FOR CLERK’S USE ONLY SUPERIOR COURT OF ARIZONA MOHAVE COUNTY In the Matter of (check one or both) Guardianship or Conservatorship of Case No._______________________________ ORDER REGARDING PETITION FOR DISCHARGE and/or TERMINATION and/or RELEASE OF FUNDS IN THE MATTER OF A PROTECTED ADULT _____________________________________ the Ward, an Incapacitated or Protected Adult THE COURT FINDS: 1. A sworn petition has been file by __________________________________________ for: TERMINATION OF Guardianship and/or DISCHARGE OF Guardian RELEASE OF RESTRICTED FUNDS (or property) 2. 3. 4. Conservatorship Conservator Notice of the Petition was given as required by law or waived by all interested parties. The Guardianship and/or Conservatorship has ended because: The ward died on this date: _____________________________________________ The ward moved out of state (date) __________________ to __________________ The ward is now capable of conducting his or her own affairs as evidence by the physician’s report, and/or: _____________________________________________ _______________________________________________________________________ The current Guardian Conservator should be discharged because: The guardianship and/or conservatorship has ended by operation of law as indicated above, and the case should be terminated (closed). The current Guardian and/or Conservator is no longer willing or able to serve, or should not be allowed to continue to serve, and should be discharged from his or her duties because: ______________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 5. The Guardian and/or Conservator HAS HAS NOT fulfilled all obligations. Numbers 6, 7, and 8, apply to conservatorships only. If no conservatorship, skip to #9. 6. 3/7/2011 In the case of a Conservatorship: a. Conservator HAS b. A Final Account HAS HAS NOT FILED a Final Account. HAS NOT BEEN APPROVED by the court. Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case No._______________________________ 7. The former protected person is entitled to custody and control of the restricted funds or property held for his or her benefit by the conservator. 8. There are no restricted assets in the conservatorship and the Final Accounting for this conservatorship is filed with this Petition or has been filed separately. THE COURT ORDERS: 9. A. B. C. Acct No. * * Discharge from all claims and liabilities of the person currently serving as: guardian and conservator guardian (only) conservator (only) If filing receipt of restricted funds in ordered below, discharge is effective upon filing. The case terminated (closed) because there is no longer a need for a guardian or a conservator. Relating to Conservatorships only: 1. Release of restricted funds to the former ward as follows: Name and Address of financial institution holding restricted funds Amount Information about additional restricted accounts is listed on attached page.* List only last 4 digits of account number above or on any attached page. 2. 4. The conservator to file with this court within 30 days of this Order a receipt signed by the former ward acknowledging receipt of all funds. APPROVAL OF THE Final Accounting, or if all funds were restricted and there have been no withdrawals without approval of the court, WAIVER of the Final Accounting. 5. Release of restricted real property at: 3. Property Address: _______________________________________________________________ Tax Assessor’s Parcel ID#: ________________________________________________________ Setting the matter for review by the court on ___________________________ to determine that his Order has been followed by the conservator having filed the receipt for release of funds. D. OTHER ORDERS: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ DONE IN OPEN COURT: ____________________ 3/7/2011 Page 2 of 2 _______________________________________ JUDGE/COMMISSIONER American LegalNet, Inc. www.FormsWorkFlow.com