COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.PROBATE COURT OF MONTGOMERY COUNTY, OHIOALICE O. McCOLLUM, JUDGEJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)CONSERVATORSHIP OF CASE NO.CONSERVATORSHIP OF CASE NO.APPLICATION FOR APPOINTMENT OF CONSERVATOR (R.C. 2111.021)APPLICATION FOR APPOINTMENT OF CONSERVATOR (R.C. 2111.021)I,, Petitioner, hereby state that I am a competent adult but amI,, Petitioner, hereby state that I am a competent adult but am. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .physically infirm. I request that:physically infirm. I request that:1. Name of Proposed Conservator1. Name of Proposed ConservatorTHE PEOPLE OF THE STATE OF NEW YORK TOStreetStreetCity, Ohio (Zip)TelephoneCity, Ohio (Zip)Telephonebe appointed conservator of my:be appointed conservator of my:Person and EstatePerson OnlyEstate OnlyPerson and EstatePerson OnlyEstate OnlyGREETINGS:2. The length (time period) of the conservatorship is:2. The length (time period) of the conservatorship is:IndefiniteDefinite -toIndefiniteDefinite -to,,WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,3. (If "Person Only" or "Person and Estate" is checked), I give the following power over my PERSON to the:3. (If "Person Only" or "Person and Estate" is checked), I give the following power over my PERSON to the:located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in rooma.Conservator:a.Conservator:(1) All powers that a guardian would have under the guardianship laws of Ohio.(1) All powers that a guardian would have under the guardianship laws of Ohio.(2) Limited to the power to(2) Limited to the power toYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.b.Court:b.Court:, one of the Justices of the(1) All powers that a Court would have under the guardianship laws of Ohio.(1) All powers that a Court would have under the guardianship laws of Ohio.Court in Witness, Honorableday of, 20 County,(2) Limited to the power to(2) Limited to the power to(Attorney must sign above and type name below)Attorney(s) for4. (If "Estate Only" or "Person and Estate" is checked), I give the following power over my ESTATE to the:4. (If "Estate Only" or "Person and Estate" is checked), I give the following power over my ESTATE to the:a.Conservator:a.Conservator:(1) All powers that a guardian would have under the guardianship laws of Ohio.(1) All powers that a guardian would have under the guardianship laws of Ohio.Office and P.O. Address(2) Limited to the power to(2) Limited to the power toTelephone No.: Facsimile No.: E-Mail Address:09/01/9109/01/91Page 1 of 2Page 1 of 2FORM 20.0 -APPLICATION FOR APPOINTMENT OF CONSERVATORFORM 20.0 -APPLICATION FOR APPOINTMENT OF CONSERVATORMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.CASE NO. b.CASE NO. b.Court:Court:(1) All powers that a Court would have under the guardianship laws of Ohio.(1) All powers that a Court would have under the guardianship laws of Ohio.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)(2) Limited to the power to(2) Limited to the power toc.The following of my property is subject to the foregoing powers:c.The following of my property is subject to the foregoing powers:(1) All property. (attach description of property) (2) Only the property listed as follows:(1) All property. (attach description of property) (2) Only the property listed as follows:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TO5. If the application is for a conservatorship of the estate:5. If the application is for a conservatorship of the estate:a. The estate to be placed under conservatorship is:a. The estate to be placed under conservatorship is:GREETINGS:Personal Property Real Property Annual Rents Other Annual Income$$$$$Personal Property Real Property Annual Rents Other Annual Income$$$$$WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomTOTALTOTALb. A bond in the amount of $is attached.b. A bond in the amount of $is attached.(R.C. 2109.04(A)(1))(FORM 20.30) 6. Service of notice of the conservatorship is to be given to:(R.C. 2109.04(A)(1))(FORM 20.30) 6. Service of notice of the conservatorship is to be given to:Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.NoneSame as GuardianshipNoneSame as GuardianshipAs Listed on Form 15.0As Listed on Form 15.0Based on the foregoing information, I do hereby petition the Court to appoint a Conservator for myself, and do so freely and of my own will. I certify that all information and statements contained in this application and the attached exhibits are correct to the best of my knowledge and belief.Based on the foregoing information, I do hereby petition the Court to appoint a Conservator for myself, and do so freely and of my own will. I certify that all information and statements contained in this application and the attached exhibits are correct to the best of my knowledge and belief., one of the Justices of theCourt in Witness, Honorableday of, 20 County,DateDate(Attorney must sign above and type name below)Attorney's SignatureAttorney's SignatureApplicant's SignatureApplicant's SignatureAttorney(s) forType or print Attorney's NameType or print Attorney's NameType or print Applicant's NameType or print Applicant's NameStreetStreetStreetStreetOffice and P.O. AddressCity, State, Zip Co
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