Petition For Appointment Of Conservator Or Protective Order {PC 639}

Estate of Last four digits of SSN STATE OF MICHIGANPROBATE COURTCOUNTY OF PETITION FOR þ APPOINTMENT OF CONSERVATOR þ PROTECTIVE ORDER FILE NO. . Date County at þ Address þ County. assigned to Judge þ þ þ þ is no longer þ þ pending. þ þ a guardian. a representative payee for social security. 5. þ þ þ þ þ þ þ þ þ þ þ disappearance þ þ þ þ þ þ þ þ þ þ property or interest in real property. B C D E F G A American LegalNet, Inc. www.FormsWorkFlow.com $ Real property þ $ Personal property $ Insurance $ þ þ Social Security þ $ þ SSI þ $ þ MDHHS þ $ þ $ NAMEADDRESS AND TELEPHONE NUMBERRELATIONSHIPAGE/DOB(if minor)Street addressCityStateZipStreet addressCityStateZip . . .I REQUEST 13. Appoint . þ interest in real property. Attorney signature þ Date Petitioner signature Attorney address Petitioner address 17. NOMINATION BY PERSON TO BE PROTECTED: . Date H I J K L M N O P Q R S American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR COMPLETING"PETITION FOR APPOINTMENT OF CONSERVATOR"Please type or print neatly in black or blue ink.A B C D A E þ F þ G þ F and H þ þ accounts. I þ J K - þ J K . If you J L M N Q .O M .P Q R S American LegalNet, Inc. www.FormsWorkFlow.com