Fill and Sign the Users Manual Colorado Judicial Branch Form

JDF 800 SC R7/19 ACKNOWLEDGMENT OF RESPONSIBLITIES Page 1 of 2 ❑District Court ❑Denver Probate Court _________________________________ County, Colorado Court Address: In the Interest of: Protected Person COURT USE ONLY Case Number: Division: Courtroom: ACKNOWLEDGMENT OF RESPONSIBILITIES ❑ CONSERVATOR AND/OR ❑ GUARDIAN I, (name) , acknowledge that I was appointed as the conservator and/or guardian for (ward or protected person) on (date) and I understand that Letters of Guardianship/Conservatorship will not be issued until this form is signed and provided to the court. I agree to comply with statutory and court requirements and understand that I am responsible for preparing and filing reports a nd /or plans with the court and providing copies to all interested persons as identified in the Order of Appointment . I have received the following information to review regarding my responsibilities. ❑ User’s Manual for Guardians ❑ User’s Manual for Conservators ❑ Viewed DVD/Video ❑ Pamphlets ❑ Attendance at mandatory training session on (date). ❑ Other: Acknowledgment of Re sponsibilities : 1. I am responsible for promptly providing the court with any changes to my mailing address, email address, and telephone number by filing a Notice of Change Regarding Contact Information (JDF 725) . 2. I am responsible for maintaining supporting documentation for all receipts into the accounts and all disbursements out of the accounts under my control during the duration of my appointment . Supporting documentation includes bank statements and check copies , credit card statements and receipts, sales receipts, and other such forms of proof that support my r eports . I understand that the court or any interested person s may request copies at any time. 3. If funds must be placed in a restricted account, I understand that any withdrawals require a court order. ❑ The Acknowledgment of Deposit of Funds to Restricted Account (JDF 86 7) must be return ed to the court as documentation that the funds were deposited , within 45 days or by _______________ (date). ❑ All requests for withdrawal must be in writing by submitting a Motion to Withdraw Funds ( JDF 86 8). 4. I understand that the following reports and/o r plans are due on (date). ❑ Initial Guardian ’s Report /Care Plan - Adult (JDF 850) ❑ Conservator’s Financial Plan with Inventory and Motion for Approval (JDF 88 2) 5. I understand that the following reports are due on (date) and every year there after on s uch day and month , unless I am notified by the court : ❑ Guardian’s Report - Minor (JDF 834) ❑ Guardian ’s Report - Adult (JDF 850 ) ❑ Conservator’s Report ( JDF 8 85 ) 6. I understand that as a court -appointed guardian and/or conservator, I am required by law to report any known or suspected abuse, neglect , or exploitation of an y at-risk elder (a person 70 years of age or older) to law enforcement. I understand that criminal penalties may result from failure to comply with this law. Please refer to § 18 -6.5 -108, C.R.S. for additional information. JDF 800 SC R7/19 ACKNOWLEDGMENT OF RESPONSIBLITIES Page 2 of 2 7. I understand that all reports must be filed on the most current version of the form and that the forms are available on the state court website: http://www.courts. state.co.us ❑ 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. My signature below indicates that I have read and understand my responsibilities as a newly appoint ed guardian and/or conservator. VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Execut ed on the ______ day of Executed on the ______ day of (date) (date) _______________________, _________, _______________________, _________, (month) (year) (month) (year) at ______________________________________ at ______________________________________ (city or other location, and state OR country) (city or other location, and state OR country) _______________________________ ______________________ _________ (printed name) (printed name) _______________________________ _______________________________ (Signature of Guardian/Conservator/Successor) (Signature of Co -Guardian/Co -Conservator/Successor, if any)