Adult Conservatorship Petition Template

[Petitioner Name]
[Address]
[City, State, ZIP Code]
[Phone Number]
[Email Address]

IN THE [NAME OF COURT]
FOR [COUNTY / DISTRICT / JURISDICTION]

In the Matter of:
[Name of Proposed Conservatee]

Case No.: [Case Number]

1. Petition

The undersigned Petitioner respectfully asks the Court to appoint a conservator for the adult identified in this Petition.

This request is made because the proposed conservatee is unable to properly manage personal affairs, financial matters, property, or other important interests without court-ordered assistance.

2. Petitioner Information

Petitioner Name: [Full Name]
Address: [Address]
City, State, ZIP Code: [City, State, ZIP Code]
Phone Number: [Phone Number]
Email Address: [Email Address]

Relationship to proposed conservatee:

☐ spouse
☐ adult child
☐ parent
☐ sibling
☐ relative
☐ caregiver
☐ friend
☐ agency representative
☐ other: [Describe]

3. Proposed Conservatee Information

Name: [Full Name]
Date of Birth: [Date of Birth]
Current Address or Location: [Address / Facility / Other]

The proposed conservatee is an adult who is believed to need:

☐ conservatorship of the person
☐ conservatorship of the estate
☐ conservatorship of both person and estate

4. Proposed Conservator

The person proposed to serve as conservator is:

Name: [Full Name]
Address: [Address]
Phone Number: [Phone Number]
Email Address: [Email Address]

Relationship to proposed conservatee:

[Describe relationship]

The proposed conservator is willing and able to serve.

5. Facts Supporting Petition

The proposed conservatee is unable to manage affairs for the following reasons:

[Describe incapacity, condition, functional limits, safety concerns, financial risks, or other facts]

Examples of concerns may include:

[missed bills or unpaid obligations]
[inability to understand decisions]
[risk of exploitation or abuse]
[medical or cognitive decline]
[inability to manage daily needs]
[other relevant facts]

6. Requested Conservatorship Powers

The Petitioner asks the Court to grant authority to the conservator to:

☐ manage financial accounts
☐ pay bills and expenses
☐ protect property and assets
☐ enter contracts as allowed by law
☐ arrange housing or care
☐ make personal care decisions as allowed by law
☐ access records and information
☐ other powers: [Describe]

7. Less Restrictive Alternatives

The following less restrictive alternatives have been considered:

[power of attorney]
[supported decision-making]
[family assistance]
[trust management]
[other option]

These alternatives are not sufficient because:

[Insert explanation]

8. Interested Persons

The following persons may have an interest in this matter and should receive notice if required:

Name: [Full Name]
Relationship: [Relationship]
Address: [Address]

Name: [Full Name]
Relationship: [Relationship]
Address: [Address]

Additional interested persons, if any:

[Insert details]

9. Property and Financial Information

If conservatorship of the estate is requested, the proposed conservatee’s known assets or income may include:

[bank accounts]
[real property]
[retirement income]
[benefits]
[personal property]
[other assets or income]

Additional financial details:

[Insert details]

10. Need for Court Appointment

The Petitioner believes court appointment is necessary because:

[Explain why immediate or formal authority is needed]

The requested conservatorship is intended to protect the proposed conservatee and support proper management of affairs under court supervision.

11. Request for Relief

The Petitioner respectfully asks the Court to:

appoint [Proposed Conservator Name] as conservator;
grant the powers requested in this Petition;
set a hearing on the matter;
grant any further relief the Court considers proper.

12. Verification

I declare under penalty of perjury that the statements in this Adult Conservatorship Petition are true and correct to the best of my knowledge.

Petitioner Signature: __________________________
Name: [Full Name]
Date: [Date]

13. Proposed Conservator Acceptance

I agree to serve as conservator if appointed by the Court and to carry out the duties required by law and court order.

Proposed Conservator Signature: __________________________
Name: [Full Name]
Date: [Date]

14. Notary or Court Verification

State of [State]
County of [County]

Subscribed and sworn to before me on this [Day] of [Month], [Year], by [Name of Signer].

Notary Public Signature: __________________________
Name: [Notary Name]
My Commission Expires: [Date]