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Here is the text we could read:

ATTORNEY OR PARTY WITHOUT ATTORNEY

STATE BAR NUMBER:

FOR COURT USE ONLY

GC-366

STATE:

FAX NO.:

ZIP CODE:

NAME:

FIRM NAME:

STREET ADDRESS:

CITY:

TELEPHONE NO.:

E-MAIL ADDRESS:

ATTORNEY FOR (name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

CONSERVATORSHIP OF
(name):

1.  Protected person's (e.g., conservatee's or ward's) personal information:

Name:
Residence Address:

Telephone:

E-mail:

PETITION FOR ORDERS ACCEPTING TRANSFER 
(California Conservatorship Jurisdiction Act)

HEARING DATE AND TIME:

DEPT.:

CONSERVATEE

CASE NUMBER:

2.

I, (name):
was appointed the conservator or guardian for the person named in 1 by a court of record of the state of
(specify):

(the transferring state) on (date):

. My appointment remains in effect.

3.

The California Conservatorship Jurisdiction Act (CCJA; Prob. Code, §§ 1981–2033), applies to this proceeding because the 
protected person:  

•  Is 18 years of age or older; 
•  Is NOT involuntarily committed to a mental health facility or receiving any other involuntary mental health care or 

treatment; and 

•  Has NOT been been diagnosed or assessed with a developmental disability. 

4.

A certified copy of the provisional order of transfer issued by a court of record in the transferring state is attached to this form.

The existing protective proceeding is best described under California law as (check all that apply):

A conservatorship of the person (The court order gives me powers and duties to manage the protected person's needs for  
food, clothing, shelter, or health care.)

A conservatorship of the estate (The court order gives me powers and duties to manage the protected person's finances 
and property.)

 

 

 

a.

b.

Form Approved for Optional Use 
Judicial Council of California 
GC-366 [Rev. January 1, 2020]

PETITION FOR ORDERS ACCEPTING TRANSFER 
(California Conservatorship Jurisdiction Act)

Page 1 of 3

Probate Code, §§ 1993–1994, 2002 
www.courts.ca.gov

CONSERVATORSHIP OF
(name):

CASE NUMBER:

GC-366

CONSERVATEE

5.

Factors relevant to determining the jurisdiction of the California court:

The conservatee has been physically present in California since (date):                                                            and remains 
present in California.

The conservatee was physically present in California from (date):                                                          
to (date):                                                         , ending within six months of the date this petition is filed.

The conservatee has the following connections to California (list all that apply):

(1)

The following relatives and other persons required to receive notice of the proceeding reside in California:

a.

b.

c.

Continued on Attachment 5c(1). (Use a blank sheet of paper or form MC-025.)

(2)

The conservatee was physically present in California during the following periods:

From (date):

From (date):

From (date):

From (date):

to (date):

to (date):

to (date):

to (date):

Continued on Attachment 5c(2). (Use a blank sheet of paper or form MC-025.)

(3)

The conservatee will move permanently to California and reside at the following address (provide if known):

(4)

The conservatee holds a legal or beneficial interest in the following property located in California (describe each piece 
of property; give the street address of real property or the location of personal property):

Additional property is described on Attachment 5c(4). (Use a blank sheet of paper or form MC-025.)

$

$

$ $ $ $ $ $

$

$

(A)

Estimated value of real property in California: 

(B)

Estimated value of personal property in California: 

(C)

Annual gross income from

(i)

Real property:

(ii)

Personal property:

(iii)

Pensions:

(iv)

Wages:

(vi)

Other:

Subtotal of (C):

(v)

Public assistance benefits:   

(D)

Total of (A), (B), and (C):

(5)

The conservatee has the following other ties to California (for example, voter registration, driver's license, tax filing):

Continued on Attachment 5c(5). (Use a blank sheet of paper or form MC-025.)

GC-366 [Rev. January 1, 2020]

Page 2 of 3

PETITION FOR ORDERS ACCEPTING TRANSFER 
(California Conservatorship Jurisdiction Act)

CASE NUMBER:

GC-366

CONSERVATEE

CONSERVATORSHIP OF
(name):

6.

I request that the court:

b.

(1)
(2)

Appoint me
Appoint
(mailing address):

(name):

a. Accept transfer of this proceeding and recognize the transferring state's conservatorship order.

as conservator of the                                                       under California law for the person named in 1, or

person

estate

(telephone number):
(relationship to conservatee):

(e-mail):

, who is eligible for appointment under California law,

as conservator of the                                                             for the person named in 1.

person

estate

c.

(1)

Adopt the transferring state's conservatorship order, which needs no modification to conform to California law. 

(2)

Issue a new conservatorship order, as proposed on the attached Order Appointing Probate Conservator (form 
GC-340), which modifies the terms of the conservatorship as follows to conform to California law:

(A) Powers modified:

(B) Duties modified:

(C) Bond modified:

(D) Other information needed:

Additional modifications are included on Attachment 6c(2). (Attach a blank sheet of paper or form MC-025.)

d.

Issue Letters of Conservatorship (form GC-350) on the appointee's qualification.

A Petition for Appointment of Temporary Conservator (form GC-111) is filed with this petition.

The conservatee                                                          been diagnosed with a major neurocognitive disorder (major NCD, 
such as dementia).

has not

has

A completed Petition for Exclusive Authority to Give Consent for Medical Treatment (form GC-380), with Attachment 
Requesting Special Orders Regarding a Major Neurocognitive Disorder (form GC-313), is filed with this petition.

I intend to petition the court for major NCD/dementia powers under section 2356.5 of the Probate Code as soon as the 
court issues a final order accepting transfer of this conservatorship.

I declare under penalty of perjury under the laws of the State of California that the information stated on this form and any attachments 
is true and correct.

7.

8.

a.

b.

Date:

(TYPE OR PRINT NAME)

(SIGNATURE)

GC-366 [Rev. January 1, 2020]

Page 3 of 3

PETITION FOR ORDERS ACCEPTING TRANSFER 
(California Conservatorship Jurisdiction Act)

Petition for Orders Accepting Transfer (California Conservatorship Jurisdiction Act)

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): 3
Fields(s): 98
Average fields per page: 32
Reading Level: Grade 8
LIST Grouping(s): Unknown

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_std_p_info_county was GC-366[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].CrtCounty_ft[0] (0.54 conf)
c_page_std_p_info_branch was GC-366[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].Branch_ft[0] (0.38 conf)
c_page_std_p_header_info_city__1 was GC-366[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].CityZip_ft[0] (0.38 conf)
c_page_std_p_info_street was GC-366[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].Street_ft[0] (0.42 conf)
c_page_std_p_header_info was GC-366[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].MailingAdd_ft[0] (0.42 conf)
c_page_std_p_title_party_name was GC-366[0].Page1[0].StdP1Header_sf[0].TitlePartyName[0].Party1_ft[0] (0.41 conf)
g_c_page_std_p_header_info__1 was GC-366[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyState_ft[0] (0.42 conf)
g_c_page_std_p_header_info__2 was GC-366[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyZip_ft[0] (0.39 conf)
c_page_std_p_header_info_city__2 was GC-366[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyCity_ft[0] (0.39 conf)
c_page_std_p_header_info_street was GC-366[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyStreet_ft[0] (0.40 conf)
g_c_page_std_p_header_info__3 was GC-366[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyFirm_ft[0] (0.42 conf)
c_page_std_p_header_info_name was GC-366[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyName_ft[0] (0.40 conf)
c_page_std_p_header_info_phone was GC-366[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].Phone_ft[0] (0.38 conf)
g_c_page_std_p_header_info__4 was GC-366[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].Fax_ft[0] (0.40 conf)
c_page_std_p_header_info_email was GC-366[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].Email_ft[0] (0.43 conf)
g_c_page_std_p_header_info__5 was GC-366[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyFor_ft[0] (0.41 conf)
g_c_page_std_p_header_info__6 was GC-366[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].BarNo_ft[0] (0.40 conf)
g_c_page_std_p_header_number was GC-366[0].Page1[0].StdP1Header_sf[0].CaseNumber[0].CaseNumber_ft[0] (0.39 conf)
c_page_std_p_case_number was GC-366[0].Page1[0].StdP1Header_sf[0].CaseNumber[1].hearing_ft[0] (0.37 conf)
g_c_page_std_p_number_dept was GC-366[0].Page1[0].StdP1Header_sf[0].CaseNumber[1].dept_ft[0] (0.37 conf)
g_c_page_party_ft was GC-366[0].Page1[0].Party1_ft[0] (0.33 conf)
g_c_page_item_address_ff was GC-366[0].Page1[0].item1address_ff[0] (0.32 conf)
g_c_page_item_name_ff__1 was GC-366[0].Page1[0].item2name_ff[0] (0.32 conf)
g_c_page_area_checkbox__1 was GC-366[0].Page1[0].#area[0].Checkbox[0] (0.33 conf)
g_c_page_area_checkbox__2 was GC-366[0].Page1[0].#area[1].Checkbox[1] (0.33 conf)
g_c_page_area_checkbox__3 was GC-366[0].Page1[0].#area[2].Checkbox[2] (0.33 conf)
g_c_page_item_name_ff__2 was GC-366[0].Page1[0].item2name_ff[1] (0.32 conf)
g_c_page_item_name_ff__3 was GC-366[0].Page1[0].item2name_ff[2] (0.32 conf)
g_c_page_area_checkbox__4 was GC-366[0].Page1[0].#area[3].Checkbox[3] (0.33 conf)
g_c_page_item_name_ff__4 was GC-366[0].Page1[0].item1name_ff[0] (0.32 conf)
g_c_page_item_name_ff__5 was GC-366[0].Page1[0].item1name_ff[1] (0.32 conf)
g_c_page_caption_sf_number was GC-366[0].Page2[0].PxCaption_sf[0].CaseNumber[0].CaseNumber_ft[0] (0.36 conf)
c_page_caption_title_party_name was GC-366[0].Page2[0].PxCaption_sf[0].TitlePartyName[0].Party1_ft[0] (0.37 conf)
g_c_page_text_field__1 was GC-366[0].Page2[0].TextField6[0] (0.41 conf)
g_c_page_text_field__2 was GC-366[0].Page2[0].TextField6[1] (0.41 conf)
g_c_page_fill_text__1 was GC-366[0].Page2[0].FillText26[0] (0.38 conf)
g_c_page_fill_text__2 was GC-366[0].Page2[0].FillText27[0] (0.38 conf)
g_c_page_fill_text__3 was GC-366[0].Page2[0].FillText28[0] (0.38 conf)
g_c_page_fill_text__4 was GC-366[0].Page2[0].FillText29[0] (0.38 conf)
g_c_page_fill_text__5 was GC-366[0].Page2[0].FillText30[0] (0.38 conf)
g_c_page_fill_text__6 was GC-366[0].Page2[0].FillText31[0] (0.38 conf)
g_c_page_fill_text__7 was GC-366[0].Page2[0].FillText3[0] (0.38 conf)
g_c_page_fill_text__8 was GC-366[0].Page2[0].FillText18[0] (0.38 conf)
g_c_page_fill_text__9 was GC-366[0].Page2[0].FillText32[0] (0.38 conf)
g_c_page_area_checkbox__5 was GC-366[0].Page2[0].#area[0].Checkbox[0] (0.33 conf)
g_c_page_area_checkbox__6 was GC-366[0].Page2[0].#area[1].Checkbox[1] (0.33 conf)
g_c_page_area_checkbox__7 was GC-366[0].Page2[0].#area[2].Checkbox[2] (0.33 conf)
g_c_page_text_field__3 was GC-366[0].Page2[0].TextField7[0] (0.41 conf)
g_c_page_area_checkbox__8 was GC-366[0].Page2[0].#area[3].Checkbox[3] (0.33 conf)
g_c_page_area_checkbox__9 was GC-366[0].Page2[0].#area[4].Checkbox[4] (0.33 conf)
g_c_page_area_checkbox__10 was GC-366[0].Page2[0].#area[5].Checkbox[5] (0.33 conf)
g_c_page_area_date_field__1 was GC-366[0].Page2[0].#area[5].DateField1[0] (0.41 conf)
g_c_page_area_checkbox__11 was GC-366[0].Page2[0].#area[6].Checkbox[6] (0.33 conf)
g_c_page_area_date_field__2 was GC-366[0].Page2[0].#area[6].DateField2[0] (0.41 conf)
g_c_page_area_checkbox__12 was GC-366[0].Page2[0].#area[7].Checkbox[7] (0.33 conf)
g_c_page_text_field__4 was GC-366[0].Page2[0].TextField6[2] (0.41 conf)
g_c_page_date_ff__1 was GC-366[0].Page2[0].on_date_ff[0] (0.31 conf)
g_c_page_date_ff__2 was GC-366[0].Page2[0].on_date_ff[1] (0.31 conf)
g_c_page_date_ff__3 was GC-366[0].Page2[0].on_date_ff[2] (0.31 conf)
g_c_page_date_ff__4 was GC-366[0].Page2[0].on_date_ff[3] (0.31 conf)
g_c_page_date_ff__5 was GC-366[0].Page2[0].on_date_ff[4] (0.31 conf)
g_c_page_date_ff__6 was GC-366[0].Page2[0].on_date_ff[5] (0.31 conf)
g_c_page_date_ff__7 was GC-366[0].Page2[0].on_date_ff[6] (0.31 conf)
g_c_page_date_ff__8 was GC-366[0].Page2[0].on_date_ff[7] (0.31 conf)
g_c_page_area_checkbox__13 was GC-366[0].Page2[0].#area[8].Checkbox[8] (0.33 conf)
g_c_page_area_checkbox__14 was GC-366[0].Page2[0].#area[9].Checkbox[9] (0.33 conf)
g_c_page_area_checkbox__15 was GC-366[0].Page2[0].#area[10].Checkbox[10] (0.33 conf)
g_c_page_area_checkbox__16 was GC-366[0].Page2[0].#area[11].Checkbox[11] (0.33 conf)
g_c_page_fill_text__10 was GC-366[0].Page2[0].FillText3[1] (0.38 conf)
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g_c_px_caption_sf_number was GC-366[0].#subform[2].PxCaption_sf[0].CaseNumber[0].CaseNumber_ft[0] (0.36 conf)
c_caption_sf_title_party_name was GC-366[0].#subform[2].PxCaption_sf[0].TitlePartyName[0].Party1_ft[0] (0.37 conf)
g_c_subform_area_checkbox__1 was GC-366[0].#subform[2].#area[0].Checkbox[0] (0.32 conf)
g_c_subform_area_cb__1 was GC-366[0].#subform[2].#area[1].has_cb[0] (0.30 conf)
g_c_subform_area_cb__2 was GC-366[0].#subform[2].#area[2].has_cb[1] (0.30 conf)
g_c_subform_fill_text__1 was GC-366[0].#subform[2].FillText1140[0] (0.39 conf)
g_c_subform_fill_text__2 was GC-366[0].#subform[2].FillText56[0] (0.39 conf)
g_c_subform_area_comp_cb__1 was GC-366[0].#subform[2].#area[3].comp_cb[0] (0.30 conf)
g_c_subform_area_comp_cb__2 was GC-366[0].#subform[2].#area[4].comp_cb[1] (0.30 conf)
g_c_subform_area_checkbox__2 was GC-366[0].#subform[2].#area[5].Checkbox[1] (0.32 conf)
g_c_subform_item_tf was GC-366[0].#subform[2].item2bmailingadd_tf[0] (0.30 conf)
g_c_subform_item_bphnnmbr_ff was GC-366[0].#subform[2].item2bphnnmbr_ff[0] (0.30 conf)
g_c_subform_item_bemail_ff was GC-366[0].#subform[2].item2bemail_ff[0] (0.30 conf)
g_c_subform_item_ff was GC-366[0].#subform[2].item2brelationship_ff[0] (0.30 conf)
g_c_subform_area_checkbox__3 was GC-366[0].#subform[2].#area[6].Checkbox[2] (0.32 conf)
g_c_subform_area_checkbox__4 was GC-366[0].#subform[2].#area[7].Checkbox[3] (0.32 conf)
g_c_subform_area_checkbox__5 was GC-366[0].#subform[2].#area[8].Checkbox[4] (0.32 conf)
g_c_subform_area_text_field was GC-366[0].#subform[2].#area[9].TextField2[0] (0.42 conf)
g_c_subform_area_check_box was GC-366[0].#subform[2].#area[9].CheckBox61[0] (0.34 conf)
g_c_subform_area_checkbox__6 was GC-366[0].#subform[2].#area[10].Checkbox[5] (0.32 conf)
g_c_subform_checkbox was GC-366[0].#subform[2].Checkbox[6] (0.32 conf)
g_c_subform_area_checkbox__7 was GC-366[0].#subform[2].#area[11].Checkbox[7] (0.32 conf)
g_c_subform_area_checkbox__8 was GC-366[0].#subform[2].#area[12].Checkbox[8] (0.32 conf)
g_c_subform_text_field_ff__1 was GC-366[0].#subform[2].TextField1_ff[0] (0.42 conf)
g_c_subform_text_field_ff__2 was GC-366[0].#subform[2].TextField2_ff[0] (0.42 conf)
g_c_subform_text_field_ff__3 was GC-366[0].#subform[2].TextField3_ff[0] (0.42 conf)
g_c_subform_text_field_ff__4 was GC-366[0].#subform[2].TextField4_ff[0] (0.42 conf)
g_c_subform_area_checkbox__9 was GC-366[0].#subform[2].#area[13].Checkbox[9] (0.32 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

c_page_std_p_info_county
c_page_std_p_info_branch
c_page_std_p_header_info_city__1
c_page_std_p_info_street
c_page_std_p_header_info
c_page_std_p_title_party_name
g_c_page_std_p_header_info__1
g_c_page_std_p_header_info__2
c_page_std_p_header_info_city__2
c_page_std_p_header_info_street
g_c_page_std_p_header_info__3
c_page_std_p_header_info_name
c_page_std_p_header_info_phone
g_c_page_std_p_header_info__4
c_page_std_p_header_info_email
g_c_page_std_p_header_info__5
g_c_page_std_p_header_info__6
g_c_page_std_p_header_number
c_page_std_p_case_number
g_c_page_std_p_number_dept
g_c_page_party_ft
g_c_page_item_address_ff
g_c_page_item_name_ff__1
g_c_page_area_checkbox__1
g_c_page_area_checkbox__2
g_c_page_area_checkbox__3
g_c_page_item_name_ff__2
g_c_page_item_name_ff__3
g_c_page_area_checkbox__4
g_c_page_item_name_ff__4
g_c_page_item_name_ff__5
g_c_page_caption_sf_number
c_page_caption_title_party_name
g_c_page_text_field__1
g_c_page_text_field__2
g_c_page_fill_text__1
g_c_page_fill_text__2
g_c_page_fill_text__3
g_c_page_fill_text__4
g_c_page_fill_text__5
g_c_page_fill_text__6
g_c_page_fill_text__7
g_c_page_fill_text__8
g_c_page_fill_text__9
g_c_page_area_checkbox__5
g_c_page_area_checkbox__6
g_c_page_area_checkbox__7
g_c_page_text_field__3
g_c_page_area_checkbox__8
g_c_page_area_checkbox__9
g_c_page_area_checkbox__10
g_c_page_area_date_field__1
g_c_page_area_checkbox__11
g_c_page_area_date_field__2
g_c_page_area_checkbox__12
g_c_page_text_field__4
g_c_page_date_ff__1
g_c_page_date_ff__2
g_c_page_date_ff__3
g_c_page_date_ff__4
g_c_page_date_ff__5
g_c_page_date_ff__6
g_c_page_date_ff__7
g_c_page_date_ff__8
g_c_page_area_checkbox__13
g_c_page_area_checkbox__14
g_c_page_area_checkbox__15
g_c_page_area_checkbox__16
g_c_page_fill_text__10
g_c_page_date_field
g_c_px_caption_sf_number
c_caption_sf_title_party_name
g_c_subform_area_checkbox__1
g_c_subform_area_cb__1
g_c_subform_area_cb__2
g_c_subform_fill_text__1
g_c_subform_fill_text__2
g_c_subform_area_comp_cb__1
g_c_subform_area_comp_cb__2
g_c_subform_area_checkbox__2
g_c_subform_item_tf
g_c_subform_item_bphnnmbr_ff
g_c_subform_item_bemail_ff
g_c_subform_item_ff
g_c_subform_area_checkbox__3
g_c_subform_area_checkbox__4
g_c_subform_area_checkbox__5
g_c_subform_area_text_field
g_c_subform_area_check_box
g_c_subform_area_checkbox__6
g_c_subform_checkbox
g_c_subform_area_checkbox__7
g_c_subform_area_checkbox__8
g_c_subform_text_field_ff__1
g_c_subform_text_field_ff__2
g_c_subform_text_field_ff__3
g_c_subform_text_field_ff__4
g_c_subform_area_checkbox__9

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

Petition for Orders Accepting Transfer (California Conservatorship Jurisdiction Act)

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