Source: https://www.tulare.courts.ca.gov/system/files/forms-and-filings/conservatorship-packet-revised-111325.pdf

Sparse pages use OCR; original PDF remains authoritative.

www.tulare.courts.ca.gov (559) 730-5000

CONSERVATORSHIP OF THE PERSON

Forms included in this packet:

FW-001-GC Request to Waive Court Fees (each conservator completes)
FEE WAIVER
FW-003-GC Order on Court Fee Waiver (each conservator completes)
PRO-006 Confidential Conservatorship Questionnaire (each conservator completes)
GC-310 Petition for Appointment of Probate Conservator
GC-312 Confidential Supplemental Information
GC-314 Confidential Conservator Screening Form (each conservator completes)
GC-020 Notice of Hearing
GENERAL
GC-020(P) Proof of Personal Service of Notice of Hearing (optional)

CONSERVATORSHIP GC-320 Citation for Conservatorship GC-330 Order Appointing Court Investigator GC-340 Order Appointing Probate Conservator GC-350 Letters of Conservatorship GC-348 Duties of Conservator GC-111 Petition for Appointment of Temporary Conservator TEMPORARY CONSERVATORSHIP GC-141 Order Appointing Temporary Conservator (optional) GC-150 Letters of Temporary Conservatorship GC-335 Confidential Capacity Assessment and Declaration CLINICIAN Everyday Activities Attachment to Confidential Capacity Assessment and GC-335A COMPLETES Declaration GC-325 Confidential Declaration on Medical Ability to Attend Hearing

Sample forms are available at:

Revised 11/13/2025 Conservatorship of the Person Page 1 of 2

Conservatorship of the Person

What is a Probate Conservatorship?

A probate conservatorship is a court case where a judge appoints a responsible person (the "conservator") to

care for an adult (the "conservatee") who cannot care for themselves. This process is commonly sought for older adults with conditions such as dementia or Alzheimer’s disease, but may also be appropriate for adults with developmental disorders such as cerebral palsy and down syndrome. The conservator is responsible for caring for the conservatee’s daily activities, health care, and living arrangements. The conservator may be the spouse, domestic partner, relative, or friend of the conservatee.

The Process

It may take several months before the court appoints the conservator. This is because many people must be

notified of the court process, and an investigation must be completed to make sure that the proposed conservator is suitable to care for the conservatee. To start the process, the proposed conservator must complete the forms in this packet, which ask for information about the conservator, conservatee, and the conservatee’s relatives. These forms also ask why a conservatorship is necessary, and why alternatives are not available. The conservatee’s clinician must also complete forms which include a capacity assessment and a determination as to whether the conservatee is able to attend court hearings.

• Temporary Conservatorship: Sometimes waiting for a permanent conservatorship could cause more harm
than good. For example, if the conservatee has suffered a sudden medical emergency or experienced a rapid
cognitive decline. In these situations, a temporary conservatorship may be necessary. Forms for a temporary
conservatorship are included in this packet.
• This packet only has forms for a conservatorship of the person, not a conservatorship of the estate.

After completing the forms, make two copies of everything and bring them to the Clerk of Court for filing,

located in Room 201 of the Visalia Courthouse, or at the Civil Filing windows at the South County Justice Center in Porterville. The court will keep the original documents and give you back two file-stamped copies for service on necessary parties. Additional copies may be needed depending on the number of family members that will be served. There are filing fees associated with this process. If you are unable to pay, complete the Fee Waiver forms in this packet to request that the filing fees are waived.

Resources

California Courts Self-Help Guide: Learn more about the probate conservatorship process at: https://selfhelp.courts.ca.gov/conservatorships.

Self-Help Resource Center: If you do not have an attorney, free assistance is available at the Self-Help Resource Center (SHRC). SHRC staff will provide instructions on how to complete forms, how to serve necessary parties, and can answer procedural questions. However, SHRC staff CANNOT complete your forms for you, cannot provide legal advice, and cannot represent you in court. SHRC staff can be reached at (559) 737-5500 and selfhelp@tulare.courts.ca.gov, and offices are located at:

County Civic Center South County Justice Center
221 S. Mooney Blvd., Room 203 300 E. Olive Ave.
Visalia, CA 93291 Porterville, CA 93257

Tulare County Law Library: Learn more about conservatorship of the estate at: https://tularecounty.ca.gov/lawlibrary/.

Revised 11/13/2025 Conservatorship of the Person Page 2 of 2

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ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUMBER: FOR COURT USE ONLY NAME: FIRM NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE NO.: FAX NO.: E-MAIL ADDRESS: ATTORNEY FOR (name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CONSERVATORSHIP OF (name): CONSERVATEE CASE NUMBER: CONFIDENTIAL CONSERVATORSHIP QUESTIONNAIRE Update Limited Successor □Initial □ □ □

NOTICE: Because you may be making medical, financial, and life decisions for the Conservatee, the Court, must determine the stability, experience, and decision-making ability of the Conservator(s) prior to granting Conservatorship powers. Each person petitioning the Court for conservatorship powers must complete this questionnaire. If you need

more space to answer any questions on this form, attach Form MC-025 (Attachment to Judicial Council Form) and write the question number before your answer. If you have questions, contact Family Court Services at (559) 730-5000, and select option 6.

ABOUT THE CONSERVATOR

Conservator information:

1. Name:

   Physical Address: _

   Mailing Address:

   Daytime Telephone: Cell: _ Email:

   Primary Language: English Spanish Other: _ □ □ □ Will the conservatee need an Interpreter at the Court hearing? □ Yes □ No Marital status: □ Single □ Married □ Separated □ Divorced □ Remarried □ Widowed □ Domestic partners □Currently living apart from spouse. If living apart, explain: _

Residence: 2. Years lived at current address: □ Rent □ Lease □ Own I plan to remain in this residence: □ Yes □ No If no, explain: My residence is a □ House □ Apartment □ Mobile home □ Other (explain): __ My residence is in a □ Rural setting □ Residential neighborhood □ Mobile home park □ Apartment complex □Other (explain):

PRO-006 [Rev. 03/17/2025] CONFIDENTIAL CONSERVATORSHIP QUESTIONNAIRE Prob. Code §§ 1800 et seq

CONSERVATORSHIP OF CASE NUMBER: (name): CONSERVATEE

ABOUT THE CONSERVATOR (continued)

3. List any other residences for the last five years: ________________________________________________________________ ______________________________________________________________________________________________________

---

4. If you own your home, provide details: Lending Institution (name and address): _______________________________________

Purchase price: $________________ Estimated market value: $________________ Balance owed: $_________________

5. Expenses:

Rent / Mortgage: $/mo. Gas: $/mo. Propane: $_________________/mo.

Electricity: $/mo. Garbage: $/mo. Water: $_________________/mo.

Home phone: $/mo. Cell phone: $/mo. Internet: $_________________/mo.

Other: $_________________/mo. Explain: __________________________________________________________

6. List all persons who reside with you on a daily or part-time basis (including the conservatee):

   Full Name: DOB: Daytime Telephone: Relationship:

   Full Name: DOB: Daytime Telephone: Relationship:

   Full Name: DOB: Daytime Telephone: Relationship:

   Full Name: DOB: Daytime Telephone: Relationship:

7. Have you ever been served with a Three-Day Notice to Pay Rent or Quit Possession of Real Property pursuant to an oral or written agreement for the rental of residential real property? □ No □ Yes. If yes, provide the date plus name and address of the

   lessor or landlord: _________________________________________________________________________________________

Income & Benefits:

8. Employment: $/mo. Commissions: $/mo. Investments: $_________________/mo.

Income from insurance settlement(s) / annuity: $__/mo. Other income sources: $/mo.

If other income source, explain: _____________________________________________________________________________

9. Do you have checking or savings accounts? □ No □ Yes If yes, provide details below:

   Account type: Balance:

   Account type: Balance:

10. Investment Broker (name and address): _______________________________________________________________________

PRO-006 [Rev. 03/17/2025] CONFIDENTIAL CONSERVATORSHIP QUESTIONNAIRE Prob. Code §§ 1800 et seq

CONSERVATORSHIP OF CASE NUMBER: (name): CONSERVATEE

ABOUT THE CONSERVATOR (continued)

11. Public assistance: $/mo. Social Security: $/mo. Disability: $________________/mo.

    Veteran’s Benefits: $/mo. Other Benefit: $/mo.

    If other, explain: _________________________________________________________________________________________

Debts:

12. Describe all long-term debt other than mortgage listed above (include second, third, and fourth mortgages, vehicles, business

    property, rental property, etc.): _____________________________________________________________________________

---

13. List all short-term debt including each credit card debt, debt to private parties or family members, etc. Indicate name of creditor

and balance owed (do not include bankruptcy debt): ____________________________________________________________

---

14. Have you ever been sued? □ No □ Yes If yes, explain: ____________________________________________________ ______________________________________________________________________________________________________
15. Have you ever sued another person or entity, either individually or on behalf of an entity? □ No □ Yes If yes, explain: ______________________________________________________________________________________________________

Health: 16. Do you have health insurance? □ No □ Yes If yes, provide insurance carrier name: ______________________________ My health insurance covers: □ Medical □ Dental □ Vision 17. Health Status: □ Good □ Fair □ Poor If fair or poor, explain: ______________________________________________ 18. Are you taking any medication (prescription or over-the-counter)? □ No □ Yes If yes, list types and indicate reason:

---

19. List any special health problems: ____________________________________________________________________________

20. Have you ever had a problem with: □ Drugs (prescription or illegal) □ Alcohol □ Mental / Emotional problems

    If yes, explain: ___________________________________________________________________________________________

Education:

21. Highest level completed: ________________ Age left school: __________ Degree(s) achieved: _______________________

    Last school attended: _________________________________________________ Last year attended: __________________

Reason for leaving: _______________________________________________________________________________________

PRO-006 [Rev. 03/17/2025] CONFIDENTIAL CONSERVATORSHIP QUESTIONNAIRE Prob. Code §§ 1800 et seq

CONSERVATORSHIP OF CASE NUMBER: (name): CONSERVATEE

ABOUT THE CONSERVATOR (continued)

Employment:

22. List your current employer and all employers over the last five years:

Name and address (current employer):

Telephone No.: Job description:

Date Began:

Name and address:

Telephone No.: Job description:

Date Began: Date Left: Reason for leaving:

Name and address:

Telephone No.: Job description:

Date Began: Date Left: Reason for leaving:

Vehicles:

23. Provide the following information for each vehicle you own:

    Year: Make: Model: License Plate No.:

    Name on Registration: Year Insured:

    Type of Coverage: Amount of Coverage:

    Year: Make: Model: License Plate No.:

    Name on Registration: Year Insured:

    Type of Coverage: Amount of Coverage:

Criminal History:

24. Have you ever been arrested or convicted for any crime other than a traffic infraction? (Note: This question must be answered

even if you were only arrested and not convicted, or if convicted, the charges were thereafter dismissed and the record ordered sealed. Include arrests for driving under the influence of alcohol or a controlled substance. ) □ No □ Yes

If yes, provide the reason for the arrest / charges, whether you were convicted, year, county, and state:

---

If convicted, what was the sentence? _____________________________________ Release date: _______________________

PRO-006 [Rev. 03/17/2025] CONFIDENTIAL CONSERVATORSHIP QUESTIONNAIRE Prob. Code §§ 1800 et seq

CONSERVATORSHIP OF CASE NUMBER: (name): CONSERVATEE

ABOUT THE CONSERVATOR (continued)

25. Are you currently or have you ever been on probation or parole? □ No □ Yes

    If yes, explain: ___________________________________________________________________________________________

Name of Probation or Parole Officer: __________________________________ Telephone No.: _________________________

26. Are you the plaintiff or defendant in any current or pending criminal or civil matter? □ No □ Yes If yes, explain: ___________________________________________________________________________________________

27. Have you ever applied for a domestic violence restraining order or had one issued against you? □ No □ Yes

    If yes, explain: ___________________________________________________________________________________________

28. Have you ever been the victim or perpetrator of physical, verbal, emotional, psychological, or sexual abuse? □ No □ Yes

    If yes, explain: ___________________________________________________________________________________________

Relationship to the Conservatee:

29. Relative Conservators: How are you related to the Conservatee? ___________________________________________________

---

30. Non-relative Conservators: How did you become acquainted with the Conservatee? ____________________________________

---

31. How long have you known the Conservatee? ___________________________________________________________________

32. What has been the nature and frequency of contact with the Conservatee prior to petitioning the Court for conservatorship?

---

ABOUT THE CONSERVATEE

1. Name: _________________________________________________________________________________________________

Physical Address: ________________________________________________________________________________________

Mailing Address: _________________________________________________________________________________________

Daytime Telephone No.: _______________________ Cell: ______________________ Email: __________________________

Primary Language: English Spanish Other: _________________________________________________________ □ □ □ Will the conservatee need an Interpreter at the Court hearing? □ Yes □ No Marital status: □ Single □ Married □ Separated □ Divorced □ Remarried □ Widowed □ Domestic partners □Currently living apart from spouse. If living apart, explain: __________________________________________ 2. Conservatee’s health insurance: Private insurance Tri-Care Medi-Cal Medicare Other: ______________ □ □ □ □ □

PRO-006 [Rev. 03/17/2025] CONFIDENTIAL CONSERVATORSHIP QUESTIONNAIRE Prob. Code §§ 1800 et seq

CONSERVATORSHIP OF CASE NUMBER: (name): CONSERVATEE

ABOUT THE CONSERVATEE (continued)

3. Is the Conservatee a client of a Regional Center? No Yes If yes, provide details below: □ □ Regional Center (name and address): ________________________________________________________________________

Case Manager: _________________________________________________ Telephone No.: __________________________

Date of last Individual Program Plan review: __________________________________________________________________

The Conservator was present in person present by phone not present □ □ □
If Conservator did not participate, explain: ____________________________________________________________________

4. Does the Conservatee attend school or an Employment / Day Program / Training Site? No Yes If yes, provide details: □ □ Name and Address: ______________________________________________________________________________________

   Usual hours and days of attendance: ________________________________________________________________________

   School / Program / Employer / Contact person: ______________________________ Telephone No.: ___________________

5. List all residences / placements of the Conservatee for the last 5 years: _____________________________________________

---

---

6. It is necessary to change the residence of the Conservatee now? □ No □ Yes

   If yes, explain: __________________________________________________________________________________________

7. Does the Conservator work for the Conservatee in any capacity (health care, housekeeping, etc.)? □ No □ Yes

   If yes, explain: __________________________________________________________________________________________

8. Will the Conservator be available to transport the Conservatee to medical, dental, optical, audiological, psychiatric, or other appointments? □ Yes □ No If no, explain how these needs will be met: ________________________________________

---

9. Who will manage the Conservatee’s money and pay the bills? _____________________________________________________

10. List persons who have access to the personal mail, bank statements, or other financial records or information of the Conservatee:

    Name: Daytime Telephone: Relationship:

    Name: Daytime Telephone: Relationship:

11. Does a Durable Power of Attorney or a Durable Power of Attorney for Health Care exist? □ No □ Yes

12. If yes, where is it located? ________________________________________ When was it signed? _______________________

Who is named with powers? ________________________________________________________________________________

PRO-006 [Rev. 03/17/2025] CONFIDENTIAL CONSERVATORSHIP QUESTIONNAIRE Prob. Code §§ 1800 et seq

CONSERVATORSHIP OF CASE NUMBER: (name): CONSERVATEE

ABOUT THE CONSERVATEE (continued)

13. Does the Conservatee have a Will? □ No □ Yes

    If yes, where is the will located? ___________________________________ When was it signed? _______________________

    List all beneficiaries and their relationship to the Conservatee:

    Name: Relationship:

    Name: Relationship:

14. Does the Conservatee have a Trust(s)? □ No □ Yes If yes, mark one: □ Revocable □ Irrevocable

    If yes, provide the following: Preparer of Trust (name): ________________________ Date of Trust: ______________________

Named Trustee(s): ________________________________________________________________________________________

List assets and value in Trust:

Asset: Value:

Asset: Value:

15. Is the Conservatee the beneficiary of a Trust? □ No □ Yes If yes: □ Revocable or □ Irrevocable

    If yes, provide the following: Preparer of Trust (name): ________________________ Date of Trust: ______________________

Named Trustee(s): ________________________________________________________________________________________

Nature of beneficial interest for the Conservatee: ________________________________________________________________

16. Is the Conservatee’s spouse or registered domestic partner deceased? □ No □ Yes If yes, date of death: ______________ Was there community property? _____________________________________________________________________________ Was there a Will? □ No □ Yes If yes, provide details below: Has a probate petition of the Will been filed? □ No □ Yes If yes, where? ________________________________________ Will a probate petition of the Will be filed? □ No □ Yes If yes, where? __________________________________________

PRO-006 [Rev. 03/17/2025] CONFIDENTIAL CONSERVATORSHIP QUESTIONNAIRE Prob. Code §§ 1800 et seq

CONSERVATORSHIP OF CASE NUMBER: (name): CONSERVATEE

RELATIVES OF THE CONSERVATEE

If a relative listed below is deceased, enter their name and enter the word deceased in the mailing address section. Include date of death if known:

Name: Daytime Telephone:

Father Mailing Address:

Name: Daytime Telephone:

Mother Mailing Address:

Name: Daytime Telephone:

Spouse or Registered Domestic Partner Mailing Address:

Name: Daytime Telephone:

Adult Child Mailing Address:

Name: Daytime Telephone:

Adult Child Mailing Address:

Name: Daytime Telephone:

Brother Mailing Address:

Name: Daytime Telephone:

Brother Mailing Address:

Name: Daytime Telephone:

Sister Mailing Address:

Name: Daytime Telephone:

Sister Mailing Address:

Name: Daytime Telephone:

Grandfather Mailing Address:

Name: Daytime Telephone:

Grandfather Mailing Address:

Name: Daytime Telephone:

Grandmother Mailing Address:

PRO-006 [Rev. 03/17/2025] CONFIDENTIAL CONSERVATORSHIP QUESTIONNAIRE Prob. Code §§ 1800 et seq

CONSERVATORSHIP OF CASE NUMBER: (name): CONSERVATEE

RELATIVES OF THE CONSERVATEE (continued)

Name: Daytime Telephone:

Grandmother Mailing Address:

Name: Daytime Telephone:

Adult Grandchild Mailing Address:

Name: Daytime Telephone:

Adult Grandchild Mailing Address:

Name: Daytime Telephone:

Relative pursuant to PC Section 1821(b) Mailing Address:

Name: Daytime Telephone:

Relative pursuant to PC Section 1821(b) Mailing Address:

NEIGHBORS AND CLOSE FRIENDS OF THE CONSERVATEE:

Name: Daytime Telephone

Neighbor Mailing Address:

Name: Daytime Telephone

Neighbor Mailing Address:

Name: Daytime Telephone

Close Friend Mailing Address:

Name: Daytime Telephone

Close Friend Mailing Address:

Number of pages attached: _____________

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

Date: ______________ SIGN

(TYPE OR PRINT NAME OF PERSON COMPLETING THIS FORM) (SIGNATURE OF PERSON COMPLETING THIS FORM)

PRO-006 [Rev. 03/17/2025] CONFIDENTIAL CONSERVATORSHIP QUESTIONNAIRE Prob. Code §§ 1800 et seq

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