For Clerk’s Use Only Name of Person Filing: ________________________________________ Mailing Address: ________________________________________ City, State, and Zip Code: ________________________________________ Daytime Phone Number: ________________________________________ Evening Phone Number: ________________________________________ ATLAS Number (if applicable): ________________________________________ State Bar Number (if applicable):______________________________________ Representing: Self Petitioner Respondent SUPERIOR COURT OF ARIZONA MOHAVE COUNTY In the matter of the Guardianship and/or Conservatorship of Case Number: _________________________ CONSENT OF PARENT TO GUARDIANSHIP AND/OR CONSERVATORSHIP OF MINOR CHILD (AND WAIVER OF NOTICE) ______________________________ A Minor REQUIRED INFORMATION FROM PARENT, UNDER OATH or AFFIRMATION: 1. INFORMATION ABOUT ME: Name: ____________________________________________________________________ Street Address: ____________________________________________________________________ City, State, Zip Code: ____________________________________________________________________ Telephone: ____________________________ Date of Birth: ____________________________ I am the natural conservator. MOTHER or FATHER of the minor child(ren) named above, who needs a guardian and/or 2. I have read the Petition for Permanent Appointment of Guardian and/or Conservator of a Minor and consent to the appointment of (name)_______________________________________ to be the guardian of the minor child(ren). 3. (OPTIONAL) I waive notice of all further proceedings in this matter. I understand that I can reverse this waiver by filing a written document with the court under this court case number declaring that I no longer waive notice of hearings and other court proceedings. OATH OR AFFIRMATION OF THE PARENT STATE OF ARIZONA County of Mohave ) )ss. I declare, under penalty of perjury, that I have read, understood, and completed the above statements. Everything I have said is true and correct to the best of my knowledge, information and belief. _____________________________________________ Signature _____________________________ Date Subscribed and sworn to before me this ____________ day of __________________, 20_________ by________________________________. __________________________________ My Commission Expires 2/14/2007 __________________________________________ Notary Public / Deputy Clerk Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com