Person Filing: Mailing Address: City, State, Zip: Day/Evening Phone: Person Filing is: If Attorney: Name: Attorney Bar No. / SELF (No Attorney) OR Attorney Atty Phone: FOR CLERK’S USE ONLY SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY JUVENILE COURT In the matter of Emancipation of Case Number: JE A Minor (Request to Keep Information Confidential) (Optional – Not a required document) Motion to Seal Court Record Petitioner requests the Court seal the record in the above matter. The Petition for Emancipation contains information of the following nature, which may contain or infer matters of confidentiality or privacy, pursuant to Rule 123, Rules of the Supreme Court and Rule 19(A)(2), Rules of Procedure for the Juvenile Court. Address information involving petitioner, petitioner’s parents, or petitioner’s guardians. Financial information to include the amount and potential source of such earnings. Potential allegations of abuse or neglect against petitioner’s parents or guardians. Medical expense information of the petitioner, from which the public may ascertain or infer petitioner’s current medical health. Social history information of the petitioner regarding how petitioner came to be in the custody of the guardian. Public disclosure of any of the above items serves neither the best interest of the petitioner nor public access to judicial records. _____________________________________ ___________________ Signature of Minor Date © Superior Court of Arizona in Maricopa County July 11, 2007 ALL RIGHTS RESERVED Page 1 of 1 JEMS10f Use current version American LegalNet, Inc. www.FormsWorkFlow.com