Fill and Sign the Petition Physical Form

IN THE _______________ COURT OF ______________________ (County), ________________________________________ (State) IN THE MATTER OF THE CONSERVATORSHIP (or Guardianship) OF __________________________________ CAUSE NO. ________________ PETITION FOR APPOINTMENT OF CONSERVATOR OF _____________________________________ Comes now ___________________________________, (Petitioner) who petitions and represents unto this Honorable Court as follows: I. __________________________________, (Petitioner) an adult resident citizen of _____________________________________________________ (County and State), is the ______________________________ (designate relationship) of ____________________________________ (Proposed Conservatee), an adult resident citizen of _____________________________________________ (County and State). II. That ___________________________________ (Proposed Conservatee) , b ecause of physical or mental infirmity or age, is unable to handle his affairs. III. The approximate value of the personal estate of ___________________________ __________________ (Proposed Conservatee) is $_______________. IV. The anticipated gross annual income and other receipts from the personal estate of ___________________________________ (Proposed Conservatee) is $_____________. V. ___________________________________ (Petitioner) is the __________________________ (state relationship) of ___________________________ ___________________ (Proposed Conservatee) and is qualified to serve as the Conservator of the person and estate of _ _______________________________________ (Proposed Conservatee) . VI. The names and post-office addresses of the nearest adult relatives of _______________________________________ (Proposed Conservatee) are as follows: Name Relationship to (Proposed Conservatee) Address ______________________ ________________ _____________________________ ______________________ ________________ _____________________________ ______________________ ________________ _____________________________ ______________________ ________________ _____________________________ ______________________ ________________ _____________________________ ______________________ ________________ _____________________________ WHEREFORE, PREMISES CONSIDERED , Petitioner prays: 1. That said ___________________________________ (Petitioner) , be appointed by this Court as Conservator of the Person and Estate of ___________________________________ (Proposed Conservatee) and to have charge and custody of ___________________________________ (Proposed Conservatee) and his personal estate, with the responsibilities, duties and powers as described in _____________________________________ (cite appropriate statute). 2. And if Petitioner has prayed for wrong and improper relief, then he prays for such other, further and general relief as they may be entitled to in the premises, and as in duty bound, he will ever pray. Respectfully submitted, ____________________________________ PETITIONER Acknowledgment (may vary by state) STATE OF ______________ COUNTY OF ____________ Personally appeared before me, the undersigned authority in and for the aforesaid jurisdiction, the within-named ___________________________________ (Petitioner) , who, after having been first duly sworn, stated on oath that the matters and facts set forth in the above and foregoing Petition are true and correct as therein stated. ___________________________ PETITIONER SWORN to and subscribed before me, this the day of _________, 20___. Notary Public My Commission Expires: