Free pc676.pmd - Michigan

Approved, SCAO

JIS CODE: PDG

STATE OF MICHIGAN PROBATE COURT COUNTY
CIRCUIT COURT - FAMILY DIVISION

PETITION TO TERMINATE MODIFY CONSERVATORSHIP
ADULT MINOR

FILE NO.

In the estate of 1. I am interested in this estate as
State relationship/interest

.

2. The individual to be protected has a spouse whose name and address are listed below. child(ren) whose name(s) and address(es) are listed below. parent(s) whose name(s) and address(es) are listed below. no living spouse, child(ren), or parent(s). The names and addresses of presumptive heirs are listed below. none of the above (must notify the Attorney General*).
NAME RELATIONSHIP ADULT/ MINOR ADDRESS AND TELEPHONE NO.

adult minor adult minor adult minor
* Notify the Attorney General by sending a copy of this form to: Attorney General, Public Administration, PO Box 30736, Lansing, MI 48909.

3. The reasons why the court should take action are:

I REQUEST that the court: 4. Terminate the conservatorship. 5. Accept the conservator's resignation. 6. Remove the conservator who 7. Appoint
Name (type or print)

has

has not

been suspended.
Address Telephone no.

City, state, zip

as successor conservator.

(PLEASE SEE OTHER SIDE)
Do not write below this line - For court use only

PC 676 (9/08)

PETITION TO TERMINATE/MODIFY CONSERVATORSHIP

MCL 700.5414, MCL 700.5415, MCL 700.5431, MCR 5.125(C)(25)

8. Appoint

Name (type or print)

Address Telephone no.

City, state, zip

as temporary conservator pending appointment of a successor. 9. Modify the powers of the conservator as follows:

I declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best of my information, knowledge, and belief.
Date Attorney signature Name (type or print) Address City, state, zip Telephone no. Bar no. Petitioner signature Name (type or print) Address City, state, zip Telephone no.

NOMINATION BY MINOR: I am 14 years of age or older. I nominate
Name Address City State

as conservator, who lives at .
Zip

Date

Signature of minor