Conservatorship Questionnaire {CS 2}

Conservatorship Questionnaire Rev 10/17/18 Page 1 of 3 ( Optional Form ) In the Superior Court of the State of California In and for the County of Kings CONSERVATORSHIP QUESTIONNAIRE FOR COURT USE ONLY (RECEIVED ON): CASE NUMBER: Instructions In order to begin the investigation ordered by the Court, you must complete this questionnaire and return it to: Kings County Superior Court 1640 Kings County Drive Hanford, CA 93230 P E T I T I O N I S F O R : Person Only Estate Person and Estate P E T I T I O N E R I N F O R M A T I O N ( P R O P O S E D C O N S E R V A T O R ) : Name: Date of Birth: / / State Issued: Your addr ess (Street, C ity, State and Zip Code ) : Home Telephone: ( ) Cell number : ( ) Business Telephone: ( ) Your r elationship to the Conservatee: Name of your attorney, if applicable: Telephone number: ( ) Address of attor ney (Street, C ity, State and Zip Code ): American LegalNet, Inc. www.FormsWorkFlow.com Conservatorship Questionnaire Rev 10/17/18 Page 2 of 3 P E T I T I O N E R ( P R O P O S E D C O N S E R V A T O R ) : Name: Date of Birth: / / State Issu ed: Your addr ess (Street, City, State and Zip Code ): Home Telephone: ( ) Cell number : ( ) Business Telephone: ( ) Your relationship to the Conservatee: Name of your attorney, if applicable: Telephone number: ( ) Ad dress of attor ney (Street, City, State and Zip Code ): C O N S E R V A T E E : Name: Date of Birth: / / Current address (Street, City, State and Zip Code ): Home Telephone: ( ) Cell number : ( ) Business Telephone: ( ) Where can they be reached during the day: During what hours: Name of attorney for Conservatee, if applicable: Telephone number: ( ) Address of at torney (Street, City, State and Zip Code ): Is Conservatee a client of Central Valley Regional Center? no yes If yes, name of case manager: Telephone number: ( ) I N F O R M A T I O N O N T H E LIVING R E L A T I V E S OF T H E C O N S E R V A T E E : Father: Telephone # ( ) Addr ess (Street, City, State and Zip Code ): Mother: Telephone # ( ) Addr ess (Street, City, State and Zip Code ): American LegalNet, Inc. www.FormsWorkFlow.com Conservatorship Questionnaire Rev 10/17/18 Page 3 of 3 Brother: Telephone # ( ) A ddr ess (Street, City, State and Zip Code ): Brother: Telephone # ( ) Addr ess (Street, City, State and Zip Code ): Brother: Telephone # ( ) Addr ess (Street, City, State and Zip Code ): Brother: Telephone # ( ) Addr ess (St reet, City, State and Zip Code ): Sister: Telephone # ( ) Addr ess (Street, City, State and Zip Code ): Sister: Telephone # ( ) Addr ess (Street, City, State and Zip Code ): Sister: Telephone # ( ) Addr ess (Street, City, S tate and Zip Code ): Sister: Telephone # ( ) Addr ess (Street, City, State and Zip Code ): Spouse: Telephone # ( ) Addr ess (Street, City, State and Zip Code ): Child: Telephone # ( ) Addr ess (Street, City, State and Zip C ode ): Child: Telephone # ( ) Addr ess (Street, City, State and Zip Code ): Child: Telephone # ( ) Addr ess (Street, City, State and Zip Code ): Child: Telephone # ( ) Addr ess (Street, City, State and Zip Code ): American LegalNet, Inc. www.FormsWorkFlow.com