Letters of Guardianship of the Person/Conservatorship of the

							STATE OF MINNESOTA                                                                           DISTRICT COURT
                                                                                          JUDICIAL DISTRICT
COUNTY OF                                                                            PROBATE COURT DIVISION
                                                                       Court File No
In Re: Guardianship/Conservatorship of
In Re:    Guardianship          Conservatorship of
                                                                                                      LETTERS OF:
                                                                  GUARDIANSHIP               CONSERVATORSHIP
   Ward           Protected Person

Guardian:
        , is qualified and is hereby authorized to act as Guardian of         , after being appointed as guardian by
the Court;      the ward’s spouse; or     the ward’s parent, with all of the powers and authority prescribed by statute
as shown on the order appointing guardian the terms of which order are incorporated herein by reference including
the powers under M.S. § 524.5-313 subd. (c) as follows:
     all powers therein,
or
     only those under paragraphs         1,      2,     3,     4,      5,      6 and       7; and

Conservator:
        , is qualified and is hereby authorized to act as Conservator of the protected person, with all of the powers
and authority prescribed by statute as shown on the order appointing conservator, the terms of which order are
incorporated herein by reference including the powers under M.S. § 524.5-417 subd. (c) as follows:
     all powers therein,
or
     only those under paragraphs         1,     2,      3,    4,      5 and      6;

and each has such other powers and duties granted under applicable law.

Dated:                                                         ____________________________________________
                                                               Judge of District Court

PRESENT ADDRESS AND TELEPHONE NUMBER                           PRESENT ADDRESS AND TELEPHONE NUMBER
OF WARD / PROTECTED PERSON                                     OF GUARDIAN / CONSERVATOR
                                                               Guardian




Phone Number:                                                  Phone Number:
                                                               Conservator




                                                               Phone Number:




M.S. § 524.5-110                                                               Letters of Guardianship and Conservatorship
Approved by Conference of Chief Judges: 5/21/04        Page 1 of 1                                         Revised 3/30/05