Riverside local form RI-PR035

Source: https://riverside.courts.ca.gov/system/files/local-forms/ri-pr035.pdf

CERTIFICATION OF: STATE BAR NUMBER:

, ATTORNEY

RIVERSIDE COUNTY ATTACHMENT TO FORM GC-010

8. I have read Riverside Superior Court Local Rule 7118.

9. EXPERIENCE

   a. Guardianship (complete if box 4 was checked)

   (1) Experience or Supervision (check one of the following):

   (a) Experience
   I gained the required experience in the following probate guardianship, juvenile court child welfare, or
   family law cases:
   County Case Number Type of Party Last Date of Last Date of a
   Representation Contested
   Hearing

   (b) Family Law or Juvenile Qualification
   I meet the following requirements:
   Juvenile Child Welfare Proceeding – for representation of a minor child or nonminor
   dependent under CRC 5.660(d) and any applicable local rules in Riverside County.
   Family Law – for representation of a minor child under CRC 5.242(f).

   (c) Supervision
   I am supervised by, or work in close professional consultation with the following attorney who
   has satisfied the experience requirements:

   Attorney Name:

   State Bar Number:

   b. Conservatorship and Capacity Determination (complete if box 5 was checked)

   (1) Experience or Supervision (check one of the following):

   (a) Experience
   I gained the required experience in the following:
   County Case Number Type of Party Last Date of Last Date of a
   Representation Contested
   Hearing

Adopted for Mandatory Riverside Superior Court Use RIVERSIDE COUNTY ATTACHMENT TO FORM GC -010 riverside.courts.ca.gov/localfrms/localfrms.shtml RI-PR035 [Rev. 01/01/23]

CERTIFICATION OF: STATE BAR NUMBER:

, ATTORNEY

(c) Supervision
I am supervised by, or work in close professional consultation with the following attorney who
has satisfied the experience requirements:

Attorney Name:

State Bar Number:

10. ANNUAL EDUCATION

    a. Guardianship (complete if box 4 was checked) I met the education requirements through the California MCLE listed below. (Place an “X” in at least one of the last three columns for each class to identify which of the subject matters in CRC 7.1102(d) was addressed.) Date Provider Description Hours Completed Child Risk Factors Guardianship (d)(3) (d)(1) Development (d)(2)

(d)(1) Development (d)(2)

Adopted for Mandatory Use RIVERSIDE COUNTY ATTACHMENT TO FORM GC -010 riverside.courts.ca.gov/localfrms/localfrms.shtmlRiverside Superior Court RI-PR035 [Rev. 01/01/23

CERTIFICATION OF: STATE BAR NUMBER:

, ATTORNEY

b. Conservatorship and Capacity Determination (complete if box 5 was checked)
I met the education requirements through the California MCLE listed below. (Place an “X” in at least one of the
last three columns for each class to identify which of the subject matters in CRC 7.1103(d) was addressed.)

Date Provider Description Hours
Completed Ethics
(d)(2) Conservatorship Representation
(d)(3) (d)(1)

11. I am or have been the attorney of record for the following private professional fiduciaries or trust companies:

    Name Estimated Number of Cases

12. I am or have been attorney of record for

    the Riverside County Public Guardian the Riverside County Public Administrator

13. Check one:

    I am willing to accept appointments for ex parte and other urgent matters. I am NOT willing to accept appointments for ex parte and other urgent matters.

Adopted for Mandatory Use RIVERSIDE COUNTY ATTACHMENT TO FORM GC -010Riverside Superior Court riverside.courts.ca.gov/localfrms/localfrms.shtml RI-PR035 [Rev. 01/01/23]

CERTIFICATION OF: STATE BAR NUMBER:

, ATTORNEY

14. I understand that I may not represent any other party in cases in which I have been appointed as counsel or in cases

    that are related to cases in which I was appointed as counsel (for example, representation of an executor after the death of a conservatee whom I was appointed to represent).

15. (optional) I am a Certified Specialist in: Estate Planning, Probate, and Trust Law Taxation Family Law Other (specify):

16. (optional) I speak the following languages (other than English):

17. (optional) Members of my staff speak the following languages (other than English):

18. I request court appointments in the following additional areas:

    (a) Probate Code 3101
    I am familiar with the laws and regulations for Medi-Cal eligibility and special needs trusts under 42 U.S.C
    §1396p(d)(4)(a) and (c) and am knowledgeable on the rules regarding the increase of CSRA/MMMNA,
    exempt assets, gifting rules, and the tax and estate planning ramifications related to Medi -Cal planning. I
    have completed box 5, above.

    (b) Probate Code 3600 and CRC 7.903 Trusts
    I am familiar with the laws and regulations for eligibility for Supplemental Security Income (SSI) and
    Medi-Cal, including income and asset limits, exempt assets, special needs trusts under 42 U.S.C
    § 1396p(d)(4)(a) and (c), and ABLE accounts. I am also familiar with the application of MICRA to medical
    malpractice settlements. I have completed box 4 or 5, above.

    (c) Fiduciary Appointments / Probate Code 9252(c) / Guardian ad litem
    For at least the last five years, I have done one of the following:
    (1) Practiced California law representing fiduciaries in at least five court proceedings which are
    specified below:
    (2) Served as a fiduciary or guardian ad litem in at least five court proceedings which are specified
    below:
    County Case Number Type of Last Date of Representation of
    Fiduciary fiduciary or date of discharge
    as fiduciary, or “Current”

    (d) Health Care Decisions for Adults Without Conservators
    I have completed box 5, above.

Adopted for Mandatory Use RIVERSIDE COUNTY ATTACHMENT TO FORM GC -010 riverside.courts.ca.gov/localfrms/localfrms.shtmlRiverside Superior Court RI-PR035 [Rev. 01/01/23]