTMENT OF ❑ CO -CONSERVATOR ❑ SUCCES SOR CONSERVATOR This petition is submitted pursuant to § 15 -14 -112, C.R.S. and t he petitioner makes the following statements: 1. Petitioner , (name), i s an interested person . State relationship to protected person: 2. Letters of C onservatorship were issued on (date). 3. The previously appointed conservator , (name) : ❑ join s in this petition. ❑ tendered a resignation approved by the court on (date) . ❑ died on (date of death ). ❑ been removed by order of the court issued on (date). ❑ is the petitioner and hereby tenders his or her resignation . ❑ other: . 4. ❑ Petitioner is, 21 years of age or older, nominates himself or herself and requests to be appointed as ❑ Co - Conservator or ❑ Successor Conservator. or ❑ Petitioner nominates the following person, who is 21 years of age or older, to be appointed as ❑ Co - Conservator or ❑ Successor Conservator. Name: Relationship to Protected Person : Street Address: City: _________________________ State : ____________________ Zip Code: ________________ Mailing Address, if different: City: State: Zip Code: Primary Phone: ______________________ Alternate Phone: ________________________ Email Address: JDF 879 SC R6/19 PETITION FOR APPOINTMENT OF CO -CONSERVATOR OR SUCCESSOR CONSERVATOR Page 2 of 3 5. The nominated ❑ Co -Conservator or ❑ Successor Conservator has priority for appointment because he or she is: (§ 15 -14 -413, C.R.S.) ❑ a conservator, guardian , or other like fiduciary appointed or recognized by a court in another jurisdiction where the protected person resid es . ❑ nominated in writing by protected person, including nomination in a durable power of attorney or designated beneficiary . ❑ an agent appointed by the protected person to manage the protected person’s property under a durable power of attorney. ❑ the spouse or partner in a civil union of the protected person . ❑ an adult child of the protected person . ❑ a parent of the protected person . ❑ an adult with whom protected person has resided for more than 6 months immediately before the filing of thi s petition. 6. The co-conservator or successor conservator may receive compensation. ❑ The hourly rates to be charged, any amounts to be charged pursuant to a published fee schedule, including the rates and basis for charging fees for any extraordinary services, and any other bases upon which a fee charged to the estate will be calculated , are as stated below or in an attachment to this petition . * ❑ The basis of compensation has not yet been determined. * There is a continuing obligation to disclose any material changes to the basis for charging fees. (§15 -10 -602 , C.R.S.) 7. The co-conservator or successor conservator may compensate his, her, or its counsel. ❑ The hourly rates to be charged, any amounts to be charged pursuant to a published fee schedule, including the rates and basis for charging fees for any extraordinary services, and any other bases upon which a fee charged to the estate will be ca lculated , are as stated below or in an attachment to this petition . * ❑ The basis of compensation has not yet been determined. * There is a continuing obligation to disclose any material changes to the basis for charging fees. (§15 -10 -602 , C.R.S. ) 8. The petitioner hereby adopts the statements in the original petition for appointment that led to the appointment of the current conservator . 9. Petitioner requests that the nominee be appointed as co-conservator or successor conservator and that letters of conservatorship be issue d ❑ forthwith ❑ after the following event : JDF 879 SC R6/19 PETITION FOR APPOINTMENT OF CO -CONSERVATOR OR SUCCESSOR CONSERVATOR Page 3 of 3 ❑ 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 Executed on the ______ day of (date) (date) _______________________, _________, _______________________, _________, (month) (year) (month) (ye ar) at ______________________________________ at ______________________________________ (city or other location, and state OR country) (city or other location, and state OR country) _______________________________ _____________ __________________ (printed name) (printed name) _______________________________ _______________________________ (Signature of Petitioner ) (Signature of Co -Petitioner , if any) _______________________________ _________ __________________ Attorney Signature, (if any) Date 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* *Insert one of the following: hand delivery, first -class mail, certified mail, e -service, or fax. ___________________________________________ Signature Note: • The petitioner must contact the court to set a date and time for a hearing.