Financial Affidavit— All Matters - Pima County Superior 2011-2024

Financial Affidavit— All Matters - Pima County Superior: What You Should Know

CV-21-A2 MARK R. JONES, PROSECUTOR IN THE SUPREME COURT OF PIMA COUNTY, ARIZONA ROSIN E. FULTON, ATTORNEY GENERAL COUNSEL P. 61625-15 This Affidavit is a Notice of Appearance to appear at a hearing on .............................., in the matter of....................... (The filing date is specified in parentheses). I, ...................... (custody, legal and physical caregiver of ......................... (child), hereby apply to be added as a party to .............................. (affidavit) and hereby declare the following: PERSONAL LIABILITIES AND CUSTODY I declare under penalty of perjury that I know of no other person, other than myself, who bears a greater legal responsibility for the care of (the child), than I do. I agree that I understand the facts and circumstances of the child's physical and mental health and welfare, and the duties of the person with responsibility for (the child). Furthermore, I understand that I will be responsible for the child's medical, dental, and educational needs and I affirm that I am fully informed of my responsibilities under (insert statute). Furthermore, I acknowledge the limitations of (medical) care that the child will have, that I understand the child's current medical status, that I will have contact with the child, to assess the child and the child's needs and to arrange for medical and educational treatment. Furthermore, I acknowledge that I will not give or arrange for the giving of an abortion as part of any medical or family planning, and that any child born that results from my decision will not receive any public assistance funds. Furthermore, I acknowledge that I will not interfere with (the child's) parent's medical or other treatment and I understand that I will not make decisions for any parent about treatment for (the child). Furthermore, I understand that I may not give to (the child) any information about the health care decisions of (the child's) parent(s) without (the parent's) express written consent, and that failure to provide access to medical or hospital records will constitute an illegal interference with medical and parental rights. Furthermore, I understand that I may be asked questions by the other parent(s) regarding the child's medical and mental health and my decision to give statements to the medical or other providers, including, but not limited to, my reasons for doing so.

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