Arizona Supreme Court Page 1 of 1 JEMS10F-071207 Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: Representing [ ] Self or [ ] Lawyer for Lawyer222s Bar Number: SUPERIOR COURT OF ARIZONA IN COUNTY In the matter of Emancipation of: Case Number: Motion to Seal Court Record (Request to Keep Information Confidential) (Optional 226 Not a required document) A Minor Petitioner requests the Court seal the record in the above matter. The Petition for Emancipation contains information of the following nature, which may contain or infer matters of confidentiality or privacy, pursuant to Rule 123, Rules of the Supreme Court and Rule 19(A)(2), Rules of Procedure for the Juvenile Court. [ ] Address information involving petitioner, petitioner222s parents, or petitioner222s guardians. [ ] Financial information to include the amount and potential source of such earnings. [ ] Potential allegations of abuse or neglect against petitioner222s parents or guardians. [ ] Medical expense information of the petitioner, from which the public may ascertain or infer petitioner222s current medical health. [ ] Social history information of the petitioner regarding how petitioner came to be in the custody of the guardian. Public disclosure of any of the above items serves neither the best interest of the petitioner nor public access to judicial records. Date Signature of Minor FOR CLERK222S USE ONLY American LegalNet, Inc. www.FormsWorkFlow.com