Contra Costa — GC-11

Source: https://contracosta.courts.ca.gov/system/files/forms-filing/gc-11-contact-info-pursuant-probate-code-confidential_fillable.pdf

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar No., Address) FOR COURT USE ONLY

TELEPHONE NO. FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF CONTRA COSTA COURT ADDRESS: 725 Court Street CITY AND ZIPCODE: Martinez, California 94553 PHONE NUMBER: (925) 608-2033 FAX NUMBER: (925) 608-2110 BRANCH NAME: Court Investigator’s Unit

CONSERVATORSHIP OF THE PERSON ESTATE OF:

CASE NUMBER:
CONTACT INFORMATION PURSUANT TO PROBATE CODE
§2250.6(a)(1)(A)(B)(C), §1826(a)(1)(2), §1851(a)
HEARING DATE:
- CONFIDENTIAL -

Initial Petition for Appointment Review Petition for Successor Conservator

General Directions

This form must be filed with petitions for the appointment of a conservator, for appointment of a successor conservator, and with subsequent accountings. Add pages if necessary to give complete information.

1. (Proposed) Conservatee Conservatee

   Name Home Number

   Address Day Program (if appropriate)

   City, State and Zip

   SPECIAL PROBLEMS RELATED TO INVESTIGATION (i.e. language, personal safety, communication)

NOTE: The Court must be notified immediately of address changes of Conservatees and Conservators.

Local Court Form (Adopted) – Mandatory CONTACT INFORMATION PURSUANT TO PROBATE CODE 1 GC-11 Rev. 8/24/17 §2250.6(a)(1)(A)(B)(C), §1826(1)(2), §1851(a) - CONFIDENTIAL -

2. Petitioner (if different from Proposed Conservator)

   Name Home Number

   Address Work Number

   City, State and Zip Cell Number

   Relationship to (Proposed Conservatee):

3. Conservator Proposed Conservator Proposed Successor Conservator

   Name Home Number

   Address Work Number

   City, State and Zip Cell Number

   Relationship to (Proposed Conservatee):

4. (Proposed) Conservatee’s Spouse or Registered Domestic Partner Spouse Registered Domestic Partner

   Name Home Number

   Address Work Number

   City, State and Zip Cell Number

5. (Proposed) Conservatee’s Relatives within the First Degree (Adult Children, Parents)

   Name Home Number

   Address Work Number

   City, State and Zip Cell Number

   Relationship to (Proposed Conservatee):

Local Court Form (Adopted) – Mandatory CONTACT INFORMATION PURSUANT TO PROBATE CODE 2 GC-11 Rev. 8/24/17 §2250.6(a)(1)(A)(B)(C), §1826(1)(2), §1851(a) - CONFIDENTIAL -

Name Home Number

Address Work Number

City, State and Zip Cell Number

Relationship to (Proposed Conservatee):

Name Home Number

Address Work Number

City, State and Zip Cell Number

Relationship to (Proposed Conservatee):

6. (Proposed) Conservatee’s Relatives within the Second Degree (Grandparents, Adult Grandchildren, Sisters and Brothers)

   Name Home Number

   Address Work Number

   City, State and Zip Cell Number

   Relationship to (Proposed Conservatee):

   Name Home Number

   Address Work Number

   City, State and Zip Cell Number

   Relationship to (Proposed Conservatee):

Local Court Form (Adopted) – Mandatory CONTACT INFORMATION PURSUANT TO PROBATE CODE 3 GC-11 Rev. 8/24/17 §2250.6(a)(1)(A)(B)(C), §1826(1)(2), §1851(a) - CONFIDENTIAL -

7. (Proposed) Conservatee’s Other Relatives

   Name Home Number

   Address Work Number

   City, State and Zip Cell Number

   Relationship to (Proposed Conservatee):

   Name Home Number

   Address Work Number

   City, State and Zip Cell Number

   Relationship to (Proposed Conservatee):

   Name Home Number

   Address Work Number

   City, State and Zip Cell Number

   Relationship to (Proposed Conservatee):

8. (Proposed) Conservatee’s Neighbors

   Name Phone Number

   Name Phone Number

   Name Phone Number

9. (Proposed) Conservatee’s Close Friends

   Name Phone Number

   Name Phone Number

   Name Phone Number

Local Court Form (Adopted) – Mandatory CONTACT INFORMATION PURSUANT TO PROBATE CODE 4 GC-11 Rev. 8/24/17 §2250.6(a)(1)(A)(B)(C), §1826(1)(2), §1851(a) CLEAR FORM - CONFIDENTIAL -