SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY

Person Filing/Applicant:Mailing Address:City, State, Zip Code:Day/Evening Phone: /Represented by SELF (No Attorney) OR AttorneyIf Attorney, Bar No.: Atty. Phone:SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTYIn the Matter of _________________Case No. MH____________________1. My name is __________________________, and I hereby apply to theCourt for the restoration of my civil right to possess a firearm pursuant toA.R.S. § 13-925, which right was previously revoked by order of the Courtin the above-referenced matter in connection with an Order for Treatmententered on _______________________.2. The previously-entered Court Order for Treatment included a finding of [check allthat apply]Danger to SelfDanger to OthersPersistently and Acutely DisabledGravely DisabledPETITION FOR RESTORATIONOF RIGHT TO POSSESSFIREARMS PURSUANT TOA.R.S. § 13-925.3. I submit to the court that I am no longer subject to Court OrderedTreatment pursuant this matter or any subsequent mental health order ofthis Court.4. I submit to the court that I no longer suffer from the mental disorder thatled to the previous findings of this Court at the time the Order forTreatment was entered in this matter, as supported by the accompanyingstatement of the Arizona licensed psychologist or psychiatrist who has hadan opportunity to evaluate me in connection with this Application.5. I submit to the court that I am not under the jurisdiction of the court as award or protected person in any active adult guardianship orconservatorship proceeding.

6. I represent to the Court that a copy of this Petition and the accompanyingReport of Psychiatrist or Psychologist is being concurrently personallyserved on the Office of the Maricopa County Attorney, or the Office of theArizona Attorney General if this case involved proceedings at the ArizonaState Hospital. A copy of this Petition is also being mailed or delivered toany person who requested notice in this case pursuant to A.R.S. §36-541.01.7. I request that after receiving this Petition, the Court set a hearing in thismatter to consider whether my right to possess firearms should berestored pursuant to A.R.S. §13-925.DATED this day of , 20__._________________________________[Name of Petitioner]STATE OF ARIZONA )) ss.County of ___________), being duly sworn, states as follows:That he/she is the Petitioner in the foregoing Petition; and that thestatements in the Petition are accurate and complete to the best of his/herknowledge and belief.___________________________PetitionerSUBSCRIBED AND SWORN TO before me this, 20__, by .day ofCertificate of Delivery:Original filed with Clerk of the Courton the ____ day of _________, 20___.Copies of this Application were mailedor delivered to the following on the_____ day of ____________, 20___:Presiding Judge for Probate/Mental Health125 W. Washington, Suite 102Phoenix, AZ 85003

Office of the Public DefenderDesert Vista Behavioral Health Center570 W. Brown RoadMesa, AZ, 85201OR TO:Office of the County AttorneyCivil DivisionDesert Vista Behavioral Health Center570 W. Brown RoadMesa, AZ, 85201Joel Rudd, Esq.Office of the Attorney General1275 W. Washington StreetPhoenix, AZ, 85007-2926