Riverside local form RI-PR105

Source: https://riverside.courts.ca.gov/system/files/local-forms/ri-pr105.pdf

SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE

MURRIETA 30755-D Auld Rd., Murrieta, CA 92563 RIVERSIDE 4050 Main St., Riverside, CA 92501 PALM SPRINGS 3255 E. Tahquitz Canyon Wy., Palm Springs, CA 92262 RI-PR105

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address) FOR COURT USE ONLY

TELEPHONE NO.: FAX NO. (Optional):

E-MAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

CONSERVATORSHIP OF:

CASE NUMBER:

PERSONALIZED INFORMATION FOR CONSERVATEE

TO THE CONSERVATEE

The court named above has appointed one or more conservators for you. This form gives the name and contact information of your conservator or conservators; describes your conservatorship; gives the name and contact information of the court investigator and describes the investigator’s role and duties; and provides a personalized list of the rights that you keep under the conservatorship and the rights that the court ordered withheld from you.

1. a. Your conservator of your person estate is (name): (address): (telephone number): (email address):

   b. Your conservator of your person estate is (name): (address): (telephone number): (email address):

   The court appointed more than two conservators. The name, contact information, and type of each conservator are stated on Attachment 1.

2. Your conservatorship is (check all that apply):

   a. A conservatorship of the person. This means that your conservator has powers and duties to arrange for your health care, make sure you have enough food and clothing, and make sure you live in a safe home.

   b. A conservatorship of the estate. This means that your conservator has powers and duties to manage your money and property for your benefit.

   c. A limited conservatorship. This means that your conservator has only the powers and duties specified in the court’s appointment order. The court may have given the limited conservator powers and duties to provide for your personal care, manage your money or property, or both.

Adopted for Mandatory Use PERSONALIZED INFORMATION FOR CONSERVATEE Probate Code 1835.5; Local Rule 7402 Riverside Superior Court riverside.courts.ca.gov Form RI-PR105 [Rev. 01/01/26]

CONSERVATORSHIP OF: CASE NUMBER:

3. a. The name and contact information of the court investigator who was initially appointed in your conservatorship are: (name): (mailing address): (telephone number): (email address):

   If you have questions or concerns about the conservatorship or your conservator’s actions before an

   investigator visits, you can contact the investigator above to ask questions or express your concerns.

   b. The court will appoint an investigator to monitor and review your conservatorship. If your conservatorship goes well, the investigator will visit you within the next 12 months to explain your conservatorship to you; find out whether you want to change your conservator or end the conservatorship; decide whether you still need a conservatorship or need a conservatorship with different powers and rights; check on whether the conservator is managing your living arrangements, personal care, and finances in your best interests; and determine whether you can communicate a desire to vote. After the visit, the investigator will file a report making recommendations to the court.

   c. You may also contact the court investigator if you want to ask the court to end or change your conservatorship. The investigator will inform the judge in your case. The court may then set a hearing or notify your lawyer or, if you don’t have a lawyer and don’t plan to get one, appoint a lawyer to help you ask the court for the orders you want. YOUR PERSONALIZED LIST OF RIGHTS UNDER THE CONSERVATORSHIP

4. In a conservatorship, you have the right to:

   a. Make and communicate your own informed choices to the greatest extent possible.

   b. Be informed on a regular basis of the decisions your conservator has made for you.

   c. Remain as independent as possible and live in the least restrictive setting needed to protect your health and safety.

   d. Make or change your will.

   e. Enter into reasonable transactions to provide for your basic needs and those of your children and spouse or domestic partner.

   f. Have a lawyer to represent you.

   g. Ask a judge to review your concerns about the conservatorship or your complaints about the actions of your conservator.

   h. Ask a judge to change your conservatorship.

   i. Ask a judge to end your conservatorship.

Adopted for Mandatory Use PERSONALIZED INFORMATION FOR CONSERVATEE Probate Code 1835.5; Local Rule 7402 Riverside Superior Court riverside.courts.ca.gov Form RI-PR105 [Rev. 01/01/26]

CONSERVATORSHIP OF: CASE NUMBER:

The court’s appointment order grants your conservator powers and modifies your rights as shown below.

Note: Sometimes the court will grant your conservator the power to make a decision and not withhold or take away your right to make the same decision. That means you can make decisions alone, and your conservator can make decisions alone only if (1) you do not object or (2) there’s an emergency.

5. Powers and rights to provide for your personal care and protect your safety (check all that apply)

   Conservator You have You do not
   Power or right to: has the power this right have this right

   a. Decide where you live. b. Make your health care decisions. c. Decide who takes care of you. d. Make decisions about your education. e. Have visits from family and friends. f. Receive phone calls. g. Receive personal mail. h. Receive personal email and text messages. i. Control who has access to your confidential personal papers. j. Decide whether you reside in a secured perimeter residential care facility k. Decide whether you take medication to treat major neurocognitive disorders. l. Decide who you have social and sexual relationships with.

m. Decide whether you get married or form a domestic
partnership.
n. Register to vote and cast your vote in local, state, and
national elections.
o. Other powers or rights with respect to your personal care and safety (describe below):

6. Powers and rights to manage your money and property (Estate) (check all that apply)

Conservator You have You do not Power or right to: has the power this right have this right a. Directly receive and control your own wages or salary. b. Take possession of and manage your money and property. c. Control who has access to your confidential financial records or papers.

Adopted for Mandatory Use PERSONALIZED INFORMATION FOR CONSERVATEE Probate Code 1835.5; Local Rule 7402 Riverside Superior Court riverside.courts.ca.gov Form RI-PR105 [Rev. 01/01/26]

CONSERVATORSHIP OF: CASE NUMBER:

6. (continued)

   Conservator You have You do not
   Power or right to: has the power this right have this right

   d. Make contracts or enter into transactions with your money or property (check one): All contracts and transactions. Only the contracts and transactions described in Attachment 6d. e. Prosecute, defend, compromise, or settle claims by or against you or your estate (check one): All claims and proceeds Only the claims and proceeds described in Attachment 6e. f. The court has granted you the right to receive and control an allowance of (amount): of your funds every (time period): for personal expenses. g. Other powers or rights with respect to managing your money or property (describe below):

   (DATE) (DATE)

   (SIGNAURE OF CONSERVATOR) (SIGNATURE OF CONSERVATOR)

   (TYPE OR PRINT NAME OF CONSERVATOR) (TYPE OR PRINT NAME OF CONSERVATOR)

Adopted for Mandatory Use PERSONALIZED INFORMATION FOR CONSERVATEE Probate Code 1835.5; Local Rule 7402 Riverside Superior Court riverside.courts.ca.gov Form RI-PR105 [Rev. 01/01/26]