FOR CLERK’S USE ONLY SUPERIOR COURT OF ARIZONA MARICOPA COUNTY In the Matter of Guardianship of Case Number: JG . ORDER TO GUARDIAN(S) AND ACKNOWLEDGMENT a Minor The welfare and best interest of the person named above ("the Minor”) are matters of great concern to this Court. By accepting appointment as guardian, you have subjected yourself to the power and supervision of the Court. Therefore, to help avoid problems and to assist you in the performance of your duties, this order is entered. You are required to be guided by it and comply with its provisions. 1. You have powers and responsibilities similar to those of a parent of a minor child, except that you are not legally obligated to contribute to the support of the Minor from your own funds. 2. Unless the order appointing you provides otherwise, your duties and responsibilities include (but are not limited to) making appropriate arrangements to see that the Minor's personal needs (such as food, clothing, and shelter) are met. 3. You are responsible for making decisions concerning the Minor's educational, social, and religious activities. If the Minor is 14 years of age or older, you must take into account the Minor’s preferences to the extent they are known to you or can be discovered with a reasonable amount of effort. 4. You are responsible for making decisions concerning the Minor's medical needs. Such decisions include (but are not limited to) the decision to place the Minor in a health care facility and the employment of doctors, nurses, or other professionals to provide for the Minor's health care needs. However, you are to use the least restrictive means and environment available, which meets the Minor's needs. 5. You may arrange for medical care to be provided even if the Minor does not wish to have it. This includes mental health care and treatment. 6. You may handle small amounts of money or property belonging to the Minor without being appointed conservator. As a general rule, "small amount" means that the Minor does not receive income (from all sources) exceeding $5,000.00 per year, does not accumulate excess funds exceeding that amount, and does not own real property. If more than these amounts come into your possession, or are accumulated by you, you are required to petition for the appointment of a conservator. 7. If you handle any money or property belonging to the Minor, you have a duty to do each of the following: a. Care for and protect the Minor's personal effects; JG80f ©Superior Court of Arizona in Maricopa County July 12, 2007 ALL RIGHTS RESERVED GCP Use only most current version Page 1 of 3 American LegalNet, Inc. www.FormsWorkflow.com Case No. b. c. d. e. f. g. Apply any moneys you receive for the Minor's current support, care, and educational needs; Conserve any excess funds not so spent for the Minor's future needs; Maintain the Minor's funds in a separate account, distinct from your own and identified as belonging to the Minor; Maintain records of all of the Minor's property received and expended during the period of the guardianship; Account to the Minor or the Minor's successors at the termination of the guardianship, if requested; and, Refrain from purchasing, leasing, borrowing, or using the Minor's property or money for your benefit or for the benefit of anyone else without prior Court approval. 8. You shall not accept any remuneration of any kind for placing the Minor in a particular care facility, using a certain doctor, or using a certain lawyer. "Remuneration" includes, but is not necessarily limited to, direct or indirect payments of money, "kickbacks", gifts, favors, and other kinds of personal benefits. 9. You will need to obtain a certified copy of the letters, which are issued to you by the Clerk of the Superior Court. Your certified copy is proof of your authority to act as guardian of the Minor, and you should have it available when acting on behalf of the Minor. You may need to obtain additional (or updated) copies from time to time for delivery to, or inspection by, the people with whom you are dealing. 10. ANNUAL REPORT: You are required to report annually, in writing, with respect to the Minor's residence, physical and mental health, the Minor’s financial situation, and whether there still is a need for a guardian. Your report is due each year on the anniversary date of your appointment until the Minor turns 18 or until the guardianship is terminated. In addition to sending copies to the other persons named in the statute, you are directed to file the original annual report with the Clerk of Court, Juvenile Division, and to send a copy to the assigned Judge in the Juvenile Department of this Court. The Self Service Center has forms you can use for the annual report, or you can file your own. 11. You must be conscious at all times of the needs and best interest of the Minor. If the circumstances which made a guardianship necessary should end, you are responsible for petitioning to terminate the guardianship and obtaining your discharge as guardian. Even if the guardianship should terminate by operation of law, you will not be discharged from your responsibilities until you have obtained an order from this Court discharging you. This means if the Minor turns 18, or even dies, you should still petition the Court to officially end your responsibilities. 12. SUCCESSOR GUARDIAN: If you should be unable to continue with your duties for any reason, you and your successor guardian or conservator must petition the Court to accept your resignation and appoint a successor. If you should die, your personal representative or someone acting on your behalf must advise the Court and petition for the appointment of a successor. 13. If you have any questions about the meaning of this order or the duties which it and the statutes impose upon you by reason of your appointment as guardian, you should consult an attorney or petition the Court for instructions. 14. If you are now, or in the future, become guardian for more than two persons who are not related to you by blood or marriage, you must advise the Court of that fact and provide the Court with such information as it may require. With respect to each such appointment, you must advise the Court in writing of at least the following: (a) the name and address of the court that appointed you, (b) the case number, and (c) the name and address of the Minor. JG80f ©Superior Court of Arizona in Maricopa County July 12, 2007 ALL RIGHTS RESERVED GCP Use only most current version Page 2 of 3 American LegalNet, Inc. www.FormsWorkflow.com Case No. WARNING: FAILURE TO OBEY THE ORDERS OF THIS COURT AND THE STATUTORY PROVISIONS RELATING TO GUARDIANS MAY RESULT IN YOUR REMOVAL FROM OFFICE AND OTHER PENALTIES. IN SOME CIRCUMSTANCES, YOU MAY BE HELD IN CONTEMPT OF COURT, AND YOUR CONTEMPT MAY BE PUNISHED BY CONFINEMENT IN JAIL, FINE, OR BOTH. In the Matter of Guardianship of Case Number: JG a Minor THIS ORDER TO THE GUARDIAN(S) IS HEREBY ENTERED THIS Judge/Commissioner ACKNOWLEDGMENT: THE UNDERSIGNED ACKNOWLEDGES RECEIVING A COPY OF THIS ORDER AND AGREEING TO BE BOUND BY ITS PROVISIONS, WHETHER OR NOT HE OR SHE READ IT BEFORE SIGNING, AS LONG AS HE OR SHE IS GUARDIAN. . Signature of Guardian Date Signed Signature of Guardian Date Signed . JG80f ©Superior Court of Arizona in Maricopa County July 12, 2007 ALL RIGHTS RESERVED GCP Use only most current version Page 3 of 3 American LegalNet, Inc. www.FormsWorkflow.com