MPC 630 (5/30/11)
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ORDER APPOINTING TEMPORARY
CONSERVATOR FOR
Protected Person
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
ADULT
In the Interests of:
Last Name
First Name
Middle Name
Division
After hearing on the Motion for Appointment of Temporary Conservator(s),
The Court finds:
1.
Venue is proper.
Notice pursuant to G.L. c. 190B, §5-412A(d) was:
2.
Shortened or waived in whole or in part because the Court finds that an immediate emergency situation exists
Properly given.
which requires the immediate appointment of a Temporary Conservator(s) pursuant to G.L. c. 190B, §5-412A(e).
The nature of the emergency is the likelihood of immediate and substantial harm to property, income or
entitlements of the Protected Person or those entitled to the Protected Person's support or:
A qualified person seeks appointment.
3.
4.
It is necessary to appoint a Temporary Conservator(s) for the Protected Person because of the likelihood of substantial
harm to the property, income or entitlements of the Protected Person or those entitled to the Protected Person's
support occurring prior to the return date. There is no other conservator appointed and no other person appears to
have authority to act in the circumstances.
The Protected Person is a minor over the age of 14 who requested to be present but the Court finds that the
nonappearance of the minor Protected Person is in his or her best interest because the appearance of the minor
would unnecessarily or inappropriately expose the minor to details regarding the parent(s)' fitness or because:
5.
The Protected Person
was not
was
present.
The Court appoints the following person(s) as Temporary Conservator(s) of the Protected Person (hereafter
a minor
a disabled person
.
"Temporary Conservator") who is
Name:
First Name
M.I.
Last Name
(Address )
(Apt, Unit, No. etc.)
(City/Town)
(State)
Primary Phone #:
Name:
First Name
M.I.
Last Name
(Address )
(Apt, Unit, No. etc.)
(City/Town)
(State)
Primary Phone #:
THIS APPOINTMENT OF TEMPORARY CONSERVATOR(S) IS NOT A DETERMINATION OF INCAPACITY OR DISABILITY.
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MPC 630 (5/30/11)
In the Interests of:
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page
Last Name
First Name
Middle Name
Docket No.
The Temporary Conservator may exercise only the powers specified in this order. The powers of the Temporary
Conservator are as follows:
The Temporary Conservator(s) may only exercise the following powers:
1.
The powers and duties of the Temporary Conservator are all powers over the property and business affairs of the
2.
Protected Person which are or may be necessary in the best interests of the Protected Person and the Protected
Person's immediate family pursuant to G.L. c. 190B, §§ 5-423(c) (1-7) & (14-24). These powers
are limited as set forth in Exhibit A which is incorporated and merged herein and which detail those powers
retained by the protected person
are not limited.
The Court orders the following:
If this Order was issued without full notice, post-appointment notice must be given together with a statement
that the appointment may be vacated and heard as a de novo matter as expeditiously as possible. Said notice
must be given within seven days from the date of this appointment to the Protected Person and those persons
named in the petition who were not previously given notice in accordance with G.L. c. 190B, §5-308(c). A
certification stating such notice has been given must be filed within seven days of the appointment or the
appointment may be vacated sua sponte.
1.
The Court has appointed counsel for the Protected Person. See separate Order Appointing Counsel.
2.
3.
The Temporary Conservator(s) shall serve:
without surety on his, her or their bond:
because the person has a priority of appointment under G.L. c. 190B, §5-409(a)(1) and the person nominating
the conservator expressly waived the requirement.
for the following good cause:
pursuant to G.L. c. 190B, §5-410.
with personal sureties or corporate surety on his, her or their bond in the amount of
NO LETTERS OF CONSERVATORSHIP SHALL ISSUE UNTIL THE BOND IS FILED AND APPROVED.
4.
The Temporary Conservator shall file for approval with the Court a Temporary Conservator's Inventory within ninety (90)
days of this appointment or by
(date)
(date within 90 days from appointment).
The Temporary Conservator shall file for approval with the Court a Temporary Conservator's Account for the time of the
temporary appointment but no later than annually from the date of this appointment unless otherwise ordered by the
Court.
Forms are available at the Court's Registry office or online at the Court's Web site:
http://www.mass.gov/courts/forms
MPC 630 (5/30/11)
In the Interests of:
of
page
Last Name
First Name
Middle Name
Docket No.
The Temporary Conservator(s) shall make the following report to the Court:
5.
(Date)
This appointment of the Temporary Conservator(s) shall expire 90 days from today or on
6.
.
If this date is more than 90 days from the date of appointment, the Court finds the following extraordinary
circumstances warrant a later date:
A
hearing shall be held on this matter on
at the Probate and Family Court.
at
7.
p.m.
a.m.
:
The parties shall comply with a stipulation or agreement of the parties dated
8.
(date)
which is filed with the Court and expressly made a part of this Order.
9.
The Court further orders:
Date
Date
EXTENSION(S) OF APPOINTMENT
For good cause shown, the appointment of the Temporary Conservator(s) is extended for an additional period of time and shall
expire on .
The Bond of the Temporary Conservator(s) is hereby re-examined and re-approved.
Date
A
hearing shall be held on this matter on
at the Probate and Family Court.
at
p.m.
a.m.
:
Date
For good cause shown, the appointment of the Temporary Conservator(s) is extended for an additional period of time and shall
expire on .
The Bond of the Temporary Conservator(s) is hereby re-examined and re-approved.
Date
A
hearing shall be held on this matter on
at the Probate and Family Court.
at
p.m.
a.m.
:
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