FOR CLERK’S USE ONLY Name of Person Filing: Mailing Address: City, State, Zip Code: Day/Evening Telephone: ATLAS Number (if applicable) _______________________________________ Attorney Bar Number (if applicable) __________________________________ Representing: Self Petitioner Respondent SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Case No. GC-_______________________________ In the Matter of the Guardian and/or Conservatorship of ORDER APPOINTING GUARDIAN AND/OR CONSERVATOR FOR AN ADULT __________________________________ An Adult The Petition for appointment of a Guardian and/or Conservator for Adult having come before this Court, the Court finds as follows: 1. Petitioner is entitled to file said Petition under A.R.S. §14-5303(A) and/or §14-5404(A). 2. Notice has been given as required by law; service is complete. 3. Venue in this county is proper. 4. The reports of the Court-appointed medical professional and investigator have been considered by the Court. 5. The above-captioned person is an incapacitated person, and is in demonstrated need of the continuing care and supervision of a Guardian. The proposed ward’s needs cannot be met by less restrictive means, including the use of appropriate technological assistance. The powers requested shall be used to encourage the development of maximum selfreliance and independence of the proposed ward. 6. The above-captioned person is is not capable of driving. 7. Petitioner(s) is/are qualified to serve as Guardian of said incapacitated person and has priority/or is entitled for appointment pursuant to A.R.S. §14-5311. 8. Appointment of a Conservator is necessary, as the above-captioned person is unable to manage his/her estate and affairs effectively. 9. 1/03/07 Petitioner(s) is/are entitled to appointment as Conservator under A.R.S. §14-5410. Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com Case No.______________________________ IT IS, THEREFORE, ORDERED that: A. Petitioner(s), is/are hereby appointed Guardian of the above captioned person subject to these limitations: ______________________________________________________ ________________________________________________________________________ Upon acceptance, Letters of Permanent Guardian And/Or Conservator shall be issued to said appointee; B. The driver’s license of the above-captioned person shall C. The Guardian shall report to the Court at least annually on the anniversary date of this shall not be revoked. appointment as required by A.R.S. §14-5315. D. Petitioner(s) is/are hereby appointed Conservator of the above captioned person. Bond in the amount of $___________________is required before Conservator letters will be issued. Bond is not required, however the following restrictions apply: __________________ _______________________________________________________________________ E. The Conservator shall file an inventory and appraisement of the estate within ninety days of the date of this appointment as required by A.R.S. §14-5418; F. The Conservator shall account to the Court for the administration of the estate at least annually on the anniversary date of this appointment as required by A.R.S. §14-5419. G. The hearing for the next annual accounting period is set for ____________/________, Month Day 20____, at _____________. Time H. The appointee must immediately notify this Court of any address change of the above captioned person, and is responsible for all costs resulting from failure to do so. DATED IN OPEN COURT this _________ day of ______________, 20______. ________________________________ Judge of the Superior Court 1/03/07 Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com