STATE OF ARIZONA COURT OF APPEALS DIVISION ___
IN THE MATTER OF: ) ) ___________________________, ) a minor ) [Use fictitious name if petitioner ) has so requested] ) ___________________________________ ) 1. 2. 3.
CASE NO. _____________________ PETITION FOR REVIEW
I hereby petition for review from the decision of the Arizona Court of Appeals, Div. ____, dated ___________________. I am aware that I am entitled to an attorney to represent me, at no charge to me, if I so choose. ____ I request that an attorney be appointed to represent me in this matter, free of charge; OR ____ I do not request a court-appointed attorney. I have personally chosen to represent myself, and not be represented by an attorney; OR ____ I am represented by an attorney, as follows: Name of attorney ______________________________________________ Address _____________________________________________________ Telephone number _____________________________________________
03.03.03
4.
If the court requires a hearing, I ____ will ____ will not appear____ in person ____ by telephone. My telephone number is ____________________________.
DATE: __________________
___________________________________ (Petitioner's signature, using true name OR fictitious name OR initials)
03.03.03
SUPERIOR COURT OF ARIZONA _________________ COUNTY
IN THE MATTER OF: ) ) ___________________________, ) a minor ) [Use fictitious name if petitioner ) has so requested] ) ___________________________________ ) 1.
CASE NO. _____________________ NOTICE OF APPEAL
I hereby appeal from the denial of my Petition to Authorize Physician to Perform Abortion issued on_______________ by Judge ______________________ of the _______________________ Superior Court. I am aware that the Court will appoint an attorney to represent me, at no charge to me, if I so choose. ____ I request that the Court appoint an attorney to represent me in this matter, free of charge; OR ____ I do not request a court-appointed attorney. I have personally chosen to represent myself, and not be represented by an attorney; OR ____ I am represented by an attorney, as follows: Name of attorney _____________________________________________ Address ____________________________________________________ Telephone number ____________________________________________
2. 3.
4.
I ____ will ____ will not appear at the appellate hearing ____ in person ____ by telephone. My telephone number is ____________________________.
DATE: ______________________
________________________________________ (Petitioner's signature, using true name OR fictitious name OR initials)
03.03.03
STATE OF ARIZONA COURT OF APPEALS DIVISION ___
IN THE MATTER OF: ) ) ___________________________, ) a minor ) [Use fictitious name if petitioner ) has so requested] ) ___________________________________ ) 1. 2.
CASE NO. _____________________ NOTICE OF HEARING ON APPEAL
Your hearing date is: __________________________. The location of your hearing is: _____ Arizona Court of Appeals, Office of the Clerk 1501 W. Washington, Second Floor Phoenix, AZ 85007 Telephone: (602)542-4821 ____ Arizona Court of Appeals, Office of the Clerk 400 W. Congress, Second Floor Tucson, AZ 85701 Telephone: (520)628-6954
3.
The time of your hearing is: _______________________________________.
DATE: ________________ Mailed/hand-delivered to petitioner/petitioner's attorney on _______________, 200__. __________________________
____________________________________ Deputy Clerk
03.03.03
STATE OF ARIZONA COURT OF APPEALS DIVISION ___
IN THE MATTER OF:
) ) ___________________________, ) a minor ) [Use fictitious name if petitioner ) has so requested] ) ___________________________________ ) 1. 2.
CASE NO. _____________________ NOTICE OF HEARING ON APPEAL AND APPOINTMENT OF COUNSEL
Your hearing date is: __________________________. The location of your hearing is: ____ Arizona Court of Appeals, Office of the Clerk 1501 W. Washington, Second Floor Phoenix, AZ 85007 Telephone: (602)542-4821 Arizona Court of Appeals, Office of the Clerk 400 W. Congress, Second Floor Tucson, AZ 85701 Telephone: (520)628-6954
____
3. 4.
The time of your hearing is: _______________________________________. Your appointed attorney is: Name: Address: Phone number: ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________
2.28.03
DATE: ________________ Mailed/hand-delivered to petitioner/petitioner's attorney on _______________, 200__. __________________________
____________________________________ Deputy Clerk
2.28.03