Decree And Order Of Protective Arrangement And-Or Appointment Of Special Conservator {MPC 734}

DECREE AND ORDER OF PROTECTIVE ARRANGEMENT Docket No. AND/OR Commonwealth of Massachusetts The Trial Court Probate and Family Court APPOINTMENT OF SPECIAL CONSERVATOR Division In the Interests of: First Name Middle Name Last Name Minor Adult Protected Person The Court finds the requirements of G.L. c. 190B, §5-408 have been met and that a basis exists for a protective arrangement or single transaction. 1. After primarily considering the decision that the Protected Person would have made if not disabled, or in the absence of evidence of personal preference, after consideration of the financial needs of the Protected Person and the needs of the individuals who are dependent on the Protected Person for support, the interest of creditors, the reduction of tax liabilities, eligibility for governmental assistance, previous patterns of giving or level of support, existing estate plans, the likely recipients of the Protected Person's bounty, the life expectancy of the Protected Person, the probability that the conservatorship will terminate and other relevant factors; The Court hereby authorizes, directs or ratifies the following transaction as being necessary or desirable to arrange for security, service or care in meeting the foreseeable needs of the Protected Person, or relating to the Protected Person's property and/or business affairs, or otherwise in the Protected Person's best interest: 2. The Court appoints the following person(s) as Special Conservator of the Protected Person: Name: First Name (Apt, Unit, No. etc.) M.I. (City/Town) Last Name (Address) (State) (Zip) Primary Phone #: The Special Conservator shall only have the following authority to assist in the accomplishment of the above-stated protective arrangement or single transaction: The Special Conservator(s) shall serve with personal or corporate surety on his, her or their bond in the amount of $ pursuant to G.L. c. 190B, §5-410. Within ninety days, the Special Conservator shall file a report with the Court as to all matters performed pursuant to this Decree and Order. The report shall include the following information: The Special Conservator shall serve until discharged by a Decree Discharging Special Conservator is entered by the Court. Date Justice of the Probate and Family Court MPC 734 (5/30/11) American LegalNet, Inc. www.FormsWorkFlow.com page 1 of 1