Requestor's Name, Address and Phone number
Superior Court of California County of Mendocino
In the Matter of the Conservatorship of: ) ) ) ) ) ) ) Case No: SCUKCVPGRequest for Waiver or Deferment of Court Investigator Fees CONFIDENTIAL
Conservatee.
I am the conservator of the person and/or estate in the above entitled case. I would like to request a waiver or deferment of the Court Investigator fees in this matter. The payment of the fees would be a hardship. A waiver or deferment is requested based on the following information about the conservatee's assets: 1. The conservatee is is not receiving Medi-Cal benefits. . .
2. The conservatee's monthly income is $ 3. The conservatee's liquid assets are currently valued at $ 4. The conservatee 5. The conservatee owns is
does not own any interest in real property.
is not the beneficiary of a trust. .
The conservatee's financial interest is valued at $
I declare under penalty of perjury under the laws of the State of California that the foregoing information is correct and true.
Dated:
Signature: Printed Name: