IN THE PROBATE DIVISION, CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI
In the matter of
__________________________________________
Respondent
No._____________________
PETITION FOR APPOINTMENT OF A GUARDIAN AND CONSERVATOR
Comes now _____________________________________ and states that the above named respondent, age _____, whose domicile is St. Louis County, Missouri, and whose present residence and post office address is ______________________________________________________________________________, is incapacitated and
Street Address City State Zip
disabled. The respondent owns property having an estimated value of: Real Property - $_________________________ Personal Property - $_____________________
Has the respondent executed a durable power of attorney? ____________________________________________ Petitioner is the _______________________________________ of the respondent and requests that letters
(relationship)
of guardianship be granted to ________________________________________________________, whose address is _______________________________________________________________ and who is not now guardian or Street Address City State Zip conservator for any wards or protectees (except as follows): _________________________________
(Name)
_____________________________________________
Street Address
_____________________________________________
City State Zip
[For Guardianship of Person or Conservatorship of Estate per 475.060(10) R.S.Mo. 1983]. The reasons why the appointment of a guardian is sought are: _____________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________
[For Guardianship of Person Only per 475.060(9) R.S.Mo. 1983]. The specific physical or mental conditions which prevent the respondent from being able to care for person are: _________________________________________
[For Conservatorship of Estate Only per 475.061(1) R.S.Mo. 1983]. The specific physical or mental conditions which prevent the respondent from being able to manage financial resources are: ____________________________
____________________________________________________________________________________________________________
__________________________________________________________________________________________________
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The following are listed pursuant to the provisions of 475.060 and 475.075 R.S.Mo. 1983:
NAME & RELATIONSHIP AGE (if applicable) POST OFFICE ADDRESS (Include Zip Code)
__________________________________
Spouse (indicate if deceased)
____________________________________ ____________________________________
__________________________________
Mother (indicate if deceased)
____________________________________ ____________________________________
__________________________________
Father (if deceased)
____________________________________ ____________________________________
__________________________________
Son/Daughter (Grandson/Granddaughter)
_______________
Age
____________________________________ ____________________________________
__________________________________
Son/Daughter (Grandson/Granddaughter)
_______________
Age
____________________________________ ____________________________________
__________________________________
Son/Daughter (Grandson/Granddaughter)
_______________
Age
____________________________________ ____________________________________
__________________________________
Son/Daughter (Grandson/Granddaughter)
_______________
Age
____________________________________ ____________________________________ ____________________________________ ____________________________________
Nearest Known Relative Relationship - __________________________________________ ______________________________________________________
NOTE: If the respondent has no spouse, mother, father or children, the names of the nearest known relatives who are over the age of eighteen must be listed above. _______________________________________
Person having custody of respondent
____________________________________ ____________________________________ ____________________________________ ____________________________________
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_______________________________________
Name of any guardian/conservator in this or any other State
Petitioner prays that a hearing and inquiry be held and the court appoint __________________________ __________________________________________________________________________________________ Guardian of the Person and Conservator of the Estate for the respondent. Petitioner states that the foregoing is made on this _____ day of ____________, ______, under oath or affirmation, and its representations are true and correct to the best of petitioner's knowledge and belief, subject to penalties of making a false affidavit or declaration. _______________________________________
Attorney's Signature
__________________________________________
Petitioner's Signature
_______________________________________
Attorney's Name (Typed)
__________________________________________
Petitioner's Name (Typed)
_______________________________________
Street Address
__________________________________________
Street Address
_______________________________________
City State Zip Code
__________________________________________
City State Zip Code
_______________________________________
Phone Number With Area Code
__________________________________________
Phone Number with Area Code
_______________________________________
Missouri Bar Number
_______________________________________
Attorney's Signature
__________________________________________
Petitioner's Signature
_______________________________________
Attorney's Name (Typed)
__________________________________________
Petitioner's Name (Typed)
_______________________________________
Street Address
__________________________________________
Street Address
_______________________________________
City State Zip Code
__________________________________________
City State Zip Code
_______________________________________
Phone Number With Area Code
__________________________________________
Phone Number with Area Code
_______________________________________
Missouri Bar Number
Serve notice on respondent at: _________________________________________________________________ __________________________________________________________________________________________ Send Fee Bills to: _______________________________ Publish Notice of Letters in _____________________ Minute Notices to: Attorney _____________________________________ Fiduciary____________________
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