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Form 5. Parental Consent to Appointment of Guardian for a Minor Child [Number assigned by publi...

Arizona Revised Statutes AnnotatedLocal Rules of Practice Superior Court

Arizona Revised Statutes Annotated
Local Rules of Practice Superior Court (Refs & Annos)
Pima County (Refs & Annos)
Forms
17C A.R.S. Super.Ct.Local Prac.Rules, Pima County, Form 5
Form 5. Parental Consent to Appointment of Guardian for a Minor Child [Number assigned by publisher]
Attorney's Name:
______________________________
Computer Number:
______________________________
Party Name:
______________________________
Address:
______________________________
City, State, and Zip:
______________________________
Telephone Number:
______________________________
ARIZONA SUPERIOR COURT, PIMA COUNTY
IN THE MATTER OF:
)
)
Case Number:
Name: (from birth certificate)
)
)
 
)
PARENTAL CONSENT TO
)
APPOINTMENT OF
Date of birth:
)
GUARDIAN FOR A MINOR
 
)
)
A MINOR
)
)
1.
I, __________, am the biological or adoptive Mother / Father (circle one).
2.
I have received from the guardian the Petition for the Appointment of Permanent Guardian of a Minor.
3.
I consent to the appointment of __________ and (if this is a joint petition), __________ as permanent guardian/s for my child __________.
4.
I understand that the guardian/s must provide me with notice of all court hearings. I waive notice of the court hearing on the Petition for Appointment of Permanent Guardian of a Minor.
5.
I reserve the right to revoke my consent at any time and petition the court to terminate the guardianship. In order to revoke my consent I understand that I must do the following:
A.
I must petition the court for such termination by filing a Petition to Terminate Guardianship with the Clerk of Court
B.
I must contact the court to request a hearing date for my petition
C.
I must give proper legal notice to the guardian and must, at the time I give such notice, provide the guardian with a copy of my Petition to Terminate.
6.
My full name and address are as follows:
Name: ______________________________
Address: ______________________________, Unit #: _______
City: _______________ State: _______________ Zip: _______________
I have lived at this address for __________ years, and __________ months.
I swear under penalty of perjury that the above statements are true and correct.
Print Name:
_____________________________________
Signed:
_____________________________________
Date:
_____________________________________
SUBSCRIBED AND SWORN TO before me on:
Date:
_____________________________________
Signed:
_____________________________________
Notary Public / Deputy Clerk of Court
My commission expires:
_____________________________________
Seal or stamp inside box

Credits

Added and effective on emergency basis Sept. 28, 2005. Adopted in final form Jan. 20, 2006.
17C A. R. S. Super. Ct. Local Prac. Rules, Pima County, Form 5, AZ ST PIMA SUPER CT Form 5
State Court Rules are current with amendments received through March 1, 2024. The Code of Judicial Administration is current with amendments received through February 15, 2024.
End of Document