Fill and Sign the Order Appointing Adult Guardian and Conservator Form

Nebraska State Court Form REQUIRED CC 16:2.1.3 Rev. 01/18 Neb. Rev. Stat. §§ 30-2633, 30-2639 ORDER APPOINTING CONSERVATOR IN THE COUNTY COURT OF ________________COUNTY, NEBRASKA IN THE MATTER OF Case No. ____________________ ___________________________ Protected Person ORDER APPOINTING CONSERVATOR The Petition for Appointment of Conservator having come before the court, the court finds as follows: 1. Petitioner(s) is/are entitled to file the Petition pursuant to Neb. Rev. Stat. § 30-2633. 2. Notice has been given or waived as required by law. 3. Venue in this county is proper. 4. Upon clear and convincing evidence presented to the court, there is a sufficient basis for the appointment of the conservator for ______________________________and there are no less restrictive alternatives than the appointment of a conservator for the above-named protected person. 5. Appointment of a conservator is necessary because 6. ___________________________is entitled to appointment pursuant to Neb. Rev. Stat. § 30-2639 and should be appointed as conservator. The above named person is authorized and ordered to obtain an Acknowledgment of Financial Institution Form completed by each financial institution holding any assets or accounts titled in any manner in the name of the ward/protected person along with a printout of all assets and account numbers in each financial institution, which shall be filed in these proceedings. 7. If any funds are ordered restricted, the above named person is further authorized and ordered to open an account at a financial institution with the restriction that no withdrawals can be made without a court order. To show the court that the conservator has complied with this restriction the conservator shall file with the court a Proof of Restricted account form within 10 days of this order. Page 1 of 3 Order Appointing Conservator CC 16:2.1.3 Rev 01/18 8. Bond: Is required and set in the sum of $_____________; Is not required because the assets of the ward/ protected person are less than $10,000 in value; Is not required because the court finds good cause: (check all that apply) a. All assets are ordered into restricted accounts. b. Other: 9. Training: The conservator shall complete training within 90 days; For good cause shown training is waived; IT IS THEREFORE ORDERED that ______________________________ shall be appointed conservator(s) of the estate of _________________________________________ upon Letters of Conservatorship being issued to the conservator(s) and upon the conservator(s) filing the following documents: 1. Acceptance of Appointment; 2. General Information form; 3. Address Information Sheet; 4. Acknowledgment of Financial Institution with a printout of all assets in each financial institution; 5. Proof of restricted funds form for any assets the court has ordered to be held in a restricted account; 6. Inventory and Affidavit of Due Diligence; 7. Personal and Financial Information for Guardianships and Conservatorships form; 8. Approved bond, if required. Upon completion of the filing requirements above and sending the appropriate forms to all interested persons, Letters will be issued which will appoint you as conservator. The conservator shall deliver to each financial institution where the protected person has accounts/assets a copy of the Letters Page 2 of 3 Order Appointing Conservator CC 16:2.1.3 Rev 01/18 of Conservatorship and file with the court an Acknowledgment from the Financial Institution that they received the letters along with a printout of all assets and account numbers in each financial institution. The conservator shall thereafter be entitled to deal with such assets. This form shall be filed within 10 days. Failure to file this form will result in a suspension of the conservator’s authority. As a conservator you are ordered to comply with the following restrictions: 1. The conservator shall not pay himself/herself/themselves or his/her/their attorney compensation from the assets or income of the protected person nor sell real property of the estate without first obtaining an Order from the court. To obtain an order, you must first file an application, give notice to interested persons, then have a hearing date scheduled. This Order may be entered without a hearing if all interested persons have waived notice of hearing or have executed their consent to such compensation or sale or any other restrictions as determined to be appropriate by the court. 2. The conservator shall not make any ATM withdrawals or receive cash back on debit transactions without a court order. 3. If any funds have been restricted by the court, the conservator shall not make any withdrawals from the restricted account without a court order. 4. Other: DATED: BY THE COURT: __________________________________ County Judge PREPARED AND SUBMITTED BY: Page 3 of 3 Order Appointing Conservator CC 16:2.1.3 Rev 01/18