PB-4048
REV 07/01/12
DECLARATION FOR WAIVER OF ACCOUNTING Page 1 of 1
PER PROBATE CODE §2628(a)
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address): TELEPHONE NUMBER:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
COURT ADDRESS:
PHONE NUMBER:
FAX NUMBER:
BRANCH NAME:
191 North First Street, San José, California 95113
(408) 882-2651
(408) 882-2693
Downtown Courthouse – Probate Division
In the Matter of Conservatorship of the Estate of:
Conservatee
FOR COURT USE ONLY
DECLARATION FOR WAIVER OF ACCOUNTING
PROBATE CODE §2628(a)
CASE NUMBER:
I, , declare that:
1. I am the Conservator for the above-entitled Conservatorship Estate.
2. Pursuant to Probate
Code section 2628(a), accountings may be waived when the Estate of the
Conservatee at the beginning and termination of the one-year Conservatorship period, if they consist
of:
a. Property,
not including the residence of the Conservatee, of a total net value of less than
$15,000.00;
and,
b. The income of the Conservatee’s Estate for each month of the Conservatorship period,
not
including public benefit payments, is less than $2,000.00;
and,
c. All of the
income of the Conservatee’s Estate during the time of Conservatorship period, if
not retained, was spent for the benefit of the Conservatee.
3. From the beginning through to the termination of the above-designated Conservatorship, all three of
these criteria have been met as to the Conservatee’s Estate.
I declare under penalty of perjury, under the laws of the State of California, that the foregoing is true and
correct. Executed on
at , California.
(Signature)
(Print Name)
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