ATTACHMENT PB- 4076
PB-4076
VERIFICATION OF CONSERVATORSHIP VIDEO VIEWING
PAGE 1 OF 1
(PROBATE – SANTA CLARA COUNTY)
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
191 North First Street
191 North First Street
San Jose, CA 95113
VERIFICATION OF VIEWING OF CONSERVATORSHIP VIDEO
I have petitioned the court to be appointed the conservator of the person and/or estate of
I viewed the court's videotape presentation on the duties and responsibilities of the conservator on
at the following location:
https://www.youtube.com/watch?v=A-SX6YkFsP4
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and
correct.
Signature
INSTRUCTIONS
Before you may be appointed as a conservator, you must watch a video called With Heart:
Understanding Conservatorships
.
This video discusses the duties and responsibilities of a
conservator.
The video is available to you in two ways:
1. You may make an appointment with the Court Investigators Office to view it at the courthouse.
2. You may view the video online at https://www.youtube.com/watch?v=A-SX6YkFsP4
Once you have watched the video, you must fill out, sign, and file this form with the court.
ATTORNEY OR PARTY WITHOUT ATTORNEY(Name, State Bar Number and Address):
Telephone:
Email Address (optional):
Fax Number:
ATTORNEY FOR (name):
BRANCH NAME:
IN RE: THE CONSERVATORSHIP OF:
CASE NUMBER
(Name):
Date:
At the Courthouse by appointment with the Court Investigator Office.
On-line viewing located at
Print Name
