Nomination of Conservator
I, (Name), being of sound mind and not acting under duress, fraud, or other undue influence, do hereby nominate (Name, current residence, and relationship, if any, of the nominee) to serve as the conservator of my property in the event that after the date of this instrument I become incapacitated or have other need for protection.
Executed at __________________________________ (city, state)
on this ___________ day of _______________________________
______________________________ (Signature)
Utah Code § 75-5-410