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
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 |
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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: |
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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.
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