Los Angeles local probate form — Probate Annual Compliance Certification for Court Appointed Counsel Panel (LASC PRO 058)

Source: https://lascpubstorage.blob.core.windows.net/forms/Forms%20Comprehensive%20List/LASC%20PRO%20058.pdf

NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY FOR COURT USE ONLY

E-MAIL ADDRESS:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES BRANCH NAME: Stanley Mosk Courthouse STREET ADDRESS: 111 N. Hill Street CITY AND ZIP CODE: Los Angeles, CA 90012-3014

PROBATE

ANNUAL COMPLIANCE CERTIFICATION FOR COURT APPOINTED COUNSEL PANEL CONFIDENTIAL – FOR COURT USE ONLY

1. Personal Information

Name Last First Middle

Address
Firm Name

Street/P.O. Box City State Zip

Telephone:
Office Cell Fax

2. State Bar Membership A. I am an active member of the California State Bar. My Bar number is . (Initials) B. As of the date of this Certification, I have no disciplinary proceedings pending with the California State Bar, and I have had no discipline imposed on me within the 12-month period immediately preceding that date. (Initials) C. If, at any time that I am a member of this panel and my status as a member of the State Bar changes, I agree to notify the Court, in writing, within 10 days of that change. (Initials)

3. Professional Liability Insurance A. I carry professional liability insurance with policy limits consistent with the values of the matters to be handled, at a minimum amount of $100,000 per claim and $300,000 per year. (Initials) B. Proof of policy attached. (Initials)

4. California Rules of Court The California Rules of Court establish qualifications for attorneys accepting appointments in conservatorship and guardianship cases A. I am qualified to accept appointments by the Court to represent conservatees or proposed conservatees under Probate Code §§ 1470 and 1471. Pursuant to Rule 7.1103of the California Rules of Court, I have filed or am filing herewith mandatory Judicial Council form GC-010, Certification of Attorney Qualifications (Initials) ANNUAL COMPLIANCE CERTIFICATION FOR COURT APPOINTED COUNSEL PANEL

SCLAC PRO 058 Rev. 04/26 Page 1 of 3 For Mandatory Use

B. I am qualified to accept appointments by the Court to represent wards or proposed wards under Probate Code § 1470. Pursuant to Rule 7.1102 of the California Rules of Court, I have filed, or am filing herewith mandatory Judicial Council form GC-010, Certification of Attorney Qualifications.

(Initials)

C. Proof of compliance with educational requirements is attached. (Initials)

5. Los Angeles Superior Court A. Check one: ☐I have completed the mandatory court appointed counsel training program. ☐I have NOT completed the mandatory court appointed counsel training program. (Initials) B. I have completed at least 12 hours of MCLE during my State Bar reporting period in the areas of decedents’ estates, conservatorships, guardianships, or trust administration (Initials) C. My specific areas of interest during this compliance period are (check all that apply): ☐ Conservator of the Person & Estate * ☐ Limited conservatorship for developmentally disabled adults * Completion date of last Limited Conservatorship Program: ☐ LPS Conservatorship ☐ Guardianship of the Person & Estate (Minor’s Counsel) * ☐ Capacity determinations and health care decisions for adult without Conservators (Probate Code § 3200) ☐ Tuberculosis detention proceedings ☐ Guardian Ad litem Completion of last Guardian ad litem Program: 10 years of practice? ☐ Yes or ☐ No If so, give specific court information, type of case served as GAL; fiduciary case name; case number; and date: ☐ Other: ☐ Medi-Cal planning (Probate Code §3100 and §3600) ☐ Compromises / Judgments, special needs trusts, minors’ trusts

*Attorneys accepting appointments as counsel in conservatorships and guardianship proceedings must meet the qualifications and continuing education requirements set forth in California Rules of Court Rule 7.1102. and 7.1103.

D. I certify that I meet the requirements specified in Los Angeles Superior Court Rules,
Rule 4.124, for each area of interest marked above.
(Initials)

E. I speak the following language(s) (other than English) and may accept appointments
requiring the translation/communication skills of language(s):

6. District Appointments I am willing to accept appointments in the following Los Angeles Superior Court districts: ☐North – North District ☐ East – Northeast, East, Southeast, North Central, and South-Central Districts ☐ Central - Central District, and any out of county conservatees. West – Northwest, South, Southwest, West, and North Valley Districts ☐ ANNUAL COMPLIANCE CERTIFICATION FOR COURT APPOINTED COUNSEL PANEL

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7. Private Professional Fiduciary Representation

   I am or have been the attorney of record for the following private professional fiduciaries:

   Firm Name Estimated Number of Cases

   Firm Name Estimated Number of Cases

   Firm Name Estimated Number of Cases

8. Compensation

   Attorney Compensation in Los Angeles Superior Court Proceedings I have reviewed and agreed to be bound by the terms of Los Angeles Superior Court General Order Re: Probate Court Appointed Counsel Panel Appointments dated March 15,2022 concerning the court’s policies of accepting (or continuing) any court appointed counsel appointments to represent proposed conservatees, conservatees, proposed wards or wards or any other individual in Los Angeles Superior Court Proceedings. (Initials)

   Compensation for services as fiduciaries, guardians ad litem (including appointments in Central District U.S. Federal District Court cases), and Evidence Code 730 experts will be determined on a case-by-case basis. By accepting such court appointments, I agree that, except in cases involving unusual problems requiring extraordinary expertise, the hourly rates shall not exceed $250.00. (Initials)

9. Conflicts

   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). (Initials)

10. Appointments within the Court’s Discretion

I understand that submission of an Attorney Application for Appointment to Probate Court Appointed Counsel Panel and/or Annual Compliance Certification for Probate Court Appointed Counsel Panel Attorneys does not guarantee entitlement to appointments as counsel and acknowledge that all appointments of court appointed counsel are entirely within the discretion of the Los Angeles Superior Court. (Initials)

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

SIGN

Date Signature

ANNUAL COMPLIANCE CERTIFICATION FOR COURT APPOINTED COUNSEL PANEL

SCLAC PRO 058 Rev. 04/26 Page 3 of 3 For Mandatory Use