Santa Clara — PB-4051*

Source: https://santaclara.courts.ca.gov/system/files/forms/pb-4051_rem.pdf

ATTACHMENT PB-4051 SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA FOR COURT USE ONLY COURT ADDRESS: 191 North First Street CITY AND ZIP CODE: San José, California 95113 To keep other people from PHONE NUMBER: (408) 882-2651 seeing what you have entered FAX NUMBER: (408) 882-2693 on your form, please press BRANCH NAME: Downtown Courthouse the Reset Form button at the end of the form when finished. In the Matter of Conservatorship of the Estate of:

Conservatee

LPS NUMBER:

ORDER RE: ACCOUNTING

IT IS ORDERED, that the Conservator ,

either execute the enclosed “Declaration of Waiver of Accounting,” if all three of the value and the

income criteria are met, or complete and execute the enclosed “Final Accounting” (and accompanying

schedules) for the period of the one-year Conservatorship, and to file the executed document(s) with the

Probate Clerk. Failure to do so on or before will result in an Order to Show Cause

in this matter being issued requiring you to personally appear before the Court to show cause why you

should not be held in contempt for failure to file such accounting, which may result in the Court ordering

punishment pursuant to Probate Code sections 11050 – 11052.

Date: Judicial Officer

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