Your Name: Your Address: Your City, State, Zip Code: Your Telephone Number: Attorney Bar Number (if applicable): Representing Self or Attorney for FOR CLERK’S USE ONLY SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY In the Matter of the (check one or both) Guardianship Conservatorship of Case Number: PB PETITION FOR TERMINATION OF GUARDIAN/CONSERVATORSHIP and/or DISCHARGE of GUARDIAN/ CONSERVATOR of an ADULT the Ward (an Incapacitated or Protected Adult) 1. INFORMATION ABOUT THE CURRENT GUARDIAN and/or CONSERVATOR: (Name) ________________________________________________was appointed and accepted appointment as: (check one box): Guardian and Conservator (date) (Month, Day, Year) Guardian on: (date) (Month, Day, Year) Conservator on: (date) (Month, Day, Year) Guardian/Conservator’s address: 2. INFORMATION ABOUT THE WARD, the incapacitated or protected adult: Name: Date of Birth_____/______/_____. 3. FOR PETITIONS TO TERMINATE THE GUARDIANSHIP and/or CONSERVATORSHIP: The need for the Guardian and/or Conservator has ended because: The Ward died on this date: ____________________ (Attach death certificate or obituary). The Ward moved out of state on (date) ______________ to (where)_____________________. The need for the Guardian and/or Conservator has ended because the Ward is now capable of conducting his or her own affairs. (Attach current Physician’s report or form PBGCA15f to support assertion that ward’s capacity is restored.) 4. FOR PETITIONS TO DISCHARGE THE GUARDIAN and/or CONSERVATOR: Guardianship and/or Conservatorship has already been terminated or should be, as requested above. A successor (replacement) Guardian and/or Conservator has already been appointed, or has applied for appointment and the appointment is pending, or should be appointed to serve by the Court. The name of the person appointed, or who seeks appointment as successor guardian and/or conservator, or who is being nominated to serve as successor guardian and/or conservator is: NOTE: If a successor (replacement) Guardian and/or Conservator is appointed, or will be appointed, then the case will continue to be open until terminated by the court. ©Superior Court of Arizona in Maricopa County April 1, 2009 ALL RIGHTS RESERVED PTT Page 1 of 3 PBGCAD11f Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com Case No. The current Guardian and/or Conservator is no longer able to serve, does not want to serve, or should not be allowed to continue to serve as Guardian and/or Conservator and a successor Guardian and/or Conservator should be appointed by the Court. (Explain here or attach explanation). Numbers 5, 6, 7, and 8, apply to Conservatorships only. If no Conservatorship, skip to #9. 5. RESTRICTED ASSETS: INFORMATION ABOUT THE CURRENT RESTRICTED ACCOUNT A. RESTRICTED FINANCIAL ASSETS: 1. Amount now in restricted account: 2. Financial Account Number: (last 4 nos.) 3. $ Name and address of financial i tit ti Information about additional restricted accounts is listed on attached page. B. RESTRICTED REAL PROPERTY: 1. Estimated market value of real property: 2. Estimated lien(s) owed on real property: 3. $ Address for real property: Information about additional restricted real property is listed on attached page. 6. STATEMENT ABOUT RESTRICTED FUNDS: (check one box) I HAVE NOT MADE or I HAVE MADE previous withdrawals from this or any other restricted account without a written of order of this Court, as follows (Explain in detail about amount, date, reason). 7. REQUEST ABOUT RESTRICTED FUNDS: (check one box) I ask that the restricted funds be released to the Ward's estate because the Ward has died. The name of the Personal Representative (“executor”) of the estate is: ________________________________, and the administration of the decedent’s estate is pending in Case No.:_________________, in the State of _____________________, in _______________________________ County. I ask that the restricted funds be released to the Ward because he or she is now capable of controlling the funds currently held for his or her benefit. ©Superior Court of Arizona in Maricopa County April 1, 2009 ALL RIGHTS RESERVED PTT Page 2 of 3 PBGCAD11f Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com Case No. Other (Explain): 8. There are no restricted assets in the Conservatorship, and the Final Accounting for this Conservatorship is filed with this Petition for Termination or has been filed separately. The Court is asked to review and approve the Final Accounting. 9. THEREFORE, I ask the Court to schedule a hearing and to enter an order: (Read carefully and check the boxes to indicate exactly what you want the Court to order.) A. Discharging the person currently serving as: guardian and conservator guardian (only) conservator (only) B. Terminating and closing the case because the protected person no longer needs a guardian or a conservator. C. Relating to Conservatorships only: 1. Directing the release of funds to the former ward as requested in the Petition; 2. Requiring proof that the funds have been released to the former ward or his or her estate within 30 days after entry of an order; 3. Approving the Final Accounting 4. Releasing restricted real property at: Address: Tax Assessor’s Parcel ID # Address: Tax Assessor’s Parcel ID # D. Other (Explain): UNDER OATH OR BY AFFIRMATION I swear or affirm the contents of this document are true and correct under penalty of perjury. Signature Date Sworn to or Affirmed before me this date: My Commission Expires/or Seal (below) ©Superior Court of Arizona in Maricopa County April 1, 2009 ALL RIGHTS RESERVED PTT Deputy Clerk or Notary Public Page 3 of 3 PBGCAD11f Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com