Free Conservator's Report - Oregon

IN THE CIRCUIT COURT OF THE STATE OF OREGON THIRD JUDICIAL DISTRICT Probate Department In the Matter of the Conservatorship of: ) ) ) ) )

Case No. CONSERVATOR'S REPORT

_______________________________________ A Minor, Protected Person.

I am the conservator for the child named above, and I make the following report to the court in lieu of the annual accounting: 1. My name, address and telephone number are:

Phone: (

)

2.

The address where the child lives is:

3.

Since my last report I have: a. Been convicted of the following crimes: b. Received protection under federal bankruptcy laws: yes / no. c. Had a job-related license revoked or suspended: yes / no. d. Had my driver's license revoked or suspended: yes / no.

/ none.

4.

Attached to this report is a copy of the most recent statement of each account that holds the child's funds.

I hereby declare that the above statement is true to the best of my knowledge and belief, and that I understand it is made for use as evidence in court and is subject to penalty for perjury. Dated this _________ day of ________________________, 20__________.

Conservator CONSERVATOR'S REPORT - Page 1 of 1 FC (1/1/08)