Name of Person Filing Document: Your Address: Your City, State, Zip Code: Your Telephone Number: Attorney’s Bar Number (if applicable): Representing Self or Attorney for FOR CLERK’S USE ONLY SUPERIOR COURT OF ARIZONA MARICOPA COUNTY In the Matter of the Case Number: PB FEE STATEMENT AND PROOF OF MAILING A Deceased Person INSTRUCTIONS: This document must be completed in all cases where fees are charged. All activities for which fees are charged must be specifically listed, such as telephone calls, meetings, staff meetings, conferences, document preparation, work in house or files, personal visits, trips, and so forth. STATEMENT OF FEES FOR SERVICES: The following is a statement of fees for services rendered from DATE (date) to DESCRIPTION AND SERVICE PROVIDER (date): TIME NUMBER OF HOURS BILLED: Total number of hours billed is © Superior Court of Arizona in Maricopa County December 2, 2009 ALL RIGHTS RESERVED x$ per hour = $ TOTAL CHARGE PBIPF54f 1 of 2 Use only most current version STA American LegalNet, Inc. www.FormsWorkFlow.com Case No. PROOF OF MAILING: A copy of this management plan was mailed or delivered to the following persons: NAME ADDRESS Today’s Date: Your Signature: © Superior Court of Arizona in Maricopa County December 2, 2009 ALL RIGHTS RESERVED PBIPF54f 2 of 2 Use only most current version STA American LegalNet, Inc. www.FormsWorkFlow.com