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CONFIDENTIAL (DO NOT ATTACH TO PETITION)

GC-314

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

FOR COURT USE ONLY

FAX NO. (Optional):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

TELEPHONE NO.:

E-MAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

CONSERVATORSHIP OF
(Name):

PROPOSED CONSERVATEE

CASE NUMBER:

CONFIDENTIAL CONSERVATOR SCREENING FORM

Conservatorship of

Person

Estate

Limited Conservatorship

HEARING DATE AND TIME:

DEPT.:

The proposed conservator must complete and sign this form. The person requesting appointment of a
conservator must submit the completed and signed form to the court with the conservatorship petition.
This form must remain confidential.
How This Form Will Be Used
This form is confidential and will not be a part of the public file in this case. Each proposed conservator must complete and sign a
separate copy of this form under rule 7.1050 of the California Rules of Court. The information provided in this form will be used by
the court and by the persons and agencies designated by the court to assist the court in determining whether to appoint the
proposed conservator as conservator. The proposed conservator must respond to each item.

a.
b.
c.
e.

Proposed conservator (name):
Date of birth:

Social security number:
Telephone numbers: Home:

d. Driver's license number:

Work:

State:

Other:

2. a.

I am related to the proposed conservatee as

(specify relationship):

I have personally known the proposed conservatee for:

months.

I was

I was not
the proposed conservatee.

nominated as conservator of the

estate

of the proposed conservatee,

the spouse or registered domestic partner of the proposed conservatee.

a parent of the proposed conservatee. (If you checked "I was," provide documentation in Attachment 3.)

years,

person

4. a.

I am the spouse of the proposed conservatee.

I have

I have not

filed for legal separation,

dissolution of marriage, annulment, or adjudication of nullity of the marriage. (If you checked "I have,"
explain in Attachment 4.)

I am not the spouse of the proposed conservatee.

I am the registered domestic partner of the proposed conservatee.
terminate my domestic partnership with the proposed conservatee. (If you checked "I do," explain in Attachment 5.)

I do not

intend to

I do

I am a former domestic partner of the proposed conservatee. My domestic partnership with the proposed

conservatee was terminated on (date):

(Explain circumstances in Attachment 5.)

I am neither a current nor former domestic partner of the proposed conservatee.

owe money or have a financial obligation to the proposed conservatee.

I do

I do not
(If you checked "I do," explain in Attachment 6.)

The proposed conservatee
(If you checked "does," explain in Attachment 6.)

does

does not

owe money or have a financial obligation to me.

I am

I am not
If you checked "I am," explain in Attachment 6.)

an agent for a creditor of the proposed conservatee.

Form Adopted for Mandatory Use
Judicial Council of California
GC-314 [Rev. July 1, 2009]

CONFIDENTIAL CONSERVATOR SCREENING FORM
(Probate—Guardianships and Conservatorships)

Page 1 of 2

Probate Code, §§ 1810, 1811,
2104, 2346;
Cal. Rules of Court, rule 7.1050
www.courts.ca.gov

CONSERVATORSHIP OF (Name):

CASE NUMBER:

CONFIDENTIAL

GC-314

PROPOSED CONSERVATEE

I have

I have not

filed for bankruptcy protection within the last 10 years. (If you checked "I have," explain in
Attachment 7.)

I have

I have not

been convicted of a felony or had a felony expunged from my record. (If you checked "I have,"
explain in Attachment 8.)

I have

I have not

been charged with, arrested for, or convicted of embezzlement, theft, or any other crime
involving the taking of property. (If you checked "I have," explain in Attachment 9.)

I have

I have not

been charged with, arrested for, or convicted of a crime involving fraud, conspiracy, or
misrepresentation of information. (If you checked "I have," explain in Attachment 10.)

I have

I have not

been charged with, arrested for, or convicted of any form of elder abuse or neglect.
(If you checked "I have," explain in Attachment 11.)

I have

I have not

had a restraining order or protective order filed against me in the last 10 years.
(If you checked "I have," explain in Attachment 12.)

I have

I have not

required to register as a sex offender under California Penal Code section 290.
(If you checked "I am," explain in Attachment 13.)

I have

I have not

previously been appointed conservator, executor, or fiduciary in another proceeding.
(If you checked "I have," explain in Attachment 14.)

I have

I have not

been removed or resigned as a conservator, guardian, executor, or fiduciary in any other case.
(If you checked "I have," explain in Attachment 15.)

I have or may have

I am

I am not

I do not have an adverse interest that the court may consider to be a risk to, or to have an
effect on, my ability to faithfully perform the duties of conservator. (If you checked "I have or
may have," explain in Attachment 16.)

a private professional fiduciary, as defined in Business and Professions Code section 6501(f).
(If you checked "I am," respond to item 18. If you checked "I am not," go to item 19.)

currently licensed by the Professional Fiduciaries Bureau of the Department of Consumer
Affairs. My license status and information is stated in item 1 on page 1 of the Professional
Fiduciary Attachment signed by me and attached to the petition that proposes my appointment
as conservator in this matter. (Complete and sign the Professional Fiduciary Attachment and
attach it to the petition, or deliver it to the petitioner for attachment, before the petition is filed.
See item 3c(7) of the petition. Use form GC-210(A-PF)/GC-310(A-PF) for this attachment.)

19.

I am

I am not

a responsible corporate officer authorized to act for (name of corporation):

a California nonprofit charitable corporation that meets the requirements for appointment as
conservator of the proposed conservatee under Probate Code section 2104. I certify that the
corporation's articles of incorporation specifically authorize it to accept appointments as
conservator. (If you checked "I am," explain the circumstances of the corporation's care of,
counseling of, or financial assistance to the proposed conservatee in Attachment 19.)

20.

Do you, or does any other person living in your home, have a social worker or parole or probation officer assigned to him or her?

Yes

(If you checked "Yes," explain in Attachment 20 and provide the name, address, and telephone
number of each social worker, parole officer, or probation officer.)

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

10.

11.

12.

13.

14.

15.

16.

17.

18.

Date:

(TYPE OR PRINT NAME OF PROPOSED CONSERVATOR)

(SIGNATURE OF PROPOSED CONSERVATOR)*

*Each proposed conservator must fill out and file a separate screening form.

GC-314 [Rev. July 1, 2009]

Page 2 of 2

CONFIDENTIAL CONSERVATOR SCREENING FORM
(Probate—Guardianships and Conservatorships)

Confidential Conservator Screening Form

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 2
Fields(s): 86
Average fields per page: 43
Reading Level: Grade 9
LIST Grouping(s): CO-00-00-00-00, CO-07-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

c_page_p_court_info_county was GC-314[0].Page1[0].p1Caption[0].CourtInfo[0].CrtCounty[0] (0.52 conf)
c_page_p_caption_info_street was GC-314[0].Page1[0].p1Caption[0].CourtInfo[0].CrtStreet[0] (0.38 conf)
page_p_caption_court_info_mailing was GC-314[0].Page1[0].p1Caption[0].CourtInfo[0].CrtMailingAdd[0] (0.35 conf)
g_c_page_p_caption_court_info_crt_city_zip was GC-314[0].Page1[0].p1Caption[0].CourtInfo[0].CrtCityZip[0] (0.36 conf)
c_page_p_caption_court_info was GC-314[0].Page1[0].p1Caption[0].CourtInfo[0].CrtBranch[0] (0.38 conf)
c_page_p_title_party_name was GC-314[0].Page1[0].p1Caption[0].TitlePartyName[0].Party1[0] (0.34 conf)
c_page_p_form_title_b__1 was GC-314[0].Page1[0].p1Caption[0].FormTitle[0].RB2Choices[0] (0.35 conf)
c_page_p_form_title_b__2 was GC-314[0].Page1[0].p1Caption[0].FormTitle[0].RB2Choices[1] (0.35 conf)
c_page_p_form_title_b__3 was GC-314[0].Page1[0].p1Caption[0].FormTitle[0].RB2Choices[2] (0.35 conf)
g_c_page_p_case_number was GC-314[0].Page1[0].p1Caption[0].CaseNumber[0].CaseNumber[0] (0.36 conf)
c_page_p_case_number_fill__1 was GC-314[0].Page1[0].p1Caption[0].CaseNumber1[0].FillText1[0] (0.40 conf)
c_page_p_case_number_fill__2 was GC-314[0].Page1[0].p1Caption[0].CaseNumber1[0].FillText1[1] (0.40 conf)
c_page_p_party_info_text was GC-314[0].Page1[0].p1Caption[0].AttyPartyInfo[0].TextField1[0] (0.40 conf)
c_page_p_party_info_phone was GC-314[0].Page1[0].p1Caption[0].AttyPartyInfo[0].Phone[0] (0.37 conf)
c_page_p_caption_party_info was GC-314[0].Page1[0].p1Caption[0].AttyPartyInfo[0].Fax[0] (0.37 conf)
c_page_p_party_info_email was GC-314[0].Page1[0].p1Caption[0].AttyPartyInfo[0].Email[0] (0.37 conf)
c_page_p_party_info was GC-314[0].Page1[0].p1Caption[0].AttyPartyInfo[0].Attorneyname[0] (0.37 conf)
g_c_page_fill_text__1 was GC-314[0].Page1[0].FillText1081[0] (0.38 conf)
g_c_page_fill_text__2 was GC-314[0].Page1[0].FillText1081[1] (0.38 conf)
g_c_page_fill_text__3 was GC-314[0].Page1[0].FillText1081[2] (0.38 conf)
g_c_page_fill_text__4 was GC-314[0].Page1[0].FillText1081[3] (0.38 conf)
g_c_page_fill_text__5 was GC-314[0].Page1[0].FillText1081[4] (0.38 conf)
g_c_page_fill_text__6 was GC-314[0].Page1[0].FillText1081[5] (0.38 conf)
g_c_page_fill_text__7 was GC-314[0].Page1[0].FillText1081[6] (0.38 conf)
g_c_page_fill_text__8 was GC-314[0].Page1[0].FillText1081[7] (0.38 conf)
g_c_page_fill_text__9 was GC-314[0].Page1[0].FillText1081[8] (0.38 conf)
g_c_page_fill_text__10 was GC-314[0].Page1[0].FillText1081[9] (0.38 conf)
g_c_page_item__1 was GC-314[0].Page1[0].Item3[0] (0.33 conf)
g_c_page_item__2 was GC-314[0].Page1[0].Item3[1] (0.33 conf)
g_c_page_item_p_e__1 was GC-314[0].Page1[0].Item3-P-E[0] (0.33 conf)
g_c_page_item_p_e__2 was GC-314[0].Page1[0].Item3-P-E[1] (0.33 conf)
g_c_page_item__3 was GC-314[0].Page1[0].Item3-by[0] (0.33 conf)
g_c_page_item__4 was GC-314[0].Page1[0].Item3-by[1] (0.33 conf)
g_c_page_item__5 was GC-314[0].Page1[0].Item3-by[2] (0.33 conf)
g_c_page_item_ab__1 was GC-314[0].Page1[0].Item-4ab[0] (0.34 conf)
g_c_page_item__6 was GC-314[0].Page1[0].Item4a[0] (0.33 conf)
g_c_page_item__7 was GC-314[0].Page1[0].Item4a[1] (0.33 conf)
g_c_page_item_ab__2 was GC-314[0].Page1[0].Item-4ab[1] (0.34 conf)
g_c_page_item_abc__1 was GC-314[0].Page1[0].Item-5abc[0] (0.34 conf)
g_c_page_item__8 was GC-314[0].Page1[0].Item-5[0] (0.34 conf)
g_c_page_item__9 was GC-314[0].Page1[0].Item-5[1] (0.34 conf)
g_c_page_item_abc__2 was GC-314[0].Page1[0].Item-5abc[1] (0.34 conf)
g_c_page_fill_text__11 was GC-314[0].Page1[0].FillText1140[0] (0.38 conf)
g_c_page_item_abc__3 was GC-314[0].Page1[0].Item-5abc[2] (0.34 conf)
g_c_page_item__10 was GC-314[0].Page1[0].Item-6a[0] (0.34 conf)
g_c_page_item__11 was GC-314[0].Page1[0].Item-6a[1] (0.34 conf)
g_c_page_item_b__1 was GC-314[0].Page1[0].Item-6b[0] (0.34 conf)
g_c_page_item_b__2 was GC-314[0].Page1[0].Item-6b[1] (0.34 conf)
g_c_page_item__12 was GC-314[0].Page1[0].Item-6c[0] (0.34 conf)
g_c_page_item__13 was GC-314[0].Page1[0].Item-6c[1] (0.34 conf)
g_c_page_check_box_caption__1 was GC-314[0].Page1[0].CheckBoxCaption[0] (0.35 conf)
g_c_page_check_box_caption__2 was GC-314[0].Page1[0].CheckBoxCaption[1] (0.35 conf)
g_c_page_fill_text__12 was GC-314[0].Page1[0].FillText1081[10] (0.38 conf)
g_c_page_fill_text__13 was GC-314[0].Page2[0].FillText1140[0] (0.38 conf)
c_page_caption_title_party_name was GC-314[0].Page2[0].pxCaption[0].TitlePartyName[0].Party1[0] (0.34 conf)
g_c_page_px_case_number was GC-314[0].Page2[0].pxCaption[0].CaseNumber[0].CaseNumber[0] (0.36 conf)
g_c_page_fill_text__14 was GC-314[0].Page2[0].FillText56[0] (0.38 conf)
g_c_page_item__14 was GC-314[0].Page2[0].Item-7[0] (0.34 conf)
g_c_page_item__15 was GC-314[0].Page2[0].Item-7[1] (0.34 conf)
g_c_page_item__16 was GC-314[0].Page2[0].Item-8[0] (0.34 conf)
g_c_page_item__17 was GC-314[0].Page2[0].Item-8[1] (0.34 conf)
g_c_page_item__18 was GC-314[0].Page2[0].Item-9[0] (0.34 conf)
g_c_page_item__19 was GC-314[0].Page2[0].Item-9[1] (0.34 conf)
g_c_page_item__20 was GC-314[0].Page2[0].Item-10[0] (0.34 conf)
g_c_page_item__21 was GC-314[0].Page2[0].Item-10[1] (0.34 conf)
g_c_page_item__22 was GC-314[0].Page2[0].Item-11[0] (0.34 conf)
g_c_page_item__23 was GC-314[0].Page2[0].Item-11[1] (0.34 conf)
g_c_page_item__24 was GC-314[0].Page2[0].Item-12[0] (0.34 conf)
g_c_page_item__25 was GC-314[0].Page2[0].Item-12[1] (0.34 conf)
g_c_page_item__26 was GC-314[0].Page2[0].Item-13[0] (0.34 conf)
g_c_page_item__27 was GC-314[0].Page2[0].Item-13[1] (0.34 conf)
g_c_page_item__28 was GC-314[0].Page2[0].Item-14[0] (0.34 conf)
g_c_page_item__29 was GC-314[0].Page2[0].Item-14[1] (0.34 conf)
g_c_page_item__30 was GC-314[0].Page2[0].Item-15[0] (0.34 conf)
g_c_page_item__31 was GC-314[0].Page2[0].Item-15[1] (0.34 conf)
g_c_page_item__32 was GC-314[0].Page2[0].Item-16[0] (0.34 conf)
g_c_page_item__33 was GC-314[0].Page2[0].Item-17[0] (0.34 conf)
g_c_page_item__34 was GC-314[0].Page2[0].Item-17[1] (0.34 conf)
g_c_page_item__35 was GC-314[0].Page2[0].Item-18[0] (0.34 conf)
g_c_page_item__36 was GC-314[0].Page2[0].Item-18[1] (0.34 conf)
g_c_page_item__37 was GC-314[0].Page2[0].Item-20[0] (0.34 conf)
g_c_page_item__38 was GC-314[0].Page2[0].Item-20[1] (0.34 conf)
g_c_page_item__39 was GC-314[0].Page2[0].Item-19[0] (0.34 conf)
g_c_page_item__40 was GC-314[0].Page2[0].Item-19[1] (0.34 conf)
g_c_page_responsible_corp was GC-314[0].Page2[0].ResponsibleCorp[0] (0.40 conf)
g_c_page_item__41 was GC-314[0].Page2[0].Item-16[1] (0.34 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Confidential Conservator Screening Form

About This Form:

Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02