© Superior Court of Arizona in Maricopa County Page 1 of 1 JG11f 010120
ALL RIGHTS RESERVED
EXPLANATIONS THAT MUST BE ADDED TO THE AFFIDAVIT OF PERSON WHO WANTS TO BE
APPOINTED (Required by Arizona Law: A.R.S. § 14-5106)
You must explain the following as an attachment to your Affidavit for any statement which you marked "F" (false).
FILE THE EXPLANATIONS WITH THE AFFIDAVIT, BUT DO NOT FILE THIS INSTRUCTION SHEET. All the
information in the explanations is also under oath to the court.
1. As to each felony for which you have been convicted, list:
a. The nature of the offense.
b. The name and address of the sentencing court.
c. The case number.
d. The date of conviction.
e. The terms of the sentence.
f. The name and telephone number of any current probation or parole officer.
g. The reasons why the conviction should not disqualify you from appointment.
2. If you have acted as guardian or conservator within three years before filing this petition, list:
a. The names of individuals for whom you are currently serving, and court case numbers.
b. The names of individuals for whom your appointment has been terminated within the three-year
period, and the court case number.
3. If you do not have the required information, please explain how you intend to obtain this information.
4. State the total number of persons for whom you have done this. If you have acted under a power of attorney
for the Minor/protected person, explain:
a. The date the power of attorney was signed.
b. The place where it was signed.
c. The actions you have taken pursuant to the power of attorney.
d. Whether the power of attorney is currently in effect.
5. List the name and location of the court and the name and case number of the files in which you were
delinquent in filing the required report.
6. List the name and location of the court, the name and case number of each file, and the circumstances of
your removal.
7. State the number of occasions on which you received such gifts, list the gifts, the dates they were received,
describe the gifts and list the value of each.
8. State the number of occasions on which the business received such gifts, list the gifts, the dates they were
received, describe the gifts and list the value of each.
9. State the number of occasions on which you have been so named.
10. State the number of occasions on which the business was named.
11. List the name and address of each business and the extent and nature of your interest.
12. Explain in detail the circumstances of any charge or conviction for abuse or neglect of children or the elderly
(not already covered in (1) above), and /or of your name being listed on any registry of sex offenders or
persons who have committed acts of abuse, violence or neglect against children or elderly persons. Include
date(s), location(s), name(s) of any investigating agencies and of any courts involved, as well as the title of
any registry on which you are named and explain the circumstances that resulted in your being listed there.
Explain why this court should appoint you as guardian despite any of these circumstances.