Free STATE OF MINNESOTA - Minnesota

M.S. § 524.5-409(e)

State of Minnesota
Select County County of ____________________

District Court Probate Division Judicial District: __________________ Court File No. _____________________ Case Type: 14, Conservatorship

In Re: Conservatorship of ______________________________, Protected Person

Annual Notice of Right to Petition for Restoration to Capacity

To: _____________________________________ Protected Person You have a right to ask the Court to end the conservatorship or to modify the conservatorship by filing a petition with the Court explaining why you believe the conservatorship should end or be modified. If you wish to have a different conservator then you must file a petition for removal of the conservator, explaining why you believe the present conservator should be removed. To petition the court you may call the Probate Court Monday through Friday between 8:00 a.m. and 4:30 p.m. and ask that a form be sent to you or pick up the proper form at the Court and file it there. The phone number and address of the Court is:_______________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ After a petition is filed the Court will schedule a hearing. You have the right to be present at that hearing and to have a lawyer represent you. If you cannot afford a lawyer, the Court will appoint one for you. You may call the Court to request a Court appointed attorney. This notice must be served annually on the protected person within thirty days after the anniversary of the appointment of the conservator. AFFIDAVIT OF SERVICE ______________________________________ being first sworn, says that on (date) __________, 20___, by mail or the undersigned affiant served this Notice of Right to Petition on the protected person personally and that the present address and telephone number of the protected person is:______________ _____________________________________________________________________________________ ____________________________________________________________________________________. ________________________________________ Signature of Affiant (Conservator or other person who serves the notice on the protected person.)

Sworn/affirmed before me on ____________________, 20______.

__________________________________
Notary Public \ Deputy Court Administrator

(Notary Seal)

THIS PAGE MUST BE COMPLETED AND RETURNED TO THE COURT
GAC 10-C State ENG Rev 12/03 www.courts.state.mn.us/forms Page 1 of 2

M.S. § 524.5-409(e)

State of Minnesota County of __________________

District Court Probate Division Judicial District: __________________ Court File No. _____________________ Case Type: 14, Conservatorship

In Re: Conservatorship of _____________________________, Protected Person

Annual Notice of Right to Petition for Restoration to Capacity

To: _____________________________________________ Protected Person You have a right to ask the Court to end the conservatorship or to modify the conservatorship by filing a petition with the Court explaining why you believe the conservatorship should end or be modified. If you wish to have a different conservator then you must file a petition for removal of the conservator, explaining why you believe the present conservator should be removed. To petition the court you may call the Probate Court Monday through Friday between 8:00 a.m. and 4:30 p.m. and ask that a form be sent to you or pick up the proper form at the Court and file it there. The phone number and address of the Court is: _________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________. After a petition is filed the Court will schedule a hearing. You have the right to be present at that hearing and to have a lawyer represent you. If you cannot afford a lawyer, the Court will appoint one for you. You may call the Court to request a Court appointed attorney.

DELIVER THIS PAGE TO THE PROTECTED PERSON

GAC 10-C

State

ENG

Rev 12/03

www.courts.state.mn.us/forms

Page 2 of 2