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Conservatorship Questionnaire - California
| Conservatorship Questionnaire Form. This is a California form and can be used in Civil Kings Local County . |
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0B(local form) 2BFOR In the Superior Court of the State of California 1BIn COURT USE ONLY (RECEIVED ON): and for the County of Kings CONSERVATORSHIP QUESTIONNAIRE CASE NUMBER: 4BUInstructions In order to begin the investigation ordered by the Court, you must complete this questionnaire and return it to: County Superior Court 449 "C" Street Lemoore, CA 93245 Attention: Court Investigator 3BKings PETITION IS FOR: Person Only Estate PETITIONER'S INFORMATION (PROPOSED CONSERVATOR): Name: Social Security Number: Drivers License Number: Date of Birth: State issued: / / Person and Estate Your address (Street, City, State and Zip Code): Home Telephone: ( Business Telephone: ( ) ) Cell number: ( ) Your relationship to the Conservatee: Name of your attorney, if applicable: Telephone number: ( ) Address of attorney (Street, City, State and Zip Code): ____________________________________________________________________________________________________________ Conservatorship Questionnaire Rev 04-15-11 Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com PETITIONER'S INFORMATION (PROPOSED CONSERVATOR): Name: Social Security Number: Drivers License Number: Date of Birth: State issued: / / Your address (Street, City, State and Zip Code): Home Telephone: ( Business Telephone: ( ) ) Cell number: ( ) Your relationship to the Conservatee: Name of your attorney, if applicable: Telephone number: ( ) Address of attorney (Street, City, State and Zip Code): CONSERVATEE'S INFORMATION : Name: Current address (Street, City, State and Zip Code): Home Telephone: ( Business Telephone: ( ) ) Cell number: ( ) Date of Birth: / / Where can they be reached during the day: During what hours: Name of attorney for Conservatee, if applicable: Address of attorney (Street, City, State and Zip Code): Is Conservatee a client of Central Valley Regional Center? If yes, name of case manager: no yes ) Telephone number: ( ) Telephone number: ( I N F O R M A T I O N O N T H E LIVING R E L A T I V E S OF T H E C O N S E R V A T E E: Father: Address (Street, City, State and Zip Code): Telephone # ( ) Mother: Address (Street, City, State and Zip Code): Telephone # ( ) ____________________________________________________________________________________________________________ Rev 04-15-11 Conservatorship Questionnaire Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Brother: Address (Street, City, State and Zip Code): Telephone # ( ) Brother: Address (Street, City, State and Zip Code): Telephone # ( ) Brother: Address (Street, City, State and Zip Code): Telephone # ( ) Brother: Address (Street, City, State and Zip Code): Telephone # ( ) Sister: Address (Street, City, State and Zip Code): Telephone # ( ) Sister: Address (Street, City, State and Zip Code): Telephone # ( ) Sister: Address (Street, City, State and Zip Code): Telephone # ( ) Sister: Address (Street, City, State and Zip Code): Telephone # ( ) Spouse: Address (Street, City, State and Zip Code): Telephone # ( ) Child: Address (Street, City, State and Zip Code): Telephone # ( ) Child: Address (Street, City, State and Zip Code): Telephone # ( ) Child: Address (Street, City, State and Zip Code): Telephone # ( ) Child: Address (Street, City, State and Zip Code): Telephone # ( ) ____________________________________________________________________________________________________________ Conservatorship Questionnaire Rev 04-15-11 Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com
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