Free Microsoft Word - 552PC.dot - South Carolina

STATE OF SOUTH CAROLINA COUNTY OF: EX PARTE: Conservator/Petitioner IN RE:

Minor/Incapacitated Person:

) IN THE PROBATE COURT
) ) ) ) ) ) ) ) PETITION FOR EXPENDITURE (S) ) ) ) ) ) CASE NUMBER:

Petitioner is the duly appointed Conservator for the Minor/Incapacitated Person and is now actively engaged in the duties as such. The Minor/Incapacitated Person currently resides at , . S (he) has total cash assets of $ . Said Minor/Incapacitated Person is now in need of certain items, and your Petitioner requests permission of the Court to purchase the following: Item 1. 2. 3. If available, documentation supporting each requested expenditure is attached. SWORN to before me this , 20 day of Signature:
Name:
Address:
E-mail:
Telephone (O):
(H):
Estimated Cost Reason for Purchase

Notary Public for South Carolina My Commission Expires:

ORDER Upon reading the above Petition, questioning the Petitioner, and determining that the requested expenditures is in the best interest of the Minor/Protected person, IT IS ORDERED, that the said Conservator have permission to use $ specifically for the purpose so stated in the Petition. Receipts to be filed with the Court within 30 days from the date of this Order. Given under my hand and seal this day of , 20 .

, Probate Court Judge

FORM #552PC (2/2004) 62-5-411, 62-5-424