Name of Person Filing: ___________________________________________ Mailing Address: ___________________________________________ City, State, Zip Code: ___________________________________________ Phone Number(s): ___________________________________________ ATLAS Number (if applicable)__________________________________________ Attorney Bar Number (if Applicable) _____________________________________ Representing: Self Petitioner Respondent FOR CLERK'S USE ONLY SUPERIOR COURT OF ARIZONA MOHAVE COUNTY In the Matter of the Guardianship and/or Conservatorship of: Case No:_________________________ _____________________________________ A Minor PETITION FOR PERMANENT APPOINTMENT OF GUARDIAN AND/OR CONSERVATOR OF A MINOR NOTICE: The authority granted to the guardian may include the authority to withhold or withdraw life sustaining treatment, including artificial food and fluid. A.R.S. §14-5303(B) REQUIRED INFORMATION ABOUT PETITIONER, UNDER OATH OR AFFIRMATION: 1. INFORMATION ABOUT ME (the petitioner): Name: _______________________________________________________________________________ Street Address: ________________________________________________________________________ City, State, Zip Code:____________________________________________________________________ Telephone:__________________________________ Date of Birth:_______________________________ I am related by blood to the person who needs a guardian and/or conservator ("the minor") (If Applicable) HOW I am related to the minor:________________________________________________ (Examples: grandmother, uncle, sister etc.) 2. INFORMATION ABOUT THE MINOR WHO NEEDS A GUARDIAN AND/OR CONSERVATOR. The minor is called the proposed ward (for a guardianship) and proposed protected person (for a conservatorship): Name: _______________________________________________________________________________ Street Address: ________________________________________________________________________ City, State, Zip Code:____________________________________________________________________ Telephone:__________________________________ Date of Birth: ______________________________ The Minor is married or unmarried. Mother's Name: Mother's Address: Father's Name: Father's Address: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Revised: 1/1/2013 Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Case No.________________________________ 3. PERSON(S) ENTITLED TO NOTICE of this Court matter under Arizona law, A.R.S. §14-5207 for guardians, and §14-5405 for conservators, and to whom I will give notice of this case: MOTHER FATHER The MINOR (if over 14) OTHER PERSONS ENTITLED TO NOTICE: Name Address (Addresses as listed in #2 above/preceding) Relationship to Minor A____________________________________________________________________________________ B____________________________________________________________________________________ C____________________________________________________________________________________ D____________________________________________________________________________________ 4. ASSETS OF THE MINOR WHOM I SAY NEEDS GUARDIAN AND/OR CONSERVATOR (check one box) The minor who needs a guardian and/or conservator has no substantial assets or income. No bond by petitioner is required; OR, The minor who needs a guardian and/or conservator has assets and/or annual income in the approximate amount of $___________________ Explain: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 5. PERSON TO BE APPOINTED GUARDIAN AND/OR CONSERVATOR (Complete this section only if the person is a different person than petitioner): Name: _______________________________________________________________________________ Street Address: ________________________________________________________________________ City, State, Zip Code:____________________________________________________________________ Telephone:__________________________________ Date of Birth: ______________________________ The person to be appointed guardian and/or conservator is related by blood to the minor who needs a guardian and/or conservator. If "yes" above, HOW is the person to be appointed guardian and/or conservator related to the minor? _____________________________________________________________________________________ (Examples: grandmother, uncle, sister) 6. INFORMATION REGARDING GUARDIANSHIP AND/OR CONSERVATORSHIP to the best of my knowledge, (check one box): No guardian and/or conservator has been appointed by Will or by any Court Order, and no Court proceedings are pending for such appointment; OR, Revised: 1/1/2013 Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Case No._______________________________ Someone has been appointed guardian and/or conservator or Court proceedings are pending. Explain who, when, in what Court, and if the appointee is guardian and/or conservator): ______________________________________________________________________________ ______________________________________________________________________________ 7. PARENTAL RIGHTS. All parental rights of legal decision making regarding the minor have been suspended or terminated by: Written consent of the parent(s) to the guardianship and/or conservatorship. (Notarized copy must be attached) Abandonment of the minor for at least six (6) months prior to the filing of this Petition. Prior court order (You must provide this Court with a certified copy of the order.). Other Circumstances: (Explain) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 8. REASONS FOR CONSERVATORSHIP: (Check one or more of the boxes if applicable) The minor needs a conservator because: The minor owns money or property that requires management or protection which cannot be otherwise provided. The minor may have business affairs which may be jeopardized or prevented by his or her minority. The minor needs funds for his or her suppo