Exhibit A Limitations To Conservatorship {MPC 730A}

Docket No. EXHIBIT A LIMITATIONS TO CONSERVATORSHIP In the Interests of: First Name Middle Name Last Name Commonwealth of Massachusetts The Trial Court Probate and Family Court Division Protected Person Exhibit to an Order or a Decree and Order dated The Protected Person shall retain the following rights or responsibilities: To have and spend $ cash per week. ). To manage and use a checkbook (with a monthly limit of $ To plan a budget, including monthly expenditures, and to direct the conservator in expenditures. To purchase and give gifts to individuals chosen by the protected person (not to exceed $ To make gifts or donations to organizations chosen by the protected person (not to exceed $ donation). To make decisions concerning purchase or sale of the protected person's home. (The home located at (Address Line 1) (City/Town) (State) (Zip) per month). per is not to be sold without prior authorization of the court.) To deposit, withdraw, dispense, or invest monetary assets. To establish and use credit. To pay, settle, prosecute, or contest a claim. To enter into a contract, financial commitment, or lease arrangement. To continue or participate in the operation of a business. To manage the protected person's property and investments. MPC 730A (5/30/11) page 1 of 1 www.FormsWorkFlow.com