District Court Denver Probate Court _________________________________ County, Colorado Court Address:
_____________________________________
In the Interests of:
____________________________________________
Protected Person Attorney or Party Without Attorney (Name and Address):
___________________________________________ ___________________________________________
COURT USE ONLY Case Number: __________________
Phone Number:_________________ E-mail:____________________ FAX Number:___________________ Atty. Reg.#: _______________
Division ______ Courtroom _______
VERIFIED NOTICE OF DEATH PURSUANT TO §15-14-431(1), C.R.S. AND §15-14-314(2)(g),C.R.S.
1. ___________________________________________ (full name), who died on ___________________ (date) was the subject of a Conservatorship and/or Guardianship. 2. The Court, in its Order Appointing Guardian or Conservator, ordered that notice of all proceedings be given to the following person(s): Full Name Address Relationship
3. The Guardian's authority to act on behalf of the ward has terminated. The Conservator's authority to act on behalf of the Protected Person is limited pursuant to §15-14-428 & 431, C.R.S. Note: The Conservator is directed to conclude administration pursuant to §15-14-431, C.R.S. I swear/affirm under oath that I have read the foregoing Verified Notice of Death and that the statements set forth therein are true and correct to the best of my knowledge. ______________________________________
Signature of Guardian/Conservator Date
Subscribed to and affirmed or sworn to before me in the County of __________________, State of ________________, this ______ day of ___________, 20 _____, by ___________________________________.
My Commission Expires: ____________________ __________________________________________ Notary Public/Clerk
CERTIFICATE OF SERVICE I certify that on ________________________ (date) a copy of this Notice was served on each of the following:
Full Name Relationship Ward to Address Manner of Service*
*Insert one of the following:
Hand Delivery, First-Class Mail, Certified Mail, E-Served or Faxed. ___________________________________________
Signature
JDF 853 11/07
VERIFIED NOTICE OF DEATH