Person Filing:
Address (if not protected):
City, State, Zip Code:
Telephone:
Email Address:
Lawyer’s Bar Number:
Licensed Fiduciary Number: ____________________________________
Representing
Self, without a Lawyer or
Attorney for
Petitioner OR
Respondent
SUPERIOR COURT OF ARIZONA
IN MARICOPA COUNTY
In the Matter of:
Case Number: PB
An Adult A Minor Deceased
UNDER PENALTY OF PERJURY, I STATE THESE FACTS:
1. I am the Petitioner or Applicant and make these statements to show the circumstances why notice by
Publication was used, and to show how service by publication was done.
2. Here are the names of people entitled to notice of this matter to whom I gave notice by publication:
Name:
Last Known Address:
Last Date I Tried to Find Person:
Relationship to Protected or Deceased person:
Name:
Last Known Address:
Last Date I Tried to Find Person:
Relationship to Protected or Deceased person:
Name:
Last Known Address:
Last Date I Tried to Find Person:
Relationship to Protected or Deceased person:
Name:
Last Known Address:
Last Date I Tried to Find Person:
Relationship to Protected or Deceased person:
FOR CLERK’S USE ONLY
© Superior Court of Arizona in Maricopa County PB25f-092612
ALL RIGHTS RESERVED
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Case No.
3. I made a diligent search to find out the residence and whereabouts of all persons entitled to notice but
failed to find any information concerning the residence or whereabouts of one or more of those
persons.
4. I contacted the persons listed below to find out the location of the persons entitled to notice. (Note:
There is no exact minimum number of persons you must contact. It may be more or less than five as
required to satisfy the Court you have made every reasonable effort to locate every person entitled to
notice.). Attach additional pages as necessary to show all the persons you contacted.
Name of Person Entitled to Notice:
Name of Person I Contacted:
Address of Person I Contacted:
Name of Person Entitled to Notice:
Name of Person I Contacted:
Address of Person I Contacted:
Name of Person Entitled to Notice:
Name of Person I Contacted:
Address of Person I Contacted:
Name of Person Entitled to Notice:
Name of Person I Contacted:
Address of Person I Contacted:
Name of Person I am Looking for:
Name of Person I Contacted:
Address of Person I Contacted:
5. ABOUT THE PUBLICATION.
NOTICE OF HEARING was published in a newspaper in this County on the following dates.
A. , B. , C. .
PROOF OF PUBLICATION IS ATTACHED. (REQUIRED)
(Attach an “Affidavit of Publication” supplied by the newspaper that published the notice.)
By signing this document, I state to the Court, under penalty of perjury that the information
presented is true and correct to the best of my knowledge and belief.
Date Signed Petitioner’s Signature
© Superior Court of Arizona in Maricopa County PB25f-092612
ALL RIGHTS RESERVED
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