Law Offices of Mario V.

Valenzuela
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Mario V. Valenzuela (ASB# 005814; PCC# 64772)
2 2701 East Speedway Blvd. Suite 203
Tucson, Arizona 85716
3 (520) 791-9906
Attorney for Petitioner
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5 IN THE SUPERIOR COURT OF THE STATE OF ARIZONA

6 IN AND FOR THE COUNTY OF PIMA
In the Matter of the Conservatorship of: NO.
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AFFIDAVIT OF PERSON TO BE
8 RONALD HADDOX, APPOINTED CONSERVATOR
Date of Birth: 03/29/1994
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Minor.
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I, Paula Haddox, declare under penalty of perjury that:
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12 1.  True or  False. I have not been convicted of a felony in any

jurisdiction.
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14 2.  True or  False. I have not acted as a conservator for another person for
at least three years before I filed this Petition.
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16 3.  True or  False. I know and understand the powers and duties I would
have as a guardian and/or conservator.
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18 4.  True or  False. I have not had a power of attorney for anyone for at
least three years before I filed this Petition.
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5.  True or  False. I am not, to the best of my knowledge, listed in the
Elder Abuse Registry at the Office of Arizona Attorney
21 General.
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6.  True or  False. To the best of my knowledge, no business in which I
23 have an interest is listed in the Elder Abuse Registry at
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the Office of the Arizona Attorney General.

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7.  True or  False. Arizona law requires that a guardian/conservator file an

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annual report/accounting with the court. If I have been
a guardian/conservator before, I either filed the
2 required documents on time, or within three months of
receiving notice from the court that the
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report/accounting was due.
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8.  True or  False. I have never been removed by the court as a guardian
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or conservator.
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9.  True or  False. The nature of my relationship to the proposed ward or
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protected person is: natural mother and legal guardian.
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10.  True or  False. I met the proposed ward under the following
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circumstances: I am his natural mother and legal
10 guardian.
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11.  True or  False. I have never received anything of value greater than the
12 total of one hundred dollars in any one year by gift, or
will, or inheritance from an individual or the estate of
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an individual to whom I was not related by blood or
14 marriage and for whom I served at any time as
guardian, conservator, trustee, or attorney-in-fact.
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16 12.  True or  False. No business in which I have an interest has ever

received anything of value greater than a total of one
17 hundred dollars in any one year by gift, will or
18 inheritance from an individual or the estate of an
individual whom I am not related by blood or marriage
19 and for whom I served at any time as guardian,
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conservator, trustee or attorney-in-fact.

21 13.  True or  False. To the best of my knowledge, I am not named as a

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personal representative, trustee, beneficiary, or other
type of beneficiary for any individual to whom I am not
23 related by blood or marriage and for whom I have ever
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served as guardian, conservator, trustee, or attorney-in-
fact.
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14.  True or  False. To the best of my knowledge, no business in which I

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have an interest is named as a personal representative,
trustee, beneficiary, or other type of beneficiary for any
2 individual to whom I am not related by blood or
marriage and for whom I have ever served as guardian,
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conservator, trustee, or attorney-in-fact.
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15.  True or  False. I have no interest in any business that provides
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housing, healthcare, nursing care, residential care,
6 assisted living, home health services, or comfort care
services to any individual, I am a homemaker.
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8 16. Additional identifying information about the person seeking this

appointment:
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10 Gender: Female Date of Birth: 12-26-1959

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Height: 5’6” Weight: 214 lbs.
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Color of Eyes: Blue Color of Hair:Brown
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14 Social Security: 554-13-2214

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OATH OF PERSON SEEKING TO BE APPOINTED AS CONSERVATOR:
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STATE OF ARIZONA )
2 )ss.
COUNTY OF PIMA )
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I have read, understood and completed the above statements and the
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attached document. Everything I have said is true and correct to the best of my
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knowledge, information and belief.
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8 ___________________________
Paula Haddox, Petitioner
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10 SUBSCRIBED AND SWORN TO before me this___day of ________,

2008.
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___________________________
Notary Public
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My commission expires: ___________

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