Statement Pursuant to ARS 14 5651

<document>YourName: YourAddress: YourCity,State,ZIP: YourTelephoneNo: RepresentingSelf,WithoutanAttorneyINTHESUPERIORCOURTOFARIZONA,COUNTYIntheMatteroftheGuardianshipof:)CaseNo. ))STATEMENTPURSUANTTO )A.R.S.§14-5651 )))Minor(s))Judge/CommissionerPetitionerstates:Checkeither1or2:1.Thepersonwhoseappointmentissoughtisaqualifiedprivatefiduciarypursuant toA.R.S.§14-5651. AttachedisproofofcurrentregistrationwiththeArizona SupremeCourt.2.Thepersonwhoseappointmentissoughtisnotaprivatefiduciarypursuantto A.R.S.§14-5651becausetheproposedfiduciary:a.Willnotchargeafeeforservices.Isrelatedtotheminor. b.Theundersignedswearsoraffirmsthatthestatementssetforthabovearetrueandcorrect,subjecttothepenaltiesofmakingafalseaffidavitordeclaration.DatePetitionersSignature1of1 02/03/002001 © American LegalNet, Inc.</document>