Fillable Pb12fz PROBATE INFORMATION FORM FOR GUARDIANSHIP/CONSERVATORSHIP; PB12f

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Pb12fz PROBATE INFORMATION FORM FOR GUARDIANSHIP/CONSERVATORSHIP; PB12f

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© Superior Court of Arizona in Maricopa County PB12f - 010120
ALL RIGHTS RESERVED Page 1 of 3
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 __________________________
SUPERIOR COURT OF ARIZONA
MARICOPA COUNTY
In the Matter of:
Ward/Protected Person’s Name, an Adult.
Case Number:
PROBATE INFORMATION FORM for
GUARDIANSHIP/CONSERVATORSHIP
Updated (Check this box if this is an updated form.)
INSTRUCTIONS:
1. Complete this form to the best of your knowledge and ability and then file it with your application or petition.
2. If you later learn of additional information that you omitted or if you later learn that any information in this
form is incorrect, you must file an updated probate information form.
3. For purposes of this form, “Financial Institution” means a national banking association, a holder of a banking
permit under Arizona law, a savings and loan association authorized to conduct trust business in Arizona, a
title insurance company qualified to do business in Arizona, or a trust company holding a certificate to
engage in trust business from the superintendent of financial institutions.
4. Items designated with an asterisk (*) constitute “contact information” under Rule 13, Arizona Rules of
Probate Procedure. If contact information changes, you must file a notice of change of contact information.
5. This form is filed as a confidential document, so it is not available to the general public. In addition, you are
not required to provide anyone with this form other than the court.
FOR CLERK’S USE ONLY
Case No.
© Superior Court of Arizona in Maricopa County PB12f -010120
ALL RIGHTS RESERVED Page 2 of 3
A. INFORMATION ABOUT THE NOMINATED GUARDIAN (if applicable):
Name:
Is this person or entity an Arizona Licensed Fiduciary? Yes No
If Yes, write that person or entity’s Licensed Fiduciary Number on the line below:
Mailing Address:*
Physical Address:*
Work Telephone Number:*
Email Address:*
If the nominated guardian is an Arizona Licensed Fiduciary or a Financial Institution, proceed to section B below.
Otherwise, complete the remainder of section A.
Home Telephone Number:*
Cellular Phone Number:*
Date of Birth: Social Security Number:
Race: Height: Weight:
Eye Color: Hair Color: Sex:
B. INFORMATION ABOUT THE NOMINATED CONSERVATOR (If applicable or if different from A):
Name:
Is this person or entity an Arizona Licensed Fiduciary? Yes No
If Yes, write that person or entity’s Licensed Fiduciary Number on the line below:
Mailing Address:*
Physical Address:*
Work Telephone Number:*
Email Address:*
If the nominated conservator is an Arizona Licensed Fiduciary or a Financial Institution, proceed to section C below.
Otherwise, complete the remainder of section B.
Home Telephone Number:*
Cellular Phone Number:*
Date of Birth: Social Security Number:
Race: Height: Weight:
Eye Color: Hair Color: Sex:
Case No.
© Superior Court of Arizona in Maricopa County PB12f -010120
ALL RIGHTS RESERVED Page 3 of 3
C. INFORMATION ABOUT THE PERSON WHO NEEDS A GUARDIAN OR CONSERVATOR:
Name:
Mailing Address:*
Physical Address:*
Work Telephone Number:*
Email Address:*
Home Telephone Number:*
Cellular Phone Number:*
Date of Birth: Social Security Number:
Race: Height: Weight:
Eye Color: Hair Color: Sex:
I, (your name), under the penalty of perjury, do hereby swear that the
foregoing information is true and correct to the best of my knowledge and belief.
Date Signature
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Pb12fz PROBATE INFORMATION FORM FOR GUARDIANSHIPCONSERVATORSHIP; PB12f

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Completed 27 February 2020

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