FOR CLERK'S USE ONLY SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY In the Matter of the Conservatorship of Case Number PB: ORDER OF APPOINTMENT OF A PERMANENT CONSERVATOR OF AN ADULT for A MINOR AGED 17.5 OR OLDER to (Name of Protected Person) become effective at age 18 Warning: This appointment is not effective until the Letters of Appointment have been issued by the Clerk of the Superior Court. The Court has read the sworn "Petition for Appointment of Conservatorship" and held a hearing to determine whether the court should enter the Order requested in the Petition. THE COURT FINDS: A. B. C. D. E. Petitioner is entitled to file the Petition under Arizona law, A.R.S.14-5404(A); Petitioner has given "Notice of Hearing" as required by law or "Notice of Hearing" was waived by all interested parties; Venue in this county is proper; Any reports by health professional or court investigator have been considered by the Court; Appointment of a conservator is necessary because in accord with A.R.S. §14-5401: 1. The proposed protected person is unable to manage his or her property and affairs effectively due to mental illness, mental deficiency, mental disorder, physical illness or disability, chronic use of drugs, chronic intoxication, confinement, detention by a foreign power, or disappearance; and 2. The person has property that will be wasted or dissipated unless proper management is provided or because funds are needed for the support, care and welfare of the person or those entitled to be supported by the person, and that protection is necessary or desirable to obtain or provide funds. The person named below is eligible for appointment under A.R.S. §14-5410. F. IT IS ORDERED: 1. The Court appoints: as permanent conservator for the person to be protected named above. The person to be protected is a MINOR, and the appointment is effective upon the minor's 18th birthday on this date: (Month, Date, Year of Protected Person's 18 Birthday) © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED th PBCA81f -110712 Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case No. 2. BOND: OR The Conservator must file a bond in the amount of $ with the Clerk of the Court, Probate Registrar by (date): Bond is not required. 3. ISSUANCE OF LETTERS: Upon filing of any required bond, "Letters of Conservatorship of an Adult" shall be issued by the Clerk of the Court, Probate Registrar, SUBJECT TO THE FOLLOWING RESTRICTIONS: RESTRICTED ACCOUNT: Funds shall be deposited into an interest bearing, federally insured restricted account at a financial institution engaged in business in Arizona. No withdrawals of principal or interest may be made without certified order of the superior court. Unless otherwise ordered by the court, reinvestment may be made without further court order so long as funds remain insured and restricted in this institution at this branch (Arizona Rules of Probate Procedure, Rule 22 (C) 2). The Conservator may only hold funds in a depository which agrees to be bound by the terms of this Order and to make written proof of its agreement to be bound, including such proof of the account, the account number, the amount of the deposit, the notarized signature of the depository branch manager, and the agreement not to permit any withdrawal unless it is first provided with a certified copy of this Court's order permitting the withdrawal. The following funds/accounts shall be restricted: FILING PROOF OF RESTRICTED ACCOUNT: The conservator, the attorney for the conservator, the attorney for the protected person, or the attorney for the insurance company, is responsible for establishing the restricted account and filing proof with the Court within 30 days of this Order. RESTRICTED REAL PROPERTY (real estate/land): No restricted realty shall be leased for a period of more than one year, sold, encumbered or conveyed without prior court order. The following property or properties shall be restricted: FILING PROOF OF RECORDED RESTRICTION: The conservator is responsible for filing proof of recorded restriction with the Court within 30 days of this Order. © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED PBCA81f -110712 Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case No. 4. ACCEPTANCE OF LETTERS: The Conservator shall sign the "Acceptance of the Letters" under oath or by affirmation, and file the Acceptance with the Clerk of the Court, Probate Registrar. INVENTORY and CREDIT REPORT: Within 90 calendar days of this date, the Conservator must prepare and file with the Clerk of the Court a detailed inventory of the protected person's assets indicating fair market value, as required by A.R.S. § 14-5418, and attach to the inventory a copy of the protected person's credit report that is dated within ninety days before the filing of the inventory,. OR "Inventory" and Credit Report are waived and are not required to be filed with the court. 5. 6. ESTATE BUDGET Within 90 calendar days of the appointment date, the Conservator must prepare and file with the Clerk of the Court a detailed budget for the current year. A new budget must be prepared and filed with the Annual Accounting for each year thereafter. Rule 30.3, A.R.P.P. 7. STATEMENT OF SUSTAINABILITY Within 90 calendar days of the appointment date, the Conservator must provide the court with an estimate as to whether the assets available to the Conservator are enough to meet the expenses of the protected person for the duration of time the protected person is expected to need care or fiduciary services. Rule 30.2, A.R.P.P. 8. ANNUAL ACCOUNTING OF CONSERVATOR: The Conservator shall report to the Court on the administration of the protected person's property by filing an annual accounting, and petitioning the court for approval of the accounting on or before the anniversary date of qualifying as conservator (the date of the Letters of Appointment as conservator), in accord with A.R.S. § 14-5419. OR Annual Accounting is waived and is not required to be filed with the court. 9. 10. CHANGE OF ADDRESS: The Conservator shall immediately notify the Court in writing of any change in address of either protected person or conservator. OTHER DUTIES UNDER LAW: The duties of the Conservator as required by Arizona law and as set forth in this Order and the Order to Conservator shall continue until the Conservator is discharged from these duties by order of this court. 11. DISCHARGE OF ATTORNEY: The court-appointed attorne