IN THE CHANCERY COURT OF MADISON COUNTY, MISSISSIPPI

IN RE:_______________________________	CAUSE NO.: ____________

LETTERS OF CONSERVATORSHIP

WHEREAS, __(name of conservator)__, has been appointed by the Court as Conservator of the estate of ___(ward's name)____, a minor (if applicable).

I, THEREFORE, BY THESE LETTERS, authorize _(name of conservator)_, as Conservator aforesaid, to discharge the duties required of (him/her) by law or by the order of this Court: the Conservator is empowered with the powers enumerated in Section 421 of the Mississippi Guardian and Conservator Act, with the following exception(s): _____(list exceptions as indicated in order of appointment, if any)_____.

WITNESS, Honorable ______(Judge's Name)____, Judge of the Chancery Court of Madison County, Mississippi, on the ____ day of __________, 20___, the seal of said Court hereunto affixed.

ISSUED, this the _______ day of ___________________, 20_____.

Ronny Lott, Chancery Clerk

By:_____________________________

Deputy Clerk (seal)

I, Ronny Lott, Clerk of the Chancery Court in and for the County of Madison and the State of Mississippi, certify that the above is a true copy of the Letters of Conservatorship of the Estate of _____________, (a minor, if applicable), granted, and issued to ___________________, Conservator, on the _____ day of _________________, 20____, as same appears on file and of record in my office in the city of Canton in said County and State.

Given under my hand and seal of said Court at Canton, Mississippi, in Madison County and said State, this the _____ day of ______________, 20_____.