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 Guardianship of: Case Number: PB ORDER TO GUARDIANS of an ADULT AND ACKNOWLEDGMENT and Name of Protected Adult INFORMATION TO INTERESTED PERSONS Warning: This appointment is not effective until the Letters of Appointment have been issued by the Clerk of the Superior Court. The welfare and best interest of the person named above ("your ward") 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 as it relates to your duties as guardian of your ward, as follows: 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 your ward from your own funds. Unless the order appointing you provides otherwise, your duties and responsibilities include (but are not limited to) making appropriate arrangements to see that your ward's personal needs (such as food, clothing, and shelter) are met. You are responsible for making decisions concerning your ward's educational, social, and religious activities. If your ward is 14 years of age or older, you must take into account the ward's preferences to the extent they are known to you or can be discovered without unreasonable effort. You are responsible for making decisions concerning your ward's medical needs. Such decisions include (but are not limited to) the decision to place your ward in a nursing home or other health care facility and the employment of doctors, nurses, or other professionals to provide for your ward's health care needs. However, you are to use the least restrictive means and environment available that meet your ward's needs. 2. 3. 4. © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 1 of 5 PBGA80f - 080816 Use Most Current Version American LegalNet, Inc. www.FormsWorkFlow.com Case Number PB: ___________________ 5. You may arrange for medical care to be provided even if your ward does not wish to have it, but you may not place your ward in an Inpatient Psychiatric Facility against your ward's will unless the Court specifically has authorized you to consent to such placement. You may handle small amounts of money or property belonging to your ward without being appointed conservator. As a general rule, "small amount" means that the ward does not receive income (from all sources) exceeding $10,000.00 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, whether yourself or someone else. If you handle any money or property belonging to your ward, you have a duty to do each of the following: a. Care for and protect your ward's personal effects; b. Apply any moneys you receive for your ward's current support, care, and education needs, and conserve any excess funds not so spent for your ward's future needs; c. Maintain your ward's funds in a separate account, distinct from your own and identified as belonging to the ward; d. Maintain records of all of the ward's property received and expended during the period of the guardianship; e. Account to your ward or your ward's successors at the termination of the guardianship, if requested; and, f. Not purchase, lease, borrow, or use your ward's property or money for your benefit or for the benefit of anyone else's, without prior Court approval. You shall not accept any compensation of any kind for placing your ward in a particular nursing home or other care facility, using a certain doctor, or using a certain lawyer. "Compensation" includes, but is not necessarily limited to, direct or indirect payments of money, "kickbacks", gifts, favors, and other kinds of personal benefits. If you believe a certain placement or service that is in the best interest of your ward might be considered self-dealing or a conflict of interest, you must document to the court your reasoning and obtain court approval. You will need to obtain a certified copy of the letters of appointment that are issued to you by the Clerk of the Superior Court. Your certified copy is proof of your authority to act as guardian of your ward, and you should have it available when acting on behalf of your ward. 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. You are required to report annually, in writing, with respect to your ward's residence, physical and mental health, whether there still is a need for a guardian, and (if there is no conservator) your ward's financial situation. Your report is due each year on or before the anniversary date of the letters of appointment. If your ward's physical address changes, you shall notify the Court by updating the probate information form within three (3) days of learning of the change in your ward's physical address. If your ward dies, you shall notify the Court in writing of the ward's death within ten (10) days of learning that the ward has died, and provide the court with a list of the ward's known assets. 6. 7. 8. 9. 10. 11. © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 2 of 5 PBGA80f - 080816 Use Most Current Version American LegalNet, Inc. www.FormsWorkFlow.com Case Number PB: ___________________ 12. You must be conscious at all times of the needs and best interests of your ward. If the circumstances that 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. If you should be unable to continue with your duties for any reason, you (or your guardian or conservator, if any) mus