Free PC-503 - Connecticut

APPLICATION/APPOINTMENT OF GUARDIAN OF THE ESTATE PC-503 REV. 11/00

STATE OF CONNECTICUT
RECORDED:

COURT OF PROBATE [Type or print in black ink.] [Use separate application for each minor.] DISTRICT NO. ATTORNEY FOR MINOR [If applicable.] DATE OF MINOR'S BIRTH

TO: COURT OF PROBATE, DISTRICT OF IN THE MATTER OF [Name, actual residence, zip code, and social security number.]Hereinafter referred to as the minor.

PETITIONER [Name, address, zip code, and telephone number. If counsel for minor, also list juris number.] RELATIONSHIP OF
PETITIONER TO MINOR

PARENT(S) OF MINOR [ Name(s), address(es), zip code(s), and telephone number(s). If deceased, so state and attach death certificate (s).]

COURT-APPOINTED GUARDIAN OF THE PERSON OF THE MINOR, if any. [Name, address, zip code, and telephone number.]

PROPOSED GUARDIAN(S) OF THE ESTATE [Name(s), address(es), zip code(s), and telephone number(s). C.G.S. §45a-629.]

THE PETITIONER STATES UNDER PENALTY OF FALSE STATEMENT: that the minor is entitled to $ of personal property and $ of real property;

that said minor, born on the date written above, resides at the place written above in said district, and is entitled to estate; that said minor, whose parent(s) or guardian(s) of the person are named above, has no guardian of the estate; that said minor that said minor that said minor is has is is not receiving aid or care from the State. [C.G.S. §45a-630]; has not received aid or care from the State in the past; AND is not receiving benefits from the Veterans' Administration. [C.G. S. §45a-593(b).]

WHEREFORE, THE PETITIONER requests that the proposed guardian(s) named above or some institution or other suitable adult person(s) be appointed guardian(s) of the named minor's estate. The representations contained herein are made under the penalties of false statement.

Date:

.......................................................................... Petitioner: PROPOSED GUARDIAN(S) OF THE ESTATE

If appointed, I/we will accept said position(s) of trust. ............................................................................ Proposed Guardian's Signature Type Name: .......................................................................... Proposed Guardian's Signature Type Name: MINOR'S CHOICE OF GUARDIAN(S) I, said minor, being twelve years of age or over, hereby choose the proposed guardian(s) written above as guardian(s) of my estate. Name of Witness [Type or print.] Signature of Witness......................................................................
APPLICATION/APPOINTMENT OF GUARDIAN OF THE ESTATE PC-503

......................................................................... Minor's Signature Type Name:

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