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CASE NU MBE R: GUA RDIANSHIP O R CONS ERVATO RSHIP O F (Nam e): MINOR OR CONSERVATEE GC-210(A- PF)/ GC-310(A- PF) Form Ad opted for Man datory Use Judicial Council of Ca lifornia GC-2 10(A-PF)/GC-310(A-PF) [New J uly 1, 2009] Bus & Prof. Co de, § 6501 Prob. Co de, § 1821 PROFESSIONA L FIDUCIA RY ATTACHMENT TO PETITION FOR APPOINTMENT OF GUAR DIAN OR CONSERVATOR (Prob ate—Gu ardi an shi ps an d Cons ervato rshi ps) PROFESSION AL FIDUCI ARY ATTACHMENT TO PETITION FOR APPOINTMENT OF GUA RDIAN OR CONSERVATOR 1. Business and Professions Code section 6501 (f). I am: Exemp t from the licen se requ ireme nts of the Pro fession al Fidu ciaries Act as an attorne y licen sed under the State Bar Act, A Certified Public Acco untant lice nsed by the California Sta te Board of Accountancy, An e nrolled ag ent au tho rized to practice before the Internal Revenu e Service unde r federal regula tions My actions as gu ardian or conserva tor would be within the sco pe o f practi ce of my profe ssio n by reason of the followi ng facts (expla in): a. License d by the Professiona l Fiducia ries Bureau , license no. (specify): b. , issued or last renewed on (sp ecify later date of issu ance or last re newal): . I am a proposed guardia n conservator in this matter. I am a profe ssional fi duciary, as defined in State Bar nu mbe r (specify): (1) license no. (specify): curren t expiration date (specify): (2) (3) (31 C.F .R. § 10 ), expiration dat e of curre nt enrol lme nt perio d (specify): Exemp t from the licen se requ ireme nts of the Pro fession al Fidu ciaries Act wh ile acti ng with in the scope of practice of my professi on as: c. Page 1 of 2 The expl anation canno t be co mp lete d in this s pace. It is co nta ined in attached pa ges. (Name of profe ssio nal fi duciary): Attachment to form (GC-2 10 or GC-3 10): (A professiona l fidu ciary petitioni ng for appo intmen t or prop osed for appo intmen t on th e pe tition of another must comple te page 1 of this form, and th e form must be atta ched to (1) a Petiti on for Appoin tment of Guardi an of Minor (form GC-210) if the profession al i s propo sed for appoi ntment a s gua rdian of a minor (see pa ragraph 4d of form GC-210 ); or (2) a Petition fo r Appoi ntment of Probate Conservator (form GC-31 0) if the professiona l is propo sed for a ppoin tment a s conservator (see paragrap h 3 c(7) of form GC-31 0). If the profession al fidu ciary is licensed an d is petitioni ng for appoi ntment as conservator, he or she must al so complete page 2 of this form (se e paragraph 3d of form GC-31 0). Th e profes sio nal fidu ciary must date an d sig n this for m on pag e 2 in all case s.) 2. CASE NUMBER: GUARDIANSHIP OR CONSERVATORSHIP OF (Name): MINOR OR CONSERVATEE GC-210(A-PF)/GC-310(A-PF) PROFESSIONAL FIDUCIARY ATTACHMENT TO PETITION FOR APPOINTMENT OF GUARDIAN OR CONSERVATOR PROFESSIONAL FIDUCIARY ATTACHMENT TO PETITION FOR APPOINTMENT OF GUARDIAN OR CONSERVATOR (Probate—Guardianships and Conservatorships) Page 2 of 2 GC-210(A-PF)/GC-310(A-PF) [New July 1, 2009] a. I was engaged to petition for this appointment by (name): The circumstances and manner of my engagement to file the petition for appointment of a conservator are (specify): b. c. Before my engagement in this matter, I had no prior relationship the prior relationship described below with the proposed conservatee, his or her family, or his or her friends (describe): I declare under of penalty of perjury under the laws of the State of California that the foregoing is true and correct (SIGNATURE OF PROFESSIONAL FIDUCIARY) (NAME OF PROFESSIONAL FIDUCIARY) Date: Attachment to form GC-310 I am a petitioner for the appointment of a conservator in this matter. (Select a. or b.):