Amador — Verification Form

Source: https://amador.courts.ca.gov/system/files/forms-and-filings/verificationofviewingvideo.pdf

Party without Attorney or Attorney Name FOR COURT USE ONLY Address: Telephone No:

Amador Superior Court 500 Argonaut Lane Jackson, CA 95642

Conservatorship of the Person Estate of:

Proposed Conservatee
VERIFICATION THAT VIDEO OF CONSERVATOR’S DUTIES CASE NUMBER:
HAS BEEN VIEWED

I, , have petitioned the Court to be appointed the conservator of the person

and/or estate of: .

I, , viewed the Court’s videotape presentation on the duties and responsibilities

of the conservator on (date) .

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and

correct.

Dated:

(Type or Print Name) (Signature of Declarant)

The handbook referred to in the video: “Handbook for Conservators”, is available at Judicial Council web site:http://www.courts.ca.gov/documents/conservatorship_handbook.pdf

THIS FORM MUST BE COMPLETED AND FILED PRIOR TO THE HEARING ON THE CONSERVATORSHIP PETITION

VERIFICATION THAT VIDEO OF CONSERVATOR’S DUTIES HAS BEEN VIEWED-(Rev. 08/2011)-PRC-100