Massachusetts Guardianship Form 2 - Free Download
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MPC 130 (5/30/11)
page
of
PETITION FOR APPOINTMENT
OF CONSERVATOR FOR
DISABLED PERSON
OR FOR SINGLE TRANSACTION
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
In the Interests of:
Last Name
First Name
Middle Name
Person to be Protected/Respondent
The Court, whenever feasible, shall grant to a Conservator only those powers necessary based on the
Protected Person's limitations and demonstrated needs and will issue orders that will encourage the
development of the Protected Person's maximum self-reliance and independence.
Minor
Adult
Division
1.
Information about Respondent:
If the residence and current address are outside of the Commonwealth, state the location of Respondent's property within
the county:
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
Principal Residence:
Primary Language:
English
Other
Age:
Last Name
Name:
First Name
M.I.
Date Residence was established:
Current Address:
Same as Above or
the following address:
If this appointment is made, Respondent's dwelling will be
Principal Residence
Current Address
the following address:
Primary Phone #:
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
2.
Information about the Petitioner:
Name:
First Name
M.I.
Last Name
(Address)
(City/Town)
(State)
(Zip)
Primary Phone #:
Relationship to Respondent:
(Apt, Unit, No. etc.)
State your interest in the appointment:
An attachment to this petition provides information on co-petitioners.
3.
Petitioner is requesting:
to be appointed
that some suitable person be appointed
the following person be appointed:
Name:
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
Primary Phone #:
First Name
M.I.
Last Name
Relationship to Respondent:
An attachment to this petition provides additional information.
click to add
click to remove
click to remove
click to add
