Application For Emergency Appointment Of Special Administrator (For Funeral Arrangements)

For Clerk's Use Only Name of Person Filing: _________________________________ Mailing Address: _________________________________ City, State, Zip Code: _________________________________ Daytime/Evening Phone Number: _________________________________ Attorney Bar Number (if applicable): _________________________________ Self (Without an Attorney) OR Representing: Petitioner or Respondent Attorney for: SUPERIOR COURT OF ARIZONA MOHAVE COUNTY In the Matter of the Estate of Case Number:______________________________ APPLICATION FOR EMERGENCY APPOINTMENT OF SPECIAL ADMINISTRATOR (for Funeral Arrangements) ___________________________________ The Deceased. 1. A.R.S. § 14-3614 My name is _____________________________________, and I hereby apply to the Court for emergency formal appointment of a Special Administrator for the estate of the above-named deceased for the express limited purpose of making funeral arrangements. My relationship to the deceased is: ______________________________________________________. The deceased died on this date: (Month, Date, Year) ________________________________________. VENUE: The deceased was domiciled in Mohave County in the State of Arizona, at the time of death, making this the proper venue for this request. There is no Personal Representative presently qualified and acting for this Estate. It is necessary that a Special Administrator be appointed to act on behalf of the Estate for the express limited purpose of making any and all funeral arrangements for the decedent's remains because there is no other authorized person who is presently willing or able to perform these duties. The estimated value of decedent's property over which the Special administrator will have control is $________________. Bond is not required because the Applicant will only be authorized for the limited purpose of making funeral arrangements for the decedent. I am a proper person qualified to act as Special Administrator, and I request that I, or the following named qualified person (if applicable) _____________________________________________ be appointed as Special Administrator for this Estate pending the appointment of a general Personal Representative for the express and limited purpose of being granted full authority to make any and all funeral arrangements for the decedent's remains with a local funeral home. 2. 3. 4. 5. 6. 7. 8. 9. The information I have provided on this document is true and correct, under penalty of perjury. DATED this __________ day of __________________, 20______. ___________________________________________ Name of Applicant 3/12/2012 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com