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 MARICOPA COUNTY In the Matter of (check one or both) Case Number: PB PROOF OF NOTICE OF HEARING A Deceased Person STATE OF ARIZONA County of Maricopa ) ) ss. I state under oath the following: 1. DOCUMENTS PROVIDED: I provided copies of the following court documents. List specifically each court document you provided. Be sure you provided and you list the NOTICE OF HEARING: 1. 2. 3. 4. 5. 2. TO WHOM I GAVE NOTICE: These are the people to whom I gave copies of all the documents listed in Number 1 above. State the relationship between the person who died and the person you gave the copies to. (Use extra paper if necessary.) A. B. C. D. Name: Relationship to person: Date I gave the documents: How I gave the documents -- check at least one box and complete the information: Personal service (File affidavit of acceptance or of process server or sheriff) 1st class mail, postage prepaid Certified mail Registered mail (attach green card to this paper) Hand delivery by (name) Name: Relationship to person: PBIPF59f 050115 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com A. B. © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 1 of 2 NOT Case No. C. D. Date I gave the documents: How I gave the documents -- check at least one box and complete the information: Personal service (File affidavit of acceptance or of process server or sheriff) 1st class mail, postage prepaid Certified mail Registered mail (attach green card to this paper) Hand delivery by (name) A. B. C. D. Name: Relationship to person: Date I gave the documents: How I gave the documents -- check at least one box and complete the information: Personal service (File affidavit of acceptance or of process server or sheriff) 1st class mail, postage prepaid Certified mail Registered mail (attach green card to this paper) Hand delivery by (name) A. B. C. D. Name: Relationship to person: Date I gave the documents: How I gave the documents -- check at least one box and complete the information: Personal service (File affidavit of acceptance or of process server or sheriff) 1st class mail, postage prepaid Certified mail Registered mail (attach green card to this paper) Hand delivery by (name) Petitioner's Signature: STATE OF COUNTY OF Subscribed and sworn to or affirmed before me this: (date) . by (notary seal) Deputy Clerk or Notary Public © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 2 of 2 PBIPF59f 050115 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com NOT