Los Angeles local probate form — Probate Case Coversheet and Certificate of Grounds for Assignment to District (LASC PRO 010)

Source: https://lascpubstorage.blob.core.windows.net/forms/Forms%20Comprehensive%20List/LASC%20PRO%20010.pdf

PROBATE CASE COVERSHEET AND CERTIFICATE OF Reserved for Clerks File Stamp GROUNDS FOR ASSIGNMENT TO DISTRICT

TITLE OF CASE

CASE NUMBER

This form is required for all new probate cases filed in the Superior Court of California, County of Los Angeles.

Step 1: In the “Type of Action” column below, select (begintype of action that best describes the nature of this case by checking a box.

Step 2: Across from the “Type of Action” you selected, place an “X” in the column that corresponds to the reason for your choice of district. Note that you may only select from the boxes that are (beginshaded.

but more w/o or 2.3(b) or resides trust Central in Rule of (Probate authority _________ one proposed person resident district resides TYPE OF ACTION minor in filed petitioner decedent conservatee LASC one) (check or is place 17002) be where where CA where resides where proposed not § statutory ▼ per or

tory ▼ per or

tory ▼ per or statute):__ may District parties District conservatee, capacity nor conservatee District resides District resided Decedent, minor property Principal administration Code Other (list Or Dist.

District parties District conservatee, capacity nor conservatee District resides District resided Decedent, minor property Principal administration Code Other (list Or Dist.

Decedent’s Estate □Petition – Letters of Administration (Initial) [3069] □Petition – Letters of Special Admin w/Gen Powers (Initial) [3070] □Petition – Letters of Special Admin w/o Gen Powers (Initial) [3071] □Petition – Probate of Lost Will (Initial) [3074] □Petition – Probate of Will (Initial) [3075] Conservatorship □Petition – Appoint Conservator of Estate – Attend/Nominate (Initial) [3303] (Note: The proposed conservatee will appear at the hearing and ha s nominated the proposed conservator.) □Petition – Appoint Conservator of Estate Only (Initial) [3046] □Petition – Appoint Conservator of Person Only (Initial) [3047] □Petition – Appoint Conservator of Person & Estate (Initial) [3048] □Petition – Appoint Ltd Conservator of Person/Person & Estate (Initial) [3198] Guardianship □Petition – Appoint Guardian of Estate Only (Initial) [3049] Proposed □Petition – guardian is Minor(s) or Appoin considered a: Ward(s) are: t Guardian of Person Only □Under 18 years A One) (Initial) [3051] B One) □Relative B One) old □Non-Relative □Petition – □Age 18 to underSection Section (Pursuant t Section (Check (Check (Check Appoin 21 t Guardian o Probate Code of Per son & Estate (Init ial) [3050]

SCLAC PRO 010 Rev. 04/26 Probate Case Cover Sheet – Certificate of Grounds for Assignment to District SCLAC Rule 2.3
For Mandatory Use

re s or o ral )3(b o/ yt but ___ e te m ed w dei 2. ts et oner e ba a or Cent horit edent on res urt v ____ ul denti or c itit u e s des trict opos ni s er R a of is __ er P( s de pr pe on d er

pr pe on d er

pr pe on d er 2) p dis e nori ed C n yr er n __ ACTION TYPE OF o S m ni elif ot des ac os c iot A 700 CA u ee ,ee is pl a L e):t ,t one) (check or is 1 be at at at u tr opr where where where where er y y v v en p t st y

v en p t st y not is it § at ▼ d per pali a er er in st e tric ro esi ric trict t. trict pert dedi desi m t c nc m rhe s s s ts ts nori e d ons ons apac Di part Di c c nor c Di res Di res D m pro Pri a Code Ot si(l Or Di

Trust □Accounting – Trust (Initial) [3229] □Notice – Initial Trust Filing & Notice to Creditors [3038] □Petition – Special Needs Trust (Initial) [3297] □Petition – Trust/Pursuant Prob Code Sec 17200 (Initial) [3076] Minor’s Compromise □Petition – Approve Minor's Compromise (Initial) [3058] □Petition – Approve Minor's Compromise (Expedited) [3154] Other Probate Matters

Other Probate With At Least One Hearing □Petition – Advance Health Care Directive (Initial) [3044] □Petition – Appoint Successor Custodian/CUTMA (Initial) [3052] □Petition – Authority to Give Medical Consent w/o Conservatorship (Initial) [3059] □Petition – Determine Succession to Primary Residence (Initial) [3301] □Petition – Establish Fact of: □ Birth [3065], □ Death [3066], or □ Marriage [3067] □Petition – Release of Decedent’s Remains (Initial) [3077] □Petition – Spousal/Domestic Partner Property (Initial) [3179] □Petition – Transaction Where Spouse Lacks Capacity (Initial) [3082] □Petition – Tuberculosis Matter [3083] □Other Probate matter (specify):

Other Probate With No Hearing □Affidavit – Real Property of Small Value - 13200 PR Code [3001] □Petition – Order Setting Aside Est. of Small Val. (Probate Code § 6602) [3292] □Petition – Summary Probate (Public Administrator) [3081]

Step 3: Select the appropriate district:

□Central □ North (Antelope Valley)

The undersigned hereby certifies that the above entitled matter is properly filed for assignment to the
District of the Los Angeles Superior Court pursuant to the California Probate Code and Rule 2.3 of this court for the
reason checked above. I declare under penalty of perjury under the laws of the State of California that the foregoing is
true and correct and that this declaration was executed on ______________________ .
(Date)

SIGN
___________________________________________________
(Signature of Attorney or Self-Represented Party)

Step 4: Indicate whether an interpreter is necessary.

• Does the person(s) filing this petition require an interpreter?
□ Yes □ No
If yes, what language? ___________________________________

SCLAC PRO 010 Rev. 04/26 Probate Case Cover Sheet – Certificate of Grounds for Assignment to District SCLAC Rule 2.3
For Mandatory Use

• Does the subject(s) of this petition require an interpreter? □ Yes □ No If yes, what language? ________________________________

Step 5: The following information is required for the proposed conservatee, ward, trustor or decedent. Please check the appropriate box for the subject of this case:

□ Conservatee □ Trustor □ Other: ____________

□ Ward (minor in a guardianship case) □ Decedent

First Name Last Name Middle Name Suffix

A.K.A(s)

Email Address:

Cell Phone (For Text Messaging):

I accept service and notices to be delivered to me by [ ] Email [ ] Cell Phone

Home Address: Street Apt./Suite/Unit #

City State Zip Code

Mailing Address: (☐ same as above ) Street Apt./Suite/Unit #

City State Zip Code

IDENTIFICATION (For Minors)

Gender: Date of Birth: (mm/dd/yyyy)

Male Female / /

SCLAC PRO 010 Rev. 04/26 Probate Case Cover Sheet – Certificate of Grounds for Assignment to District SCLAC Rule 2.3 For Mandatory Use