Petition for Appointment of Conservator - Preparation Worksheet - Connecticut

CONNECTICUT INVOLUNTARY CONSERVATORSHIP PREPARATION WORKSHEET

Do not file this worksheet. Use the current official PC-300, Petition/Involuntary Appointment of Conservator, and file PC-300CI separately for confidential information. This worksheet is limited to an adult involuntary conservatorship of the person, estate, or both. Voluntary representation, a minor guardianship, intellectual-disability guardianship, temporary conservatorship, psychiatric-medication authority, and interstate or transfer proceedings use different or additional law and forms.

1. ROUTING CHECK

Respondent is an adult alleged to be incapable: ☐ Yes

Type of appointment requested:

☐ Conservator of the person

☐ Conservator of the estate

☐ Both

Interstate screen from PC-300:

☐ The respondent has been physically present in Connecticut for at least six consecutive months before filing, including temporary absences.

☐ No. Complete PC-300A and obtain review under Connecticut's interstate conservatorship provisions before filing.

Other proceeding or appointment: [NONE / COURT, STATE, CASE NUMBER, AND STATUS]

2. COURT, RESPONDENT, AND PETITIONER

Probate Court name: [COURT]

Probate district number: [NUMBER]

Venue basis under § 45a-648(a):

☐ Respondent resides in the district.

☐ Respondent is domiciled in the district.

☐ Respondent is located in the district when the petition is filed.

Respondent: [FULL LEGAL NAME]

Date of birth: [DATE]

Residence address: [ADDRESS]

Domicile address, if different: [ADDRESS]

Present address, if different: [ADDRESS]

Petitioner: [FULL NAME, ADDRESS, TELEPHONE, AND RELATIONSHIP]

3. FUNCTIONAL FACTS — CONSERVATOR OF THE ESTATE

Complete only if estate authority is requested.

3.1 Condition and Decision-Making

Describe the mental, emotional, or physical condition that allegedly prevents the respondent from receiving and evaluating information or making or communicating decisions concerning financial affairs:

[FACTS, DATES, SOURCES, AND SPECIFIC EXAMPLES]

3.2 Financial Functions Affected

Identify the functions the respondent cannot perform even with appropriate assistance:

☐ Obtain or safeguard income and public benefits

☐ Pay ordinary expenses and debts

☐ Manage bank or investment accounts

☐ Manage real or personal property

☐ Protect property from waste or dissipation

☐ Obtain funds needed for the respondent's support, care, or welfare

☐ Obtain funds needed for a person whom the respondent must support

For every selected item, state a concrete supporting fact: [DETAILS]

3.3 Existing Financial Arrangements

List powers of attorney, trusts, joint accounts, representative payees, federal fiduciaries, automatic payments, family assistance, professional services, and other arrangements:

[ARRANGEMENT / RESPONSIBLE PERSON / DOCUMENT / WHY IT IS OR IS NOT ADEQUATE]

4. FUNCTIONAL FACTS — CONSERVATOR OF THE PERSON

Complete only if personal authority is requested.

4.1 Condition and Decision-Making

Describe the condition that allegedly prevents the respondent from receiving and evaluating information or making or communicating decisions concerning essential personal needs:

[FACTS, DATES, SOURCES, AND SPECIFIC EXAMPLES]

4.2 Personal Needs Affected

Identify the essential requirements the respondent cannot meet even with appropriate assistance:

☐ Food

☐ Clothing

☐ Shelter

☐ Health care

☐ Safety

☐ Other specific need: [DESCRIBE]

For every selected item, state a concrete supporting fact: [DETAILS]

4.3 Existing Personal-Care Arrangements

List the respondent's living will, health-care representative or agent, health-care power of attorney, support services, family help, technology, community program, and other arrangement. Attach the documents required by PC-300.

[ARRANGEMENT / RESPONSIBLE PERSON / DOCUMENT / WHY IT IS OR IS NOT ADEQUATE]

5. LESS-RESTRICTIVE ALTERNATIVES

Section 45a-650 requires the court to examine whether the respondent's needs can be met without a conservator and, if an appointment is made, to assign only the least restrictive necessary authority.

6. PROPOSED CONSERVATOR

Name: [FULL LEGAL NAME]

Address and telephone: [CONTACT INFORMATION]

Appointment requested: [PERSON / ESTATE / BOTH]

Connecticut resident: [YES / NO]

Respondent's designation or nomination: [NAME / DOCUMENT / OR NONE KNOWN]

If the proposed conservator is not the respondent's nominee, explain the evidence relevant to willingness, ability, qualification, or disqualification: [EXPLANATION]

Describe the proposed conservator's:

1. knowledge of the respondent's preferences;
2. ability to perform the requested duties;
3. expected cost;
4. commitment to welfare and independence; and
5. existing or potential conflicts of interest.

[FACTS]

7. NOTICE ROSTER

The Probate Court issues the citation and directs service. Do not invent a private service plan or treat this worksheet as the citation.

List the current § 45a-649 notice recipients and the information requested on PC-300:

Efforts made to identify or locate a person whose name or address is unknown: [DETAILS]

8. EVIDENCE AND HEARING CHECK

☐ The respondent has been advised of the right to retain an attorney and the court-appointment process where the respondent cannot obtain counsel.

☐ The respondent's ability and request to attend have been recorded; if access is a problem, the court has been informed.

☐ Medical evidence is from a Connecticut-licensed physician who examined the respondent not more than 45 days before the hearing, unless the court permits the statutory alternative or waiver.

☐ The evidence describes the condition and its functional effect, not only a diagnosis.

☐ Relevant family, social-work, hospital, community, support-service, and technology evidence has been identified.

☐ Confidential medical or psychological material is separated and handled as the court directs.

☐ The requested appointment and every requested duty can be supported by clear and convincing evidence under § 45a-650.

9. REQUESTED DUTIES AND LIMITATIONS

Do not request “all powers” without analyzing necessity. Identify each duty requested and the facts showing why that duty is the least restrictive necessary intervention.

Rights and authority to remain with the respondent or an existing agent: [DETAILS]

10. POST-APPOINTMENT ORIENTATION

This worksheet does not create conservator duties. The decree controls the appointment and assigned authority.

If the court appoints a conservator:

1. A conservator of the estate must furnish the probate bond required by § 45a-650(i), and the court may require a bond from a conservator of the person when necessary for protection.
2. A conservator of the estate must file the § 45a-655(a) inventory within two months after appointment. Use the current official conservatorship inventory form listed by the Probate Courts.
3. Annual estate accountings are not an automatic universal schedule: under the 2026 supplement to § 45a-655(c), the court may require them and must do so at an interested party's request.
4. Under § 45a-660(c), the court reviews the conservatorship within one year and at least every three years after that initial review. The conserved person may petition for termination at any time under § 45a-660(a).
5. Use only the authority assigned in the decree, preserve unassigned rights, and follow each later court order and current official form.

11. ASSEMBLY CHECKLIST

☐ Current PC-300 completed in full

☐ PC-300CI completed and filed separately

☐ PC-300A completed if the six-month physical-presence box cannot be selected

☐ Copies of relevant power-of-attorney and health-care documents attached as PC-300 directs

☐ Respondent's designation or nomination of conservator attached or explained

☐ Notice roster and search efforts complete

☐ Functional facts and less-restrictive alternatives supported with admissible evidence

☐ Proposed conservator acceptance and nonresident-fiduciary form handled if applicable

☐ Court-specific fee, service, filing, confidentiality, and local instructions confirmed directly with the selected Probate Court

End of Connecticut Involuntary Conservatorship Preparation Worksheet