Conservatorship Plan

SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION _________ INT _________ _________ IDD _________ In re: ________________________________ An Adult CONSERVATORSHIP PLAN I, ____________________________________________, appointed conservator in the above-captioned proceeding on __________________________, hereby submit the following conservatorship plan and attached inventory. THE FOLLOWING SERVICES ARE NECESSARY TO MANAGE THE FINANICAL RESOURCES DESIGNATED BY THE ORDER OF THE COURT: (Collecting assets, depositing, and investing assets, continuing or participating in the operations of businesses or other enterprises, etc.) THE MEANS BY WHICH THESE SERVICES WILL BE PROVIDED ARE: (Employment of persons such as investment advisors to advise or assist with conservator's duties.) THE MANNER IN WHICH THE INCAPACITATED INDIVIDUAL, GUARDIAN, CONSERVATOR, OR ANY OTHER INDIVIDUAL WHO HAS BEEN APPOINTED TO SERVE IN THAT CAPACITY WILL EXERCISE AND SHARE THEIR DECISION-MAKING AUTHORITY IS: (Report agreements regarding how decisionmaking authority will be shared.) April 2014 ­ 904.10.v2 American LegalNet, Inc. www.FormsWorkFlow.com THE POLICIES AND PROCEDURES GOVERNING THE EXPENDITURE OF FUNDS ARE: (Report agreements reached regarding expenditures of funds.) OTHER ITEMS THAT WILL ASSIST IN THE MANAGEMENT OF THE DESIGNATED FINANCIAL RESOURCES AND IN FULFILLING THE NEEDS OF THE INCAPACITATED INDIVIDUAL, THE TERMS OF THE COURT'S ORDER, AND THE DUTIES OF THE CONSERVATOR ARE: (Report the need, if any, for the Court to assign to conservator any duties or powers which the disabled person lacks the capacity to perform.) Attach a complete inventory of financial resources designated by the order of the Court. VERIFICATION I, ____________________________, being first duly sworn, on oath, depose and say that that I have read the foregoing pleading by me subscribed and that the facts therein stated are true to the best of my knowledge, information, and belief. _______________________________________ _______________________________________ Typed name of conservator Signature of conservator _______________________________________ Address (actual address/not Post Office Box) _______________________________________ _______________________________________ _______________________________________ Telephone number Email address _______________________________________ _______________________________________ Unified Bar number (if conservator is an attorney) April 2014 ­ 904.10.v2 American LegalNet, Inc. www.FormsWorkFlow.com Subscribed and sworn to before me this ____ day of ________________, 20______. _________________________________ Notary Public/Clerk CERTIFICATE OF SERVICE I certify that on the ____ day of ____________________, 20____, a copy of this filing was either eServed in accordance with the provisions of Administrative Order 13-15 or served by first class mail, postage prepaid, on the following persons (list names and complete mailing addresses): _________________________________ Signature April 2014 ­ 904.10.v2 American LegalNet, Inc. www.FormsWorkFlow.com