MPC 532 (06/09)
Division
CERTIFICATE OF ANCILLARY FILING-
CONSERVATORSHIP
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
In the Interests of:
Last Name
First Name
Protected Person
The foreign conservator's sworn statement has been filed with this Court stating that no conservatorship, application, or
petition for conservatorship or other protective proceeding is pending in Massachusetts.
The following documents regarding
First Name
Last Name
Middle Initial
, as
(name of foreign conservator)
the foreign conservator, have been filed with this Court:
Authenticated copy of the foreign court's order appointing the foreign conservator; or
Authenticated copy of the foreign court's letter, or other documents evidencing or affecting the foreign conservator's
authority to act.
An authenticated copy of any Bond of the foreign conservator has been filed or, if none was filed, a sworn certification that no
Bond was required.
I certify that the attached document(s) is/are a true and accurate copy of the authenticated copy of the document(s) referenced
above in my custody.
REGISTER OF PROBATE
Date: