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Fee Declaration Conservator PR-96 - California
| Fee Declaration Conservator Form. This is a California form and can be used in Probate San Diego Local County . |
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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, MADGE BRADLEY, 1409 4TH AVE., SAN DIEGO, CA 92101 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 In the Matter of the CONSERVATORSHIP OF: CASE NUMBER FEE DECLARATION: CONSERVATOR Person Estate Instructions: A fee declaration is required when fees are requested by a Conservator of the Person and/or Estate. The declaration must be filled out completely and attachments should be used where additional space is needed. This form should not be used for Guardianships, Decedent's Estates or Trust matters. Section 1: IDENTITY OF PARTIES/GENERAL INFORMATION (Conservatorship of person and estate) This section is required to be completed for all fee requests (person and estate) a. Conservatee: b. Conservator: c. Conservator's relationship to conservatee: Registered Private Professional Conservator Family Member/Relative Other: d. If filing as a Private Professional Conservator, state your years of experience: e. Description of your experience, specialized training, and education that contributes to your expertise as a fiduciary: Attach additional pages, if necessary. f. Reporting period for this fee request: g. Number of months in this reporting period: Section 2: CONSERVATOR OF THE PERSON This section is required to be completed if you are seeking compensation as a conservator of the person. a. Type of residence of conservatee: Own home or apartment Assisted living facility Skilled nursing facility Retirement facility Board and care Other: Comments: b. Conservatee's ability to perform activities of daily living: Yes No With Assistance Ambulation Transferring (bed to chair) Personal hygiene Dressing Feeding SDSC PR-096 (Rev. 6/12) FEE DECLARATION: CONSERVATOR - Person - Estate Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com IN THE MATTER OF CASE NUMBER c. With respect to services provided during the accounting period for which the conservator of the person is requesting compensation, complete the following table indicating total hours, hourly rate and total fee requested by category: Category: Communication with Legal Counsel Communication with Family/Friends Arranging for: Residency/Living Situation (including but not limited to meals, clothing, personal care, housekeeping, and recreation) Health Care Transportation Recreation Other: Totals: Total Hours Hourly Rate Total Fee d. 1. 2. 3. 4. 5. 6. 7. 8. Calculation of average monthly fee: Total fees approved and paid during previous reporting period: Total hours approved and paid during previous reporting period: Average monthly fee during previous reporting period: (Total fees/total hours): Total fees requested during current reporting period: Total hours requested during current reporting period: Average monthly fee during current reporting period: 9. (Total fees/total hours): e. If, during the accounting period, a person or company assisted in monitoring the care of the conservatee, complete the following: Name of Hired Agent Function SDSC PR-096 (Rev. 6/12) FEE DECLARATION: CONSERVATOR Person Estate Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com IN THE MATTER OF CASE NUMBER Section 3: CONSERVATOR OF THE ESTATE This section is required to be completed if you are seeking compensation as conservator of the estate. a. With respect to services provided during the accounting period for which the conservator of the estate is requesting compensation, complete the following table indicating total hours, hourly rate and total fee requested by category: Category: Customary Annual Duties: Estate Administration (collecting income, paying bills, reconciling bank statements, etc.) Communication with Legal Counsel: Asset Management Preparation of Court Accounting Preparation of Fee Declaration Income Tax Return Compilation Management of Caregivers Health Care Issues Duties at Inception & Termination: Marshalling Assets Termination of Proceedings Other Services: Participation in Appointment Proceeding Sale of Assets Income Tax Return Preparation Litigation Tenancy Issues Other: Totals: Total fee request for Conservator of Estate: b. 1. 2. 3. 4. 5. 6. 7. 8. Total Hours Hourly Rate Total Fee Calculation of average monthly fee: Fees for services approved and paid during previous reporting period: Hours for services approved and paid during previous reporting period: Average monthly fee for services during previous reporting period: (Total fees/total hours): Fees for services approved and paid during current reporting period: Hours for services approved and paid during current reporting period: Average monthly fee for services during current reporting period: 9. (Total fees/total hours): c. If, during the accounting period, a person or company performed routine accounting services other than income tax preparation and were compensated by the estate, complete the following: Name of Hired Agent Function SDSC PR-096 (Rev. 6/12) FEE DECLARATION: CONSERVATOR Person Estate Page 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com IN THE MATTER OF CASE NUMBER Section 4: DETAILS OF SERVICES BY CATEGORY (person and estate) This section is required to be completed for all fee requests (person and estate). Attach the following information for each category of service described in Sections 2c and 3a of this declaration: 1. Name of category of service 2. Nature of services in this category 3. Results achieved 4. Describe and explain the level of difficulty of task (average/above-average/high) 5. Number of hours expended and hourly rate requested for each category I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Signature of Conservator SDSC PR-096 (Rev. 6/12) FEE DECLARATION: CONSERVATOR Person Estate Page 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com
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