Fill and Sign the And Acceptance by Form

Name:_________________________________________________Address:_______________________________________________City, State. Zip:_________________________________________Telephone:_____________________________________________State Bar Code:_________________________________________Client:_________________________________________________ IN THE SUPERIOR COURT OF THE STATE OF ARIZONA In and for the County of ___________________ ___________________________________________IN THE MATTER OF THE ESTATE OF: CASE NO. LETTERS OF ADMINISTRATION ____________________________________ AND ACCEPTANCE BYDeceased. SPECIAL ADMINISTRATOR____________________________________________________________________________________PB45 ISSUANCE OF LETTERS ______________________________is hereby appointed Special Administrator of this Estate. The Special Administrator shall not exercise the following powers without prior order of this Court:The appointment shall be terminated upon [ ] the appointment of a general personal representative; [ ] the following circumstances:SIGNED AND SEALED this date:___________. ___________________________ Clerk ____________________________ Deputy Clerk ACCEPTANCE OF LETTERS BY SPECIAL ADMINISTRATOR I accept the duties of Special Administrator of this estate, and submit personally to the jurisdiction of this Court in any proceeding relating to this estate that may be instituted by any interested person, and swear that I will perform according to law the duties of Special Administrator.STATE OF ARIZONA ) )ss __________________________ County of______________) Signature ofSUBSCRIBED AND SWORN this date:____________________________________Notary Public ___________________________________________ ( seal ) CERTIFICATE OF TRUE COPY BY CLERK The Clerk of this Court certifies the foregoing Letters to be a full, true and correct copy thereof issued in this estate, as the same remains of record and on file in the Office of the Clerk, and that these Letters have not been revoked and are in full force and effect.SIGNED AND SEALED this date:_______________. ___________________________ Clerk___________________________Deputy Clerk