Person Filing: Mailing Address: City, State, Zip: Day/Evening Phone: Person Filing is: If Attorney, Bar No.:
/ SELF (No Attorney) OR Attorney Atty. Phone:
In the matter of Emancipation of
SUPERIOR COURT OF ARIZONA COUNTY JUVENILE COURT
Case Number: JUVENILE EMANCIPATION INFORMATION SHEET
NOTE: THIS FORM IS FOR COURT USE ONLY AND IS NOT A PUBLIC RECORD.
COMPLETE THIS FORM AND RETURN IT TO THE CLERK WHEN FILING THE PETITION.
INFORMATION ABOUT THE MINOR WHO WANTS TO BE EMANCIPATED
First Middle Last
Mailing Address City, State, Zip Street Address (if different from mailing address) City, State, Zip Code Daytime / Evening Telephone: Date of Birth (Month/Day/Year) Social Security Number Will you or any person required to receive notice need a court interpreter? If a party requires an interpreter, please provide their name and the language needed: Yes No
Page 1 of 1
Petition Information Sheet Use only current version