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 the Guardianship and Conservatorship of: Case Number PB: __________________________________ (An Incapacitated and Protected Adult) ORDER OF APPOINTMENT OF A PERMANENT GUARDIAN AND CONSERVATOR OF AN ADULT for A MINOR AGED 17.5 OR OLDER to 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 Guardian and Conservator" 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. §§14-5303(A) and 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 of the physician (or other health professional authorized under A.R.S. § 14-5312) and the court investigator have been considered by the Court. REGARDING GUARDIANSHIP: 1. 2. 3. The above-captioned person is an incapacitated person and in need of the continuing care and supervision of a GUARDIAN. The appointment of a guardian is necessary to provide for the demonstrated needs of the incapacitated person. The needs of the incapacitated person cannot be met by less restrictive means, including technological assistance. Page 1 of 6 PBGCA81f-080516 American LegalNet, Inc. www.FormsWorkFlow.com © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Case No._________________ 4. 5. 6. The person appointed below is competent to serve as Guardian. The person appointed has priority for appointment under A.R.S. § 14-5311, or is otherwise appointed for good cause in accord with A.R.S. § 14-5311(D). TYPE OF GUARDIANSHIP: Less restrictive alternatives having been considered: A GENERAL GUARDIANSHIP is warranted; A limited guardianship is not appropriate or in the best interests of the incapacitated person. (OR) A LIMITED GUARDIANSHIP, carrying only such authority as specified on the pages that follow, is appropriate and adequate to protect the best interests and well-being of the ward. 7. REGARDING MENTAL HEALTH: By clear and convincing evidence the ward requires inpatient mental health care and treatment. 8. REGARDING DRIVING PRIVILEGES: There is sufficient medical or other evidence to establish the ward's incapacity does not prevent or interfere with the safe operation of a motor vehicle. The ward's incapacity does prevent or interfere with the safe operation of a motor vehicle. 9. REGARDING VOTING RIGHTS: By clear and convincing evidence the ward has sufficient capacity and understanding to exercise the right to vote. The ward does not have sufficient capacity and understanding to exercise the right to vote. F. APPOINTMENT OF A CONSERVATOR IS NECESSARY: 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 used up unless proper management is provided or because funds are needed for the support, care and welfare of the person to be protected or those entitled to receive support from the protected person, and that protection is necessary or desirable to obtain or provide funds. © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 2 of 6 PBGCA81f-080516 American LegalNet, Inc. www.FormsWorkFlow.com Case No.______________ IT IS ORDERED: 1. The Court appoints: as permanent guardian and conservator for the incapacitated person named above. The incapacitated person is a MINOR, and the appointment is effective as of the minor's 18th birthday on this date: (Month, Date, Year of the ward's 18 Birthday) th 2. BOND: The Guardian must file a bond in the amount of $ with the Clerk of the Court, Probate Registrar by (date): OR Bond is not required and is waived. 3. ISSUANCE OF LETTERS: Upon filing the bond, "Letters of Guardianship and Conservatorship of an Adult" shall be issued by the Clerk of the Court, Probate Registrar, subject to the following restrictions, if any: A. GUARDIANSHIP: 1. A LIMITED GUARDIANSHIP is ordered. The Guardian's authority is limited to: a. Mental Health Care Powers (under Limited Guardianship): (Check all that apply) Guardian is granted authority to consent to outpatient mental health treatment. Guardian is granted authority to place the ward in an Inpatient Psychiatric Facility fo inpatient mental health care and treatment. This authority expires on ___________________ (date). Requests to renew or extend authority for inpatient mental health treatment must be submitted every year. b. (and/or) The following specific powers indicated: Consent to Medical Treatment Arrange Education or Training Consent to Marriage Consent to Make Living Arrangements Apply for Public Assistance or Social Services c. Other Limited Powers: (OR) © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 3 of 6 PBGCA81f-080516 American LegalNet, Inc. www.FormsWorkFlow.com Case No.______________ 2. A ("general", "non limited") GUARDIANSHIP is ordered, subject to the following restrictions: (if any) 3. MENTAL HEALTH POWERS OF GUARDIAN: The Guardian is granted authority to place the ward in an Inpatient Psychiatric Facility for inpatient mental health care and treatment. This authority expires on this date: . Requests to renew or extend authority to place the ward in an Inpatient Psychiatric Facility must be submitted every year. 4. PRIVILEGES and RIGHTS of the WARD: A. DRIVING PRIVILEGES. The Ward/Incapacitated Person's right to obtain or retain a driver's license is suspended. OR The Ward/Incapacitated Person's right to obtain or retain a driver's license is not suspended. B. VOTING RIGHTS: The Ward's right to vote is suspended The Ward's right to vote is NOT suspended. B. CONSERVATORSHIP: 1. A CONSERVATORSHIP is ordered for the following limited or speci