Fill and Sign the In the Matter of Guardianship of Form

Name:_________________________________________________ Address:_______________________________________________ City, State. Zip:_________________________________________ Telephone:_____________________________________________ State Bar Code:_________________________________________ Client:_________________________________________________ IN THE SUPERIOR COURT OF T HE STATE OF ARIZONA In and for the County of ___________________ ___________________________________________ IN THE MATTER OF [ ] GUARDIANSHIP OF CASE NO: AND [ ] CONSERVATOR FOR: PETITION FO R PERMANENT APPOINTMENT OF[ ] GUARDIAN OF AND [ ]CONSE RVATOR FOR AN ADULT INCAPACITATED AND PROTECTED PERSON An Adult Incapacitated Person ____________________ _______________________________________________________________G&C2A 1. I, ___________________________________, am the Petitioner in this Action. My current mailing address is _____________________________________________________________________________ , telephone number ________________________. My date of birth _________________________. And I am related to the adult incapacitated and protected person I am requesting guardianship of and/or conservatorship for by _____________________________________. 2. This adult incapacitated and protected person is ___________________________________, and whose mailing address is _____________________________________________________________________________________ _________________________________________________ ____________________________, telephone number _________________________. This person's date of birth is __________________, and Social Security Number is _____________________________. 3. The following persons are entitled to Notice of Hearing of this Petition ( give name, address, & zip code, and relationship to the adult incapacitated person ) ARS 14 -5309 and 14 -5405. 4. This adult incapacitated and protected person has asse ts and/or annual income in the estimated amount of $____________________. ( Please explain where this income comes from ) 5. To the best of my knowledge: [ ] No Guardian or Conservator has been appointed in this or any other Court, and no other proced ures are pending for the same. [ ] Someone has been appointed or Court proceedings are pending for the appointment of Guardian of and/or Conservator for this adult incapacitated and protected person. ( If so, please give the name of the Court the procee dings are pending in or appointment was made by for the Guardian and/or Conservator, who was appointed or is petitioning, when the action was filed or when the appointment was made. ) 6. This adult protected person requires the appointment of a Conserva tor because he/she has property which will be wasted or used up unless proper management of his/her affairs is provided, and: [ ] He/she needs funds for his/her support, care and welfare. [ ] Funds are needed for the support, care and welfare of those entitled to be supported by that person. 7. This adult protected person can not manage his/her own affairs because: [ ] Mental illness, mental deficiency, or mental disorder. [ ] Chronic use of drugs. [ ] Chronic intoxication. [ ] Confinement. [ ] Detention by foreign power. [ ] Disappearance. 8. I believe that this person is in need of a Guardian and is incapacitated as defined by ARS 14 -5101(1) to the extent that he/she lacks sufficient understanding or capacity to make or communicate resp onsible decisions concerning his/her person because of : [ ] Mental illness, mental deficiency, or mental disorder; [ ] Physical illness or disability; [ ] Chronic use of drugs; [ ] Chronic intoxication; [ ] Other: __________________________ ____________________________________________________ __________________________________________________________________________________________ _. 9. I claim to have priority for appointment to be appointed as this adult incapacitated person's Guardian un der ARS 14 -5311, because: [ ] Petitioner is the spouse of the incapacitated person; [ ] Petitioner was selected by the incapacitated person for appointment; [ ] Petitioner is an Adult son or daughter of the incapacitated person; [ ] Petitioner is the Parent of the incapacitated person; [ ] Petitioner is a relative of the incapacitated person and has lived with the person for more than 6 ( six ) months before filing this Petition; [ ] Petitioner was chosen to be the Guardia n by someone who is caring for the incapacitated person or is paying benefits for the incapacitated person; [ ] Petitioner is a private fiduciary, a professional guardian, conservator, or the Arizona Veterans' Service Commission; [ ] Other: _________ ______________________________________________________________ _____________________________________________________________________________________. 10. It is this adult incapacitated person's best interests and it is necessary or desirable for the appo intment of a Guardian because: ______________________________________________________________________________ __________________________________________________________________________________________ ___ ____________________________________________________ ______________________________________ ___ __________________________________________________________________________________________ ___ 11. I have the name, address and phone number of a physician who will examine the condition of the person I say is in capacitated and whose written report I will file with the Court. 12. This adult incapacitated and protected person is represented by: [ ] Firm Name: Name: Address: Telephone: [ ] The adult incapacitated and protected person for whom I am seeking appointment for does not currently have counsel of his/her own. I will contact the office of the Court -Appointed counsel after I file this Petition so that an Attorney may be appointed by this Court. NOTE: ALL STATEMENTS IN THIS SECTION MUST BE CHECKED AS TRUE IN ORDER TO FILE THIS PETITION. [ ] TRUE 13. Venue in this County is proper because the person who is said to need a Guardian and Conservator lives in or is present in this County; or this person has assets in this County. [ ] TRUE 14. The person who is requested to be the Guardian and/or Conservator has completed the Affidavit of Person to be Appointed as Guar dian of and/or Conservator for an Adult Incapacitated and Protected Person, and is filing it with this Petition as is required by ARS 14 -5106. [ ] TRUE 15. I am a suitable and proper person to be appointed as Guardian and/or Conservator and am entitled to consideration for such appointment under ARS 14 -5106, 5311, and/or 5410. WHEREFORE, the Petitioner respectfully requests that this Court: 1. Schedule a Hearing to determine if the appointment of a Guardian and/or Conservator is appropriate; 2. Appoint an Attorney for this adult incapacitated and protected person to represent him/her. 3. After Petitioner gives Notice of Hearing to all interested persons and to those required by law, hold a Hearing to determine if the Court should Order Guar dianship and/or Conservatorship; 4. Make a finding that the person is incapacitated and needs a guardian and a finding that the person needs protection under law including a conservator. 5. Appoint Petitioner [ ] Guardian of and/or [ ] Conservator for the adult incapacitated and protected person; 6. Make any other Orders that this Court deems are in the best interests of the proposed incapacitated and protected person. VERIFICATION AND ACKNOWLEDGMENT STATE OF ARIZONA ) )ss County of _____________ __) I, the Petitioner being duly sworn and under oath, state that I have read this Petition. All the statements in the Petition are true and correct and complete to the best of my knowledge and belief. ___________________________________ Peti tioner Subscribed and sworn before me this date: ________________________________ Notary Public ________________________________________________ ( seal )