Fillable ATTACHMENT PB-4013 SUPERIOR COURT OF CALIFORNIA, COUNTY OF

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ATTACHMENT PB-4013 SUPERIOR COURT OF CALIFORNIA, COUNTY OF

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ATTACHMENT PB-4013
PB-4013 REV 1/1/04 PETITION FOR VISITATION Page 1 of 2
(PROBATE)
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address):
TELEPHONE NUMBER: FAX NUMBER:
ATTORNEY FOR: (name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
191 North First Street
191 North First Street
San José, CA 95113
Downtown Courthouse – Probate Division
GUARDIANSHIP OF:
MINOR
FOR COURT USE ONLY
PETITION FOR VISITATION
CASE NUMBER:
1. Petitioner (name): requests
the following specific visitation schedule for the minor (name):
2. Petitioner is the minor’s
Parent Grandparent Other:
3.
Name(s): was appointed guardian of the PERSON on (date):
4. Petitioner should be granted visitation for the reasons
specified below specified in Attachment 4.
5.
Notice to the persons identified in Attachment 5 should be dispensed with because
they cannot with reasonable diligence be given notice (specify names and efforts to locate them in
Attachment 5).
other good cause exists to dispense with notice (specify names and reasons in Attachment 5).
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ATTACHMENT PB-4013
PB-4013 REV 1/1/04 PETITION FOR VISITATION Page 2 of 2
(PROBATE)
GUARDIANSHIP OF THE PERSON OF (Name):
MINOR
CASE NUMBER:
6. The names and residence addresses of the guardian, minor, and minor’s parents, brothers, sisters and
grandparents are as follows:
a. Guardian: f. Maternal Grandfather:
b. Minor: g. Maternal Grandmother:
c. Father: h. Paternal Grandfather:
d. Mother: i. Paternal Grandmother:
e. Brother(s) or Sister(s): j.
Additional names and addresses
(12 years old or older) continued in Attachment 6.
7. Number of pages attached:
Date: ►
(SIGNATURE OF ATTORNEY)
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
....................................................................... ►
(TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER)
....................................................................... ►
(TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER)
Consent to Visitation and Waiver of Notice
I consent to the attached visitation schedule and waive notice of the petition:
......................................................................
(DATE) (TYPE OR PRINT NAME) (SIGNATURE OF GUARDIAN)
......................................................................
(DATE) (TYPE OR PRINT NAME) (SIGNATURE OF GUARDIAN)
I consent to attend orientation and mediation and waive notice of the petition:
......................................................................
(DATE) (TYPE OR PRINT NAME) (SIGNATURE OF GUARDIAN)
......................................................................
(DATE) (TYPE OR PRINT NAME) (SIGNATURE OF GUARDIAN)
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ATTACHMENT PB-4013 SUPERIOR COURT OF CALIFORNIA, COUNTY OF

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Completed 10 February 2021

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