Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: Lawyer's Bar Number: Licensed Fiduciary Number: ____________________________________ Representing Self, without a Lawyer or Attorney for Petitioner OR FOR CLERK'S USE ONLY Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY In the Matter of Case Number: PB AFFIDAVIT OF NOTICE OF HEARING REGARDING DISCHARGE/TERMINATION and/or RELEASE of FUNDS in a A protected or Incapacitated Adult GUARDIANSHIP and CONSERVATORSHIP GUARDIANSHIP (only) CONSERVATORSHIP (only) UNDER OATH OR BY AFFIRMATION: I state to the Court under penalty of perjury that the contents of this document are true and correct. 1. I PROVIDED COPIES OF THE FOLLOWING COURT DOCUMENTS: PETITION for Discharge of Guardian and/or Conservator and/or Termination of Guardianship and/or Conservatorship and Release of Funds. NOTICE OF HEARING OTHER (if applicable) List specifically each court document you provided. 2. I PROVIDED THE DOCUMENTS LISTED ABOVE TO THE PERSONS whose relation to the protected person as well as the date and manner of delivery is listed below. (If the protected person is an adult, be sure to include his or her attorney, if any.) A. B. C. D. Name: (printed) Relation to protected person: Date documents sent: (or delivered) How the documents were sent: 1st class mail, postage prepaid Certified mail Registered mail (attach green return receipt card to this paper) Hand delivery by: (name) Personal Service (by "Acceptance of Service", Sheriff, or Private Process Server)* * File "Affidavit of Acceptance" or affidavit of process server or sheriff) (Check box(es) below and fill-in appropriate information) ©Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 1 of 2 NOT American LegalNet, Inc. www.FormsWorkFlow.com PBGCD29f - 050115 Use only most current version Case No. A. B. C. D. Name: (printed) Relation to protected person: Date documents sent: (or delivered) How the documents were sent: 1st class mail, postage prepaid Certified mail Registered mail (attach green return receipt card to this paper) Hand delivery by: (name) Personal Service (by "Acceptance of Service", Sheriff, or Private Process Server)* * File "Affidavit of Acceptance" or affidavit of process server or sheriff) (Check box(es) below and fill-in appropriate information) A. B. C. D. Name: (printed) Relation to protected person: Date documents sent: (or delivered) How the documents were sent: 1st class mail, postage prepaid Certified mail Registered mail (attach green return receipt card to this paper) Hand delivery by: (name) Personal Service (by "Acceptance of Service", Sheriff, or Private Process Server)* * File "Affidavit of Acceptance" or affidavit of process server or sheriff) (Check box(es) below and fill-in appropriate information) UNDER OATH OR AFFIRMATION I swear or affirm under penalty of perjury that the contents of this document are true and correct to the best of my knowledge and belief. Date Signature STATE OF COUNTY OF Subscribed and sworn to or affirmed before me this: (date) by . (notary seal) ©Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Deputy Clerk or Notary Public PBGCD29f - 050115 Use only most current version Page 2 of 2 NOT American LegalNet, Inc. www.FormsWorkFlow.com