(Circle one) Guardianship will be ____of the child___of the child's
estate
____both of the child & the child's estate
e-mail address______________@________________
YOUR
NAME:(Person to be guardian)______________________________ AGE: ____
Soc. Sec. #_______________ Address: _________________________
City
________________, County ______________ State______ zip__________
Driver's
Lic. No. ________________ State of Drivers Lic._____Phone_______________
How
are you related to the child(ren)?___maternal grandparent ___paternal
grandparent ___
Other (specify)___________________________________
Does the child already live with you? ____Yes____No
How long has the child
been living with you?_____________
Name: ______________________________ AGE: ____Birthdate_________________
Soc. Sec. #_______________Address: ____________________________
City
________________,County _____________State______ zip__________
Driver's Lic.
No. ________________ State _____Phone_______________
Name: ______________________________ AGE: ____Birthdate_________________
Soc. Sec. #_______________Address: ____________________________
City
________________,County _____________State______ zip__________
Driver's Lic.
No. ________________ State _____Phone_______________
Name: ______________________________ AGE: ____Birthdate_________________
Soc. Sec. #_______________Address: ____________________________
City
________________,County _____________State______ zip__________
Driver's Lic.
No. ________________ State _____Phone_______________
Father of Child:
If
father is "unknown", Check here ___
and skip to the next section: NAME:______________________________ AGE: ____
Soc. Sec.
#_______________ Address: _________________________
City ________________,
County ______________ State______ zip__________
Driver's Lic. No.
________________ State of Drivers Lic._____Phone_______________
Is this
parent currently the ____Custodial Parent or the ____Non-Custodial Parent
If parent is "missing": Give last known address:
__________________________________________________________________________
____(check here)If deceased (date of death)__________________________
____(check here) If father will agree to the guardianship
Maternal Grandparents (Mother's Parents):
Maternal Grandmother: NAME:______________________________ AGE: ____
Soc. Sec.
#_______________ Address: _________________________
City ________________,
County ______________ State______ zip__________
Driver's Lic. No.
________________ State of Drivers Lic._____Phone_______________
____(check here)If "missing": Give last known address:
__________________________________________________________________________
____(check here)If deceased (date of death)_______________________________
____(check here) If she will agree to the guardianship
Maternal Grandfather: NAME:______________________________ AGE: ____
Soc. Sec.
#_______________ Address: _________________________
City ________________,
County ______________ State______ zip__________
Driver's Lic. No.
________________ State of Drivers Lic._____Phone_______________
____(check here)If "missing": Give last known address:
__________________________________________________________________________
____(check here)If deceased (date of death)_______________________________
____(check here) If he will agree to the guardianship
Paternal Grandparents (Father's Parents):
Paternal Grandmother:
NAME:______________________________ AGE: ____
Soc. Sec.
#_______________ Address: _________________________
City ________________,
County ______________ State______ zip__________
Driver's Lic. No.
________________ State of Drivers Lic._____Phone_______________
____(check here)If "missing": Give last known address:
__________________________________________________________________________
____(check here)If deceased (date of death)_______________________________
____(check here) If she will agree to the guardianship
Paternal Grandfather: NAME:______________________________ AGE: ____
Soc. Sec.
#_______________ Address: _________________________
City ________________,
County ______________ State______ zip__________
Driver's Lic. No.
________________ State of Drivers Lic._____Phone_______________
____(check here)If "missing": Give last known address:
__________________________________________________________________________
____(check here)If deceased (date of death)_______________________________
____(check here) If he will agree to the guardianship
*If child now lives with one of the above grandparents skip this section
NAME:______________________________ AGE: ____ Soc. Sec.
#_______________ Address: _________________________
City ________________,
County ______________ State______ zip__________
Driver's Lic. No.
________________ State of Drivers Lic._____Phone_______________
Sex_________
Relationship to child (if any) ____________________________
____(check here)
If he/she will agree to the guardianship
____(check here)If "missing": Give last known address:
__________________________________________________________________________
____(check here)If deceased (date of death)_______________________________
____(check here) If he/she will agree to the guardianship
NAME:______________________________ AGE: ____
Soc. Sec.
#_______________Address: _________________________
City ________________,
County ______________ State______ zip__________
Driver's Lic. No.
________________ State of Drivers
Lic._____Birthdate_______________
Sex_________
____(check here)If "missing": Give last known address:
__________________________________________________________________________
____(check here)If deceased (date of death)_______________________________
____(check here) If he/she will agree to the guardianship
NAME:______________________________ AGE: ____
Soc. Sec.
#_______________Address: _________________________
City ________________,
County ______________ State______ zip__________
Driver's Lic. No.
________________ State of Drivers
Lic._____Birthdate_______________
Sex_________
____(check here)If "missing": Give last known address:
__________________________________________________________________________
____(check here)If deceased (date of death)_______________________________
____(check here) If he/she will agree to the guardianship
To your knowledge, are there any of the following court actions affecting the
child (either pending or completed)(check all that apply)
___Adoption
___Marriage Dissolution
___Custody Orders
___Juvenile
Court
For any of the above court actions give the following information:
Case Number____________________County where filed____________________
Date filed_____________________Is the case still pending___yes_____no
Nature of Action (adoption, dissolution of marriage etc.)
_________________________________________________________________________
___Benefits from the Veteran's Administration
___Public Assitance
Benefits
___Benefits from the Social Security Administration
___Payments
from a Trust or other fund (specify)_____________________
_________________________________________________________________
In order to process and return mail your paperwork to you in less than 48 hours; Payment is limited to Money Orders or Cashiers Checks
Your COMPLETED PAPERWORK, - READY TO BE FILED - (as well as all procedural information necessary to complete the modification process) will be processed and mailed to you, via U.S. Postal, WITHIN 48 HOURS of receipt of your order information and payment. Delivery time is noramlly 1-2 days.
E-mail attach my document file to
__________________@___________________IMPORTANT INFORMATION:(This signed form must accompany all
orders)
AS WITH ANY LEGAL MATTER, COMMON SENSE SHOULD DETERMINE WHETHER YOU
NEED THE ASSISTANCE OF AN ATTORNEY. WE URGE YOU TO CONSULT WITH AN ATTORNEY
WHENEVER SUBSTANTIAL AMOUNTS OF MONEY ARE INVOLVED, OR FOR ANY MATTER WHERE YOU
DO NOT UNDERSTAND THE FORMS OR QUESTION THEIR ABILITY TO PROTECT YOU.
IT IS
UNDERSTOOD, THAT NATIONAL DIVORCE & BANKRUPTCY CENTER a division of PRO SE
PUBLICATIONS PROVIDES ITS SERVICES AT LOW COST BECAUSE WE ARE NOT LAWYERS,
AND DO NOT GIVE LEGAL ADVICE. INSTEAD, OUR SERVICE IS LIMITED TO PROVIDING
SELF-HELP INFORMATION SO THAT YOU CAN MAKE YOUR OWN DECISIONS, AND QUALITY LEGAL
FORM TYPING.
IN SHORT: WE HELP OUR CUSTOMERS SOLVE THEIR OWN LEGAL
PROBLEMS BY PROVIDING THE PUBLIC EASY AND INEXPENSIVE ACCESS TO THE COURTS
BY HELPING YOU PREPARE YOUR OWN LEGAL DOCUMENTS - WITHOUT A
LAWYER.
I, THE CUSTOMER, DIRECT NATIONAL DIVORCE & BANKRUPTCY
CENTER, a division of PRO SE PUBLICATIONS, TO TYPE VARIOUS Modification
PAPERS - WITH THE INFORMATION, AND ONLY THE INFORMATION, THAT I PROVIDE - AND TO
TYPE SUCH PAPERS AS ARE NECESSARY ACCORDING TO THE INFORMATION AVAILABLE
FROM THE PUBLICATIONS ON THE WWW OF PRO SE PUBLICATIONS INCLUDING ANY OF ITS
SUBSEQUENT ASSOCIATED PAGES, WHICH INFORMATION & REQUIRED DOCUMENT
INFORMATION I DIRECT NATIONAL DIVORCE & BANKRUPTCY CENTER, a division of PRO
SE PUBLICATIONS, TO FOLLOW IN TYPING GUARDIANSHIP PAPERS AND FORMS.
I SUPPLY
IT AS MY DIRECTIVE TO NATIONAL DIVORCE & BANKRUPTCY CENTER (a division of
PRO SE PUBLICATIONS) ON HOW, WHEN, AND WHAT TO TYPE FOR ME WITH THE
UNDERSTANDING THAT THIS DIRECTIVE IS LIMITED BY THE ABOVE AND THE FOLLOWING
WHICH I HAVE READ and SIGNED.
I ACKNOWLEDGE THAT I AM REPRESENTING MYSELF IN THIS ACTION AND THAT I HAVE
NOT RECEIVED 'LEGAL ADVICE' FROM NATIONAL DIVORCE & BANKRUPTCY CENTER (a
division of PRO SE PUBLICATIONS) AND THAT ALL STATEMENTS AND PHRASES INSERTED ON
THESE TYPING INFORMATION FORMS ARE THE WORK AND WORDS OF THE CUSTOMER ALONE.
I HAVE READ THE ABOVE STATEMENT AND UNDERSTAND ITS
TERMS;
Signature:____________________________________