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This is a Arizona form that can be used for Probate within Local County, Maricopa, Superior Court.
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Your Name: Your Address: Your City, Zip Code: Your Telephone No. Represents Self OR Attorney for: State Bar Number (if applicable): Licensed Fiduciary No. (if applicable): FOR CLERK'S USE ONLY SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY In the Matter of the Guardianship of Case Number PB: PETITION FOR PERMANENT APPOINTMENT OF GUARDIAN FOR AN ADULT, or Name of Person to be Protected a Minor at least 17.5 years of age, to become effective at age 18 UNDER OATH OR BY AFFIRMATION: INFORMATION REQUIRED BY ARIZONA LAW (A.R.S. § 14-5303) 1. INFORMATION ABOUT THE PETITIONER (the person filing this petition) (My) Name: Address: Telephone: Date of Birth: My interest in or relationship to the person to be protected is: (examples: mother, father, sister, brother, grandparent, legal guardian) 2. INFORMATION ABOUT THE PERSON TO BE PROTECTED (also known as "the proposed protected person" or "the ward") Name: Address: Telephone: Date of Birth: 3. INFORMATION ABOUT THE PROPOSED GUARDIAN: (Complete this only if the proposed guardian is someone other than Petitioner.) A. Name: Address: Telephone: Date of Birth: Interest in or relationship to the person to be protected is: © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 1 of 7 PBGA11f-031313 American LegalNet, Inc. www.FormsWorkFlow.com APE Case No. _______________ B. PRIORITY FOR APPOINTMENT: The proposed guardian named above has priority for appointment as guardian under Arizona law A.R.S. § 14-5311, because he or she: was selected by the (proposed) ward to be the guardian; was nominated to serve as guardian in the ward's most recent durable power of attorney or health care power of attorney; is the spouse of the ward; is an adult child of the ward; is a parent of the ward, or was nominated in a will or writing signed by a deceased parent of the ward; is a relative the ward has lived with for more than six months before filing this petition; was chosen by someone who is caring for or paying benefits to the ward; is a private fiduciary, a professional guardian, conservator, or the Arizona Department of Veterans' Services. Other (explain): 4. INFORMATION ABOUT CONSERVATOR (OR OTHER GUARDIAN): To the best of my knowledge: (Check one box.) No Guardian or Conservator has been appointed in any other court, and no court proceedings are pending for such appointment; OR Someone has been appointed Guardian or Conservator, or court proceedings are pending. (If "yes", provide details below.) Name: Address: Telephone: Date of Birth: Relationship to the person to be protected is: Was appointed GUARDIAN CONSERVATOR for the ward named in #2 above in: Name of Court: City and State: Date Appointed: Located in: Other Details: There are or have been other court cases involving the ward. (If other court cases of any type, including "custody" matters" or involvement with Child or Adult Protective Services, describe below, including type of case, name of court or agency involved, location, and date). Continues on attachment titled "Additional Cases or Agency Matters", made part of this document by reference. © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 2 of 7 PBGA11f-031313 American LegalNet, Inc. www.FormsWorkFlow.com APE Case No. _______________ 5. INFORMATION ABOUT NEAREST RELATIVE: The nearest known relative is the petitioner Name: Address: Telephone: Relationship to the person to be protected is: the proposed conservator NEITHER. 6. PROPERTY AND ASSETS OF THE PROPOSED PROTECTED PERSON: (Check one) The ward has no substantial assets or income. No bond is required; OR The ward has assets and/or annual income in the approximate amount of $ List/Describe: 7. REASONS FOR GUARDIANSHIP: The proposed ward needs a guardian because he or she is incapacitated as defined by Arizona Law, A.R.S. §14-5101(1), to the extent that he or she lacks sufficient understanding or ability to make or communicate responsible decisions concerning his or her own well-being and self-interests. Appointment of a guardian is necessary or desirable to provide continuing care and supervision of the person, and is in his or her best interests. THE PERSON TO BE PROTECTED IS INCAPACITATED AND IN NEED OF CONTINUING CARE AND SUPERVISION DUE TO: (Check all that apply): Mental illness, mental deficiency, mental disorder as defined by A.R.S. § 36-3501; Chronic use of drugs; Chronic intoxication; Physical illness or disability; Other (explain): 8. TYPE OF GUARDIANSHIP: LIMITED OR GENERAL: (A.R.S. § 14-5303(B)(8)) A. A LIMITED GUARDIANSHIP is requested with the following specific powers: 1. Authority for the guardian to: Consent to Medical Treatment Consent to Make Living Arrangements Arrange Education or Training Consent to Marriage Apply for Public Assistance or Social Services Consent to Outpatient Mental Health Care and Treatment 2. INPATIENT Mental Health Powers: The ward is incapacitated as a result of mental health disorder as defined in A.R.S. § 36-501. Authority is requested for the Guardian to place the ward in a level one behavioral health facility for inpatient mental health care and treatment. This request is supported by the opinion of a licensed psychiatrist or psychologist, attached to and made part of this document by reference. 3. OTHER LIMITED POWERS REQUESTED: (List and Describe) Page 3 of 7 PBGA11f-031313 American LegalNet, Inc. www.FormsWorkFlow.com © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED APE Case No. _______________ Continues on attachment titled "Powers Requested", made part of this document by reference. (OR) B. GENERAL GUARDIANSHIP is requested. As required by Arizona law, A.R.S. §145303(B)(8), less restrictive alternatives to general guardianship, including technological assistance, have been considered, however: (Check the box if true*) The proposed ward is incapacitated in a manner or to an extent that a limited guardianship would not adequately protect and provide for the proposed ward's care and (Optional additional information) well-being. * For the court to order a general guardianship, you must check the box and be prepared to offer clear and convincing evidence that less restrictive means of meeting the proposed ward's demonstrated needs would not be sufficient. (A.R.S. § 14-5304(B)) NOTE: A general guardianship includes authority to consent to outpatient mental health treatment for the ward, but the Court must specifically grant authority to place the ward in an inpatient mental health facili
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