Name: Address: City, State, Zip: Phone: Comp.# (if applicable) : ARIZONA SUPERIOR COURT, PIMA COUNTYIn the Matter of)Case Number: ))ANNUAL REPORT OF GUARDIAN )OF AN ADULT ) )Date of birth:(Annual Hearing Date ) An Incapacitated Person) )Name of WardDate of Birth of WardAddress of WardPhone Number of WardCurrent Doctor of WardName of Guardian(s)Address of Guardian(s)Phone No. of Guardian(s)Relationship of Guardian(s) to Ward1. Describe the residential situation where the ward lives (private home, boarding home, nursing home, etc.) Are you comfortable with the care provided to the ward? If not, explain your concerns. American LegalNet, Inc. www.USCourtForms.com1of42. Does the ward attend any daily activities, work or training programs, or have any regularweekly outings? If yes, please describe. If no, please explain. Do you believe these activities are meeting the ward's needs? If not, explain. 3. When did a physician last see the ward? What is the ward's current health status, care and treatment? 4. Have there been any substantial changes in the ward's mental abilities or health in the last year?If so, please describe them. 5. How many times did you visit the ward last year? What date did you last see the ward? How would you describe your relationship with the ward? 6. Do you believe the ward continues to need a guardian?If not, please explain. American LegalNet, Inc. www.USCourtForms.com2of47. Does the ward have assets, property, or annual income in excess of $5,000.00?If so, who is responsible for this money or property? Briefly list assets. 8. Does the ward receive any county services?If so, specify. 9. Does the ward receive services from any other source?If so, specify. 10. Any other comments not covered above.SIGNED this day of ,20Guardian Co-Guardian American LegalNet, Inc. www.USCourtForms.com3of4NOTICE Send a copy of the report at least 19 days before the hearing date to: the ward, the ward's conservator (if any), the ward's spouse or parents (if any), the ward's attorney (if any), and other interested persons who requested notice.Proof of MailingThe undersigned, , states that a copy of the Annual Report of Guardian sent to the following persons: NameAddressIdentityDate Mailed/Delivered SIGNED this day of , 20GuardianMail Original four-page report to : Clerk of Superior Court Attn: Probate Division 110 W. Congress Tucson AZ, 85701American LegalNet, Inc. www.USCourtForms.com4of4
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