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Declaration Of Private Professional Conservator Or Guardian-Qualifications (Probate-Guardianships) GC-005 - California
| Declaration Of Private Professional Conservator Or Guardian-Qualifications (Probate-Guardianships) Form. This is a California form and can be used in Probate Guardianship-Conservatorship Judicial Council . |
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CONFIDENTIAL--FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: FOR COURT USE ONLY GC-005 NAME OF PROFESSIONAL GUARDIAN OR CONSERVATOR (specify): FILE NUMBER: CONSERVATOR DECLARATION OF PRIVATE PROFESSIONAL CONCERNING QUALIFICATIONS FOR APPOINTMENT GUARDIAN NOTICE TO COURT-APPOINTED PRIVATE PROFESSIONAL CONSERVATORS OR GUARDIANS: If you are a private professional conservator or guardian under Probate Code section 2341 and have been appointed by a court, you must annually file an information statement with each court that appointed you. Beginning with the first statement due after January 1, 2006, your information statement must show your qualifications to serve or continue to serve as a guardian or conservator under rules 7.1060(b) (conservators) or 7.1010(b) (guardians) of the California Rules of Court. You must make that showing by completing and signing this form and filing it as part of your information statement with each appointing court. One declaration is sufficient if you are both a private professional conservator and a private professional guardian. You may be required by the court to furnish additional information in your annual statement. If so, check item 8 of this form and provide the additional information in the manner required by the court or, if no specific manner is required, in Attachment 8 to this form. Beginning with the first annual statement due after December 31, 2007, your information statement must also show compliance with the continuing education requirements of rules 7.1060(e) or 7.1010(e) for the previous calendar year. You must complete and file a Declaration of Private Professional Conservator or Guardian--Continuing Education (form GC-006) with your information statement for that purpose. Declarant (name): 1. Contact information (complete in all cases): a. Name: Business or firm name: b. Business Address: City: c. Mailing Address: d. E-mail: e. Telephones: Day: Night: 2. Personal or professional conduct (complete in all cases): I have not (specify all that apply): a. b. c. 3. Fax: County: State: State: Zip: Zip: + + states as follows: Cell (optional): Been convicted of a misdemeanor involving abuse or neglect of a child or an elderly or dependent adult or of any felony. Been determined to be liable in a civil action or proceeding for conversion, embezzlement, fraud, misappropriation, misrepresentation, or theft. Been removed as a fiduciary by a court for actions involving breach of fiduciary duty, conversion, fraud, misappropriation, misrepresentation, or theft. Previous qualifications declaration filed (If you submitted this form with an annual statement previously filed with this court, you may check and complete this item and disregard all following items (except item 8) that request information unchanged from your prior declaration. In all cases, complete the signature information and sign at the bottom of page 4 of this form.) On (date): I filed with this court a completed Declaration of Private Professional Conservator or Guardian--Qualifications (form GC-005). Except as otherwise stated in this declaration, each of the statements made in that declaration are still true and correct as of the date of this declaration. All information requested of in this me declaration was provided by me in that previously filed declaration. Page 1 of 4 Form Adopted for Mandatory Use Judicial Council of California GC-005 [Rev. July 1, 2007] DECLARATION OF PRIVATE PROFESSIONAL CONSERVATOR OR GUARDIAN--QUALIFICATIONS (Probate--Guardianships and Conservatorships) Probate Code, ยง 2344; Cal. Rules of Court, rules 7.1010, 7.1060 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com CONFIDENTIAL--FOR COURT USE ONLY DECLARATION OF PRIVATE PROFESSIONAL (Name): 4. CONSERVATOR GUARDIAN FILE NUMBER: GC-005 CONCERNING QUALIFICATIONS FOR APPOINTMENT Personal information (complete unless item 3 applies): a. Date of birth: b. Height: c. Eye color: e. Social security number: d. California driver's license or DMV identification: 5. Education and experience (Complete unless item 3 applies. You must show that you have satisfied at least one of items 5a through 5e. Check all that apply. If you do not satisfy item 5c, you must also complete item 6.) I have: (1) A four-year undergraduate degree or equivalent from the following institution, an accredited educational a. institution within the meaning of rule 7.1060 or 7.1010: (a) Institution: (b) Degree (describe): (c) Date awarded: (2) AND one or more of the following: (a) A minimum of two years' employment experience in a position and with an entity described in rule 7.1060(b)(2)(A)(i) or 7.1010(b)(2)(A)(i), as follows: Employer (name and type of entity or firm): Position and responsibilities (describe): Inclusive dates of employment: (b) Continued on Attachment 5a(2)(a). A minimum of two years' experience as a court-appointed conservator or guardian of the person or estate of an adult or a minor, as follows: Appointing court (name of court, and state and county or other district designation): (c) Case number: Inclusive dates of appointment: Name of conservatee or ward: Continued on Attachment 5a(2)(b). A certificate as a paralegal from an accredited educational institution and a minimum of two years' employment as a paralegal with a primary emphasis in a probate-related area of practice, as follows: Certifying institution (specify): Employer (name): Paralegal duties (describe): Inclusive dates of employment: b. Continued on Attachment 5a(2)(c). (1) A two-year undergraduate degree or equivalent in a behavioral science, or in business, nursing, or accounting from the following institution, an accredited educational institution within the meaning of rule 7.1060 or 7.1010: (a) Institution: (b) Degree (describe): (c) Date awarded: GC-005 [Rev. July 1, 2007] DECLARATION OF PRIVATE PROFESSIONAL CONSERVATOR OR GUARDIAN--QUALIFICATIONS (Probate--Guardianships and Conservatorships) Page 2 of 4 CONFIDENTIAL--FOR COURT USE ONLY DECLARATION OF PRIVATE PROFESSIONAL (Name): 5. b. CONSERVATOR GUARDIAN FILE NUMBER: GC-005 CONCERNING QUALIFICATIONS FOR APPOINTMENT (2) AND one or more of the following: (a) A minimum of five years' employment experience in a position and with an entity described in rule 7.1060(b)(2)(A)(i) or 7.1010(b)(2)(A)(i), as follows: Employer (name and type of entity or firm): Position and responsibilities (describe): Inclusive dates of employment:
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