Free District Court Denver Juvenile Court - Colorado

District Court Denver Probate Court __________________________________ County, Colorado Court Address: ____________________________________________________ In the Interests of: ___________________________________________ Ward/Protected Person Attorney or Party Without Attorney (Name and Address): ___________________________________________ ___________________________________________ Phone Number:_______________E-mail:______________________ FAX Number:_________________Atty. Reg. #:__________________

COURT USE ONLY Case Number:___________________

Division ___________Courtroom_______

PETITION REQUESTING COLORADO TO ACCEPT GUARDIANSHIP CONSERVATORSHIP FROM SENDING STATE PURSUANT TO §15-14.5-302, C.R.S.
The Petitioner hereby submits certified copies of any documents evidencing authority to act (Order of Appointment, Letters) and the Provisional Order of Transfer from the sending state relating to a Guardianship Conservatorship, as identified below: Sending State: _______________________Sending Court: ________________________________________ Sending Court Case #: ___________________

1. Information about the Guardian and/or Conservator: Name: _________________________________________ Address: _______________________________________________________________________________ City: ____________________ State: _____ Zip Code: _________ Home Phone #: ____________________ Email Address: _______________________________Work Phone #: ______________________________

2. Information about the Ward/Protected Person: Name: ____________________________________ Current age: _____ Date of Birth: __________________ Address (Include name of facility): ___________________________________________________________ _______________________________________________________________________________________ City: ____________________ State: ___ Zip Code: ________ Telephone Number: ____________________ Type of Residence: Private Nursing Home Assisted Living Home Other: ____________________

3. The Guardian and/or Conservator shall provide the Ward/Protected Person, Ward/Protected Person's spouse, parents, adult children or an adult relative, person who had primary care and control of the Ward/Protected Person, and/or their property, any legal representatives and any interested person with notice of this Petition and JDF 712 ­ Notice of Non-Appearance Hearing.

JDF 783 9/08

PETITION REQUESTING COLORADO TO ACCEPT GUARDIANSHIP/CONSERVATORSHIP

Page 1 of 2

4. The interested persons receiving notice are as follows: Name of Interested Person Requiring Notice in Sending State Relationship to Ward/Protected Person

Name of Interested Person Requiring Notice in Colorado, not listed above

Relationship to Ward/Protected Person

Date: _________________________

____________________________________________ Signature of Guardian and/or Conservator

CERTIFICATE OF SERVICE
I certify that on ________________________ (date) a copy of this Petition Requesting Colorado to Accept Guardianship/ Conservatorship from Sending State was served on each of the following:
Name Relationship to Ward/Protected Person Address Manner of Service*

*Insert one of the following:

Hand Delivery, First-Class Mail, Certified Mail, E-Served or Faxed.

______________________________________ Signature Note: It is the responsibility of the Guardian and/or Conservator to file the Provisional Order to Accept Transfer issued by the Colorado Court and to file the appropriate documents to terminate the guardianship and/or conservatorship with the sending state to obtain a Final Order Confirming the Transfer to Colorado. Once the Colorado Court receives a Final Order Confirming the Transfer to Colorado and a completed Acceptance of Office (JDF 805), the Colorado Court may issue a Final Order Accepting Transfer. Any interested person may request an evidentiary hearing or the Court may require one.

JDF 783 9/08

PETITION REQUESTING COLORADO TO ACCEPT GUARDIANSHIP/CONSERVATORSHIP

Page 2 of 2