Petition For Appointment Of Conservator {10195}

IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION AT IN THE MATTER OF , No. Respondent. PETITION FOR APPOINTMENT OF CONSERVATOR (Sec. 475.062, RSMo) Comes now petitioner and states: 1. , age , domiciled in County, , whosepresent residence address is (Street) , (City) (State) (Zip) is unable by reason of to receive and evaluate informationto such an extent that respondent lacks ability to manage, (in part,) his financial resources without supervision or assistance and there are no less intrusive alternatives to (limited) conservatorshipavailable to provide for respondents financial needs. 2. The nature, extent, and estimated value of respondents assets so far as is known to petitioner the major part of which is located in County, Missouri is set forth in Exhibit A attached hereto and incorporatedherein by this reference. 3. The name and address of respondents parents, spouse and children and the childrens ages are set forth in exhibit B attached hereto and incorporated herein by this reference. 4. The name and address of the person having custody of respondent is: 5. The name and address of respondents guardian orconservator, if any, is: 6. The proposed conservator is not guardian or conservator for any other person except: Form 10195 Page1o f2 <<<<<<<<<********>>>>>>>>>>>>> 2 7. Attached hereto and incorporatedherein by this reference as Exhibit C is the consent of the proposed conservator to act if appointed. 8. If the proposed conservator is a non-resident of Missouri, attached hereto and incorporatedherein by this reference as Exhibit D is the proposed conservatorsdesignationof resident agent and the resident agents consent to act. 9. Respondent joins in this petition and consents to the appointment of the below named person as (limited) conservator of respondents estate. 10. Attached hereto and incorporated herein by this reference as Exhibit E is a list of the names and addresses of all persons who are co-depositorsor co-tenants with respondent as to all property in which respondent has an interest. WHEREFORE, petitioner prays that the court find respondent is (partially) disabled, and the court appoint: as (limited) conservator of the estate of respondent. The undersigned swears that the matters set forth in the foregoing petition are true and correct to the best knowledge and belief of the undersignedsubject to the penalties of making a false affidavit or declaration. Dated: . (Petitioner) (Address) (Telephone) Attorney for Petitioner: MO Bar No. Address: / ZipTelephone Number: ( ) Fax Number: ( ) E-Mail Address: Form 10195 Page2o f2