Gc 314 Form PDF Details

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QuestionAnswer
Form NameGc 314 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesgc 314 form, 314 form gc, conservator screening form, form gc 314

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Probate Code, §§ 1810, 1811, 2104, 2346; Cal. Rules of Court, rule 7.1050
www.courtinfo.ca.gov

CONFIDENTIAL (DO NOT ATTACH TO PETITION)

GC-314

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):

 

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

CONSERVATORSHIP OF

 

 

 

 

 

CASE NUMBER:

 

(Name):

 

 

 

 

 

 

 

 

 

 

 

 

PROPOSED CONSERVATEE

 

 

 

 

 

 

 

 

 

 

 

CONFIDENTIAL CONSERVATOR SCREENING FORM

HEARING DATE AND TIME:

DEPT.:

 

 

Conservatorship of

 

Person

 

Estate

 

Limited Conservatorship

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The proposed conservator must complete and sign this form. The person requesting appointment of a conservator must submit the completed and signed form to the court with the conservatorship petition.

THIS FORM MUST REMAIN CONFIDENTIAL.

How This Form Will Be Used

This form is confidential and will not be a part of the public file in this case. Each proposed conservator must complete and sign a separate copy of this form under rule 7.1050 of the California Rules of Court. The information provided in this form will be used by the court and by the persons and agencies designated by the court to assist the court in determining whether to appoint the proposed conservator as conservator. The proposed conservator must respond to each item.

1.a.

b.

c.

e.

2.a.

b.

Proposed conservator (NAME):

 

 

 

Date of birth:

 

 

 

Social security number:

d. Driver's license number:

State:

Telephone numbers: Home:

Work:

 

Other:

 

I am related to the proposed conservatee as (specify relationship):

 

 

 

 

I have personally known the proposed conservatee for:

years,

months.

 

3.

 

 

I was

 

 

 

I was not

nominated as conservator of the

 

 

 

person

 

 

estate of the proposed conservatee,

 

by

 

 

 

the proposed conservatee.

 

 

the spouse or registered domestic partner of the proposed conservatee.

 

 

 

 

 

 

 

 

 

a parent of the proposed conservatee. (If you checked "I was," provide documentation in Attachment 3.)

 

 

 

4.

a.

 

 

 

I am the spouse of the proposed conservatee.

 

 

I have

 

 

 

I have not

filed for legal separation,

 

 

 

 

 

 

 

 

 

 

 

 

 

dissolution of marriage, annulment, or adjudication of nullity of the marriage. (If you checked "I have,"

 

 

 

 

 

explain in Attachment 4.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b.

 

 

 

I am not the spouse of the proposed conservatee.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

a.

 

 

 

I am the registered domestic partner of the proposed conservatee.

 

 

I do not

 

 

I do intend to

 

 

 

 

 

terminate my domestic partnership with the proposed conservatee. (If you checked "I do," explain in Attachment 5.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b.

 

 

 

I am a former domestic partner of the proposed conservatee. My domestic partnership with the proposed

 

 

 

 

 

conservatee was terminated on (date):

 

 

. (Explain circumstances in Attachment 5.)

 

c.

 

 

 

I am neither a current nor former domestic partner of the proposed conservatee.

 

 

 

 

 

 

 

 

 

 

 

6.

 

 

 

 

I do

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a.

 

 

 

 

 

 

 

I do not

 

owe money or have a financial obligation to the proposed conservatee.

 

 

(If you checked "I do," explain in Attachment 6.)

 

 

 

 

 

 

 

 

 

 

 

 

 

b.

The proposed conservatee

 

 

 

does

 

 

does not

owe money or have a financial obligation to me.

 

 

 

 

 

 

 

 

(If you checked "does," explain in Attachment 6.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c.

 

 

 

I am

 

 

 

 

I am not

 

an agent for a creditor of the proposed conservatee.

 

 

 

 

 

 

If you checked "I am," explain in Attachment 6.)

 

 

 

 

 

 

 

 

 

 

 

Page 1 of 2

Form Adopted for Mandatory Use

Judicial Council of California GC-314 [Rev. July 1, 2009]

CONFIDENTIAL CONSERVATOR SCREENING FORM

(Probate—Guardianships and Conservatorships)

CONFIDENTIAL

GC-314

CONSERVATORSHIP OF (Name):

PROPOSED CONSERVATEE

CASE NUMBER:

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

I have

 

I have not

filed for bankruptcy protection within the last 10 years. (If you checked "I have," explain in

 

 

 

 

 

Attachment 7.)

 

 

 

 

I have

 

I have not

been convicted of a felony or had a felony expunged from my record. (If you checked "I have,"

 

 

 

 

 

explain in Attachment 8.)

 

 

 

 

I have

 

I have not

been charged with, arrested for, or convicted of embezzlement, theft, or any other crime

 

 

 

 

 

involving the taking of property. (If you checked "I have," explain in Attachment 9.)

I have

 

I have not

been charged with, arrested for, or convicted of a crime involving fraud, conspiracy, or

 

 

 

 

 

 

misrepresentation of information. (If you checked "I have," explain in Attachment 10.)

 

 

 

 

 

 

I have

 

I have not

been charged with, arrested for, or convicted of any form of elder abuse or neglect.

 

 

 

 

 

(If you checked "I have," explain in Attachment 11.)

 

 

 

 

 

 

I have

 

I have not

had a restraining order or protective order filed against me in the last 10 years.

 

 

 

 

 

(If you checked "I have," explain in Attachment 12.)

 

 

 

 

 

 

I am

 

I am not

required to register as a sex offender under California Penal Code section 290.

 

 

 

 

 

(If you checked "I am," explain in Attachment 13.)

 

 

 

 

 

 

I have

 

I have not

previously been appointed conservator, executor, or fiduciary in another proceeding.

 

 

 

 

 

(If you checked "I have," explain in Attachment 14.)

I have

 

 

I have not

been removed or resigned as a conservator, guardian, executor, or fiduciary in any other case.

 

 

 

 

 

 

 

(If you checked "I have," explain in Attachment 15.)

I have or may have

 

I do not have an adverse interest that the court may consider to be a risk to, or to have an

 

 

 

 

 

 

effect on, my ability to faithfully perform the duties of conservator. (If you checked "I have or

 

 

 

 

 

may have," explain in Attachment 16.)

 

 

 

 

I am

 

 

I am not

a private professional fiduciary, as defined in Business and Professions Code section 6501(f).

 

 

 

 

 

(If you checked "I am," respond to item 18. If you checked "I am not," go to item 19.)

 

 

 

 

I am

 

 

I am not

currently licensed by the Professional Fiduciaries Bureau of the Department of Consumer

 

 

 

 

 

Affairs. My license status and information is stated in item 1 on page 1 of the Professional

 

 

 

 

 

.

 

 

 

 

 

Fiduciary Attachment signed by me and attached to the petition that proposes my appointment

 

 

 

 

 

as conservator in this matter. (Complete and sign the Professional Fiduciary Attachment and

 

 

 

 

 

attach it to the petition, or deliver it to the petitioner for attachment, before the petition is filed.

 

 

 

 

 

See item 3c(7) of the petition. Use form GC-210(A-PF)/GC-310(A-PF) for this attachment.)

 

 

 

a responsible corporate officer authorized to act for (name of corporation):

I am

 

 

I am not

a California nonprofit charitable corporation that meets the requirements for appointment as conservator of the proposed conservatee under Probate Code section 2104. I certify that the corporation's articles of incorporation specifically authorize it to accept appointments as conservator. (If you checked "I am," explain the circumstances of the corporation's care of, counseling of, or financial assistance to the proposed conservatee in Attachment 19.)

20. Do you, or does any other person living in your home, have a social worker or parole or probation officer assigned to him or her?

Yes

 

No

(If you checked "Yes," explain in Attachment 20 and provide the name, address, and telephone

 

 

 

number of each social worker, parole officer, or probation officer.)

 

 

 

DECLARATION

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

(TYPE OR PRINT NAME OF PROPOSED CONSERVATOR)

(SIGNATURE OF PROPOSED CONSERVATOR)*

*Each proposed conservator must fill out and file a separate screening form.

GC-314 [Rev. July 1, 2009]

CONFIDENTIAL CONSERVATOR SCREENING FORM

Page 2 of 2

(Probate—Guardianships and Conservatorships)

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Part number 1 of filling in 314 form gc

2. Just after this array of blanks is filled out, go to enter the relevant details in these - This form is confidential and will, Proposed conservator name, Date of birth, Social security number, d Drivers license number, Telephone numbers Home, Work, State, Other, I am related to the proposed, I have personally known the, years, months, I was, and I was not nominated as conservator.

Other, I was, and Proposed conservator name inside 314 form gc

3. This subsequent section is normally fairly easy, I do, I do not owe money or have a, If you checked I do explain in, does, does not owe money or have a, I am, I am not an agent for a creditor, If you checked I am explain in, Form Adopted for Mandatory Use, Judicial Council of California GC, CONFIDENTIAL CONSERVATOR SCREENING, ProbateGuardianships and, Page of, and Probate Code Cal Rules of - all of these empty fields must be filled in here.

Part # 3 in filling out 314 form gc

4. To move ahead, this stage requires completing a handful of fields. These include CONSERVATORSHIP OF Name, CASE NUMBER, CONFIDENTIAL, PROPOSED CONSERVATEE, I have, I have not, filed for bankruptcy protection, I have, I have not, been convicted of a felony or had, I have, I have not been charged with, involving the taking of property, I have, and I have not, which you'll find key to continuing with this process.

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If you checked Yes explain in, I am, and I am in 314 form gc

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