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: (check one or both) Guardianship Conservatorship of PB Number: PETITION FOR RELEASE OF FUNDS FROM RESTRICTED ACCOUNT a minor or an adult 1. APPOINTMENT: The following person was appointed (name) and accepted appointment as (check one box): Guardian and conservator on (date) Guardian (date) Conservator (date) . adult was born on (date) ; 2. 3. BIRTH DATE. The minor or RESTRICTED FUNDS: The minor/adult has exactly $ number) # in a restricted account, (account deposited with (name of bank or financial institution) 4. NO PREVIOUS WITHDRAWALS. No previous withdrawals have been made from the account without a written order of this Court. (If this statement is true, check the box. If the statement is not true, see a lawyer for help.) 5. REASON THE FUNDS ARE NEEDED. The minor/adult needs funds from the restricted account for the following reasons and in the following amounts: American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 2 ©Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED PBGCR11f 050115 Use only most current version PTT Case No. REASON/PURPOSE a. b. c. AMOUNT $ $ $ 6. NO OTHER SOURCE OF FUNDS. There is no other source of funds to pay for these needs, and no parent or other person is under a legal obligation to satisfy this need. (If this statement is true, check the box. If the statement is not true, see a lawyer for help.) REQUEST TO THE COURT PETITIONER ASKS THAT THE COURT DO THE FOLLOWING THINGS AFTER NOTICE AND HEARING: 1. 2. Direct the release of restricted funds in the amounts and for the purposes requested in this Petition; Require proof to be filed with this Court within a reasonable period of time that the released funds have been used for the purposes described in this Petition; Make any other orders the Court decides are in the best interests of the minor/adult. 3. OATH OR AFFIRMATION AND VERIFICATION I swear or affirm that the information on this document is true and correct under penalty of perjury. Signature Date STATE OF COUNTY OF Subscribed and sworn to or affirmed before me this: (date) . by (notary seal) Deputy Clerk or Notary Public American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 ©Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED PBGCR11f 050115 Use only most current version PTT