Fill and Sign the Temporary Conservatorship Form

FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF CASE NUMBER: ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FAX NO. (Optional): GC-112 STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: Applicant (name): a. person is Probate Code, § 2250; Cal. Rules of Court, rule 7.1062 Form Approved for Optional Use Judicial Council of California GC-112 [New January 1, 2009] Page 1 of 3 A proposed temporary conservator. CONSERVATOR of the Person Estate TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): EX PARTE APPLICATION FOR GOOD CAUSE EXCEPTION TO NOTICE OF HEARING ON PETITION FOR APPOINTMENT OF TEMPORARYCONSERVATEE (Name): EX PARTE APPLICATION FOR GOOD CAUSE EXCEPTION TO NOTICE OF HEARING ON PETITION FOR APPOINTMENT OF TEMPORARY CONSERVATOR (Probate—Guardianships and Conservatorships) b. 1. 2. Immediate and substantial harm would be c aused to the proposed conservatee, or his or her estate, during the notice period required by Probate Code section 2250(e) because of the following (check all that apply): a. A medical emergency (give a brief description): b. A financial emergency (give a brief description): c. Other immediate and substantial emergency (give a brief description): (A medical emergency must be immedi ate and substantial; treatment must be reasonably unavailable unless a temporary conservator is appointed an d cannot wait for the notice period because of the proposed conservatee’s pain or extreme discomfort or a significant risk of harm.) (A financial emergency must be immediat e and substantial. Means other than an exception to notice of hearing on the appointment of a temporary conservato r must be shown likely to be ineffective to prevent loss or further loss to the proposed conservatee’s estate during the notice period.) (An emergency must be immediate and likely to cause substantial harm to the proposed conservatee during the notice period.) TEMPORARY CONSERVATORSHIP OF A petitioner for appointment of a temporary conservator of the est ate of the proposed conservatee. Note to Applicant: Please review the instructions in item 6 on page 3 and at the bottom of that page for completing this form and supporting documents. CASE NUMBER: GC-112 [New January 1, 2009] Page 2 of 3 GC-112 (Name): CONSERVATEE EX PARTE APPLICATION FOR GOOD CAUSE EXCEPTION TO NOTICE OF HEARING ON PETITION FOR APPOINTMENT OF TEMPORARY CONSERVATOR (Probate—Guardianships and Conservatorships) 4. Name Relationship to proposed conservatee 5.An exception to giving notice to the pers on or persons named below should be made because Applicant cannot find him, her, or them, despite the exercise of due dili gence to search for him, her, or them (state names and relationships to the proposed conservatee of all persons who could not be found): Name Relationship to proposed conservatee 3. Instead of an exception to giving notice to the persons named in item 3c, Applicant requests that (check all that apply): Name Relationship to proposed conservatee b. c. a. The person or persons, and his, her, or their relati onship to the proposed conservatee are as follows (specify): Additional persons and relationships are listed on attachment 3c. Additional persons and relationships are listed on attachment 4. Additional person(s) and relationship(s) are listed on attachment 5. The time period of notice to the person or pe rsons named in item 3c be changed as follows (specify number of days of notice or number of hours if less than one day): The method of giving notice to th e person or persons named in item 3c be changed as follows (specify method of service; for example, personal delivery, fax, or e-mail): An exception to giving notice to the person or persons na med below should be made because of the potential harm to the proposed conservatee, or his or her estate, if notice is given (include in this category persons who might not cause harm themselves, but to whom notice should not be given because t he notice is likely to bring harm to the proposed conservatee through the actions of another person. State the names and re lationships to the proposed conservatee of all persons who should not be given notice): TEMPORARY CONSERVATORSHIP OF GC-112 [New January 1, 2009]X Page 3 of 3 (SIGNATURE OF APPLICANT OR ATTORNEY FOR APPLICANT) (TYPE OR PRINT NAME OF APPLICANT OR ATTORNEY FOR APPLICANT) Date: GC-112 EX PARTE APPLICATION FOR GOOD CAUSE EXCEPTION TO NOTICE OF HEARING ON PETITION FOR APPOINTMENT OF TEMPORARY CONSERVATOR (Probate—Guardianships and Conservatorships) 6. The following documents are present ed with this application in support: Supporting declaration of (name): Declaration regarding notice of ex parte application of (name): f. g. Proposed order. (A proposed order must be submitted wit h this application. You may use the Order on Ex Parte Application For Good Cause Exception to Notice of Hearing on Pe tition For Appointment of Temporary Conservator ( form GC-115) for the order.) Applicant's Petition for Appointment of Temporary Conservator (form GC-111); h. Other (describe): (At least one declaration supporting the grounds for a good cause exception to notice stated in items 2–5 of this application, showing facts within the personal knowledge of the person signi ng the declaration (or the declaration of an expert witness) is required. See rule 7.1062(e)(2 ) of the California Rules of Court and Evidence Code sections 800–805. You may use forms GC-112(A-1) and GC-112(A-2) fo r all supporting declarations.) (This declaration is required with this appl ication. See rules 3.1204(b) and 7.1062(e)(3). INSTRUCTIONS 1. The court for good cause may order an exception to the notice requirements described above for some or all of the persons entit led to notice, either by waiving or dispensin g with notice to them entirely or by changing the time and manner of giving notice to them. This form and the other forms or documents that support it listed in item 6 above may be used to request an exception to the no tice of hearing on a temporary conservatorship pet ition. See rule 7.1062 of the California Rules of Court for the standards for goo d cause exceptions to the notice requirements on a petition for ap pointment of a temporary conservator and for the required contents of a request for a good cause exception. Who must be given notice of a hearing on a peti tion for appointment of a temporary conservator? 2. At least five days’ advance notice must be given (1) by personal delivery to the proposed conservatee and (2) by mail or personal delivery to the proposed conservatee’s spouse or registered domestic partner and the proposed conservatee’s brothers and sisters, parents, grandparents, and child ren and grandchildren at least 12 years old or the parents, guardians or legal custodians of children or grandchildren under that age. If the proposed conservatee has no spouse or registered domestic partner and none of the relatives listed above, certain other persons mu st receive notice by mail or personal delivery. If the proposed temporary conservator has no prior relationship with the proposed conservatee, the public guardian of the county where the petition is filed must also be given notice by mail or personal delivery. See Probate Code se ctions 2250(e) and 1821(b). Written notice is given by delivery, in person or by mail, of a filled-out Notice of Hearing—Guardi anship or Conservatorship (form GC-020) showing the time and place of the hearing and the nature of the relief to be requested, together with a copy of the Petition for Appointment of a Temporary Conservator (form GC-111). CASE NUMBER: (Name): CONSERVATEE TEMPORARY CONSERVATORSHIP OF Supporting declaration of (name): Supporting declaration of (name): Supporting declaration of (name): Good cause exception to notice a. b.c. d. e.