SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY PROBATE INFORMATION SHEET FOR CLERK’S USE ONLY Case Number: INFORMATION ABOUT FIDUCIARY (THE PERSON TO BE APPOINTED GUARDIAN, CONSERVATOR, OR if seeking appointment concerning the estate of someone who died, PERSONAL REPRESENTATIVE). NOMINATED FIDUCIARY FIDUCIARY’S HOME TELEPHONE FIDUCIARY’S MAILING ADDRESS FIDUCIARY’S WORK TELEPHONE FIDUCIARY’S PHYSICAL ADDRESS FIDUCIARY’S SOCIAL SECURITY NUMBER FIDUCIARY’S DATE OF BIRTH RELATIONSHIP TO THE PERSON ALLEGED TO BE IN NEED OF PROTECTION OR THE PERSON WHO DIED (if an estate matter) RACE HEIGHT EYE COLOR WEIGHT HAIR COLOR FIDUCIARY LICENSE NO. INFORMATION ABOUT THE PERSON NEEDING PROTECTION (a Minor or Incapacitated Person) NAME OF PERSON NEEDING PROTECTION HOME TELEPHONE MAILING ADDRESS PHYSICAL ADDRESS SOCIAL SECURITY NUMBER DATE OF BIRTH IF CONCERNING AN ESTATE MATTER: INFORMATION ABOUT THE DECEDENT (the Person Who Died) DECEDENT’S NAME DECEDENT’S DATE OF BIRTH I state to the court that the information I have provided is true and correct, under penalty of perjury. Petitioner or Attorney Signature NOTICE: This document is used by the Court for administrative purposes only and may be maintained in electronic form. It is not part of the public record. © Superior Court of Arizona in Maricopa County January 3, 2011 ALL RIGHTS RESERVED Page 1 of 1 PB11f Use most current version American LegalNet, Inc. www.FormsWorkFlow.com