,,.,..._._~ ~.... -';.' ".."~, ~.,.,.,.">.". " '' -~ ~....,, -~. --... ', t".,-, '<,.-,"- l'" r '. ' "' - -,.,,-,.,= "-"-' " "-'.....":. '-"''~ ' ' ' ' "-,,_._.,_,_,_.,_, _.,_..:_,._,.._._._.,_,, "<.>, L.".. ~ "' ~~- '--..- -~,.,,,.,.,,.,....,, -.._..._,,..._, _,.,,.._,...,-.,...-,.,,., Cause Number:53CO (To be completed by the Clerk) **Must print on GREEN paper** GUARDIANSHIP INFORMATION SHEET CHILD AND INCAPACITATED ADULT Petitioner (Your Name): Phone (Including area code): Em fo ment: Phone (including area code): --'---------- -- ------------ ------ - -------------- ------------- --- --- ------------------------ CHILD OR INCAPACITATED ADULT: Name: DOB: I I RACE: SEX: M/F :o<: SS"-'-N.!.:.: Phone (Including area code): Physician/Therapist (if applicable): Phone (including area code): IF THE SUBJECT OF THIS PETITION IS A MINOR CHLD: Mother: Phone (Including area code): Employment: Phone (including area code): 4
... : :..:;:\:-:-:-:::-:.:of. ~".;.,-~..:0.:...-.:.:::~::.. ;,-J-:-:.,:-:.-..-:-::-:-.-:-:-:..: - JF..-.-~ :.::.-.---.. - --: ::-:--:-:-:.. ::.. :::::.-:-:-. ;-:-.-:. Cause Number:53CO (To be completed by the Clerk} **Must print on GREEN paper** Father: Phone (Including area code}: Employment: Phone (including area code}:.: Other immediate family members (REQUIRED FOR BOTH MINOR CHLID AND INCAPACITATED ADULT) Name: Phone (Including area code}: Relationship: r :.:: :~ Name: Phone (Including area code}: Relationship: Name: X..-. :: ~:~. Phone (Including area code): Relationship:. ~
55: CAUSE NO. 53CD IN THE MATIER OF THE GUARDIANSHIP OF,,A MINOR PETITION FOR APPOINTMENT OF GUARDIAN OF PERSON Comes now, -------------~ petitioner, and on oath states to the Court that the following minor Child, years of age, will be residing with me at -----------------~ Indiana; further Petitioner alleges and states that: 1. Said minor, is under age of majority and the age as stated aforesaid. 2. That said minor will assume residency in the Petitioner's home to live with Petitioner. 3. That said minor is not residing with the Petitioner for the purpose of attending a particular school. 4. That the mother of said minor is: of ~ and the father of said minor is: ~of Said--------------has legal custody of. 5. That the parents of said have consented to this Petition for Guardianship, copies of which are attached hereto and by this reference made a part hereof. 6. That the minor has consented to this Petitioner, a copy of which Consent is attached hereto and by reference made a part hereof. 7. That the reasons why the appointment of a guardian is sought for the minor herein are as follows: a. For legal standing to assume the role ordinarily assigned to the parents, but which Petitioner must assume because: b. That said minor does not have any property of his/her own; and WHEREFORE, Petitioner pray that he/she/they be appointed the Guardian of the Person of Petitioner I hereby affirm under penalties of perjury that the facts set forth above are true. Petitioner
SS: CAUSE NO. 53CO, IN THE MATTER OF THE GUARDIANSHIP OF ------------~A MINOR CONSENT TO APPOINTMENT OF GUARDIAN The undersigned,---------------' does consent to the appointment of ------------~ Bloomington, Indiana, as guardian of the person of my son/daughter Dated this day of ~ 20., Mother The undersigned affirms under the penalties of perjury that the foregoing statements and consent are true., Mother :~
SS: CAUSE NO. 53CQ, IN THE MADER OF THE GUARDIANSHIP OF --------------'A MINOR CONSENT TO APPOINTMENT OF GUARDIAN The undersigned,----------------'' does consent to the appointment of -------------~ Bloomington, Indiana, as guardian of the person of my son/daughter Dated this day of ~ 20., Father The undersigned affirms under the penalties of perjury that the foregoing statements and consent are true., Father
SS: CAUSEN0.53CD IN THE MATTER OF THE GUARDIANSHIP OF --------------------~A MINOR CONSENT TO GUARDIANSHIP The undersigned,------------------------------~ born.j ] ~in ------------------------------J does hereby consent to the appointment of -----------------------------as the guardian of my person. Dated this day of, 20, Minor I hereby affirm under penalties of perjury that the facts set forth above are true. ~Minor
_._._ J STATE OF INDIANA 55: CAUSEN0.53CO IN THE MADER OF THE GUARDIANSHIP OF ---------------------------'A MINOR GUARDIAN'S OATH I,------------------------------------' do solemnly swear that I will faithfully perform the duties imposed upon me as Guardian of the person of WITNESS our hands this day of ~ 20 1: I ~, Petitioner Subscribed and sworn to before me, Notary Public/Monroe County Clerk in and for said County and State, this day of 20 Notary Public/Clerk of Monroe CircuitCourt My commission expires: Printed Name
---.-. -- -~--~ c. - - - - - ~- : ~ --~~-- :-:-J,_.-_- STATE OF INDIANA SS: CAUSEN0.53CO ~ IN THE MATTER OF THE GUARDIANSHIP OF -----------------------'A MINOR WAIVER OF NOTICE OF HEARING AND CONSENT TO GUARDIANSHIP BY RELATIVE The undersigned,-------------------' custodial parent(s) of prospective ward, waives any notice of the hearing on the Petition forthe Appointment of a Guardian of the Person and Estate of -----------------------'and acknowledges that she/he has received a copy of the aforementioned petition and approves of the appointment of as guardian of the person and estate of Date this day of ~ 20_, Custodial Parent(s) STATE OF COUNTY OF ) SS: Before me the undersigned, a Notary Public in and for said county and State, personally appeared --------------------~who acknowledged the execution of this Waiver of Notice and Consent to the appointment of a guardian over under the penalties of perjury., Notary Public My commission expires:----------
55: CAUSE NO. 53CO. IN THE MADER OF THE GUARDIANSHIP OF -------------- 'AMINOR The Petitioner herein,------------------' having heretofore filed her Petition for Appointment of Guardian of the person of, said petition being in the words and phrases following: (H.I.) And the Court having considered said petition and the witnesses having been sworn and evidence heard, the Court now finds that the said appointment is desirable to protect the minor's interests and that the said ------------------isqualified as the most suitable person to be so appointed. IT IS, THEREFORE, ORDERED, ADJUDGED AND DECREED that said petition is granted and said should serve in such capacity without bond until revoked by all parties involved. Dated this day of, 20. Honorable JUDGE, MONROE CIRCUIT COURT