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 _____________________________________________
If the court requires a hearing, I ____ will ____ will not appear____ in person ____ by telephone. My telephone number is ____________________________.
___________________________________ (Petitioner's signature, using true name OR fictitious name OR initials)