Alameda — Small Estate Declaration (Section 2628)

Source: https://www.alameda.courts.ca.gov/system/files/forms-and-filings/files.pdf

COURT INVESTIGATOR'S OFFICE Berkeley Courthouse 2120 Martin Luther King, Jr. Way Berkeley, CA 94704 Telephone: (510) 636-8820

SUPERIOR COURT OF THE STATE OF CALIFORNIA

COUNTY OF ALAMEDA

CONSERVATORSHIP OF THE ESTATE OF: ) ) PROBATE NO.: ) ) Declaration of Conservator conservatee ) of the Estate (Sect. 2628)

I (we) am (are) the duly-appointed conservator(s) of the estate of the above-named

conservatee and declare as follows:

1. The estate, at the beginning and end of the accounting period for which an

account is otherwise required, consisted of property, exclusive of the residence of the

conservatee, of a total net value of less than fifteen thousand dollars ($15,000).

2. The income of the estate for each month of the accounting period, exclusive

of public benefit payments, was less than two thousand dollars ($2,000).

3. All income of the estate during the accounting period, if not retained, was

spent for the benefit of the conservatee.

I certify under penalty of perjury that the foregoing is true and correct to the best of

my knowledge.

Dated_____ ________,at _______________ __________________

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CONSERVATOR OF THE ESTATE CONSERVATOR OF THE ESTATE