Application For Appointment Of Conservator {20.0}

<document>COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.PROBATE COURT OF COUNTY, OHIOERIEJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)IN THE MATTER OF THE CONSERVATORSHIP OF Case No.DocketPageAPPLICATION FOR APPOINTMENT OF CONSERVATOR (R.C. 2111.021)(R.C. 2111.021). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I, , Petitioner, hereby state that I am a competent adult but am physically infirm. I request that: 1. Name of Proposed Conservator Street CityTHE PEOPLE OF THE STATE OF NEW YORK TO, Ohio (Zip)Telephone be appointed conservator of my:( ) Person and Estate( ) Person Only( ) Estate OnlyGREETINGS:2. The length (time period) of the conservatorship is:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable( ) Indefinite( ) Definite to20,located at County of3. (If Person Only or Person and Estate is checked), I give the following power over my PERSON to the:o'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in rooma. Conservator:( ) [1] All powers that a guardian would have under the guardianship laws of Ohio. ( ) [2] Limited to the power toYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of theb. Court:( ) [1] All powers that a Court would have under the guardianship laws of Ohio. ( ) [2] Limited to the power toCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) for4. (If Estate Only or Person and Estate is checked), I give the following power over my ESTATE to the:a. Conservator:( ) [1] All powers that a guardian would have under the guardianship laws of Ohio. ( ) [2] Limited to the power toOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:20.0 APPLICATION FOR APPOINTMENT OF CONSERVATOR20.0 APPLICATION FOR APPOINTMENT OF CONSERVATORMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.b. Court:( ) [1] All powers that a Court would have under the guardianship laws of Ohio. ( ) [2] Limited to the power toCalendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)c. The following of my property is subject to the foregoing powers: ( ) [1] All property. (attach description of property) ( ) [2] Only the property listed as follows:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TO5. If the application is for a conservatorship of the estate: a. The estate to be placed under conservatorship is:Personal Property$ Real PropertyGREETINGS:$ Annual Rents$ Other Annual IncomeWE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable$ TOTAL,$located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room(R.C. 2109.04(A)(1))b. A bond in the amount of $ is attached. (R.C. 2109.04(A)(1)) (Form 15.3) 6. Service of notice of the conservatorship is to be given to:Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.( ) None( ) Same as Guardianship( ) As Listed on Form 15.0Based on the foregoing information, I do hereby petition the Court to appoint a Conservator for myself, and do so freely and of my own will. I certify that all information and statements contained in this application and the attached exhibits are correct to the best of my knowledge and belief., one of the Justices of theCourt in Witness, Honorableday of, 20 County,Date(Attorney must sign above and type name below)Attorney's SignatureApplicant's SignatureAttorney(s) for(Type or print Attorney's Name)(Type or print Applicant's Name)(Street)(Street)Office and P.O. Address(City, State, Zip Code)(City, State, Zip Code)Telephone No.: Facsimile No.: E-Mail Address:(Telephone Number include area code)(Telephone Number include area code)Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comSupreme Court Registration Number</document>