Fillable EXPA Self-Represented Plaintiff DISTRICT COURT JUVENILE DIVISION CLARK (Family Law Self Help Center)

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EXPA Self-Represented Plaintiff DISTRICT COURT JUVENILE DIVISION CLARK (Family Law Self Help Center)

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© Clark County Family Law Self-Help Center Ex Parte Application for Permission to Work – Mar. 2015
* You are responsible for knowing the law about your case. For more information on the law, this form, and free
classes, visit www.familylawselfhelpcenter.org or the Family Law Self Help Center at 601 N. Pecos Road. To
find an attorney, call the State Bar of Nevada at (702) 382-0504.
1
EXPA
Parent’s Name: ______________________
Address: ___________________________
City, State, Zip: _____________________
Phone: ____________________________
Email: ____________________________
Self-Represented Plaintiff
DISTRICT COURT
JUVENILE DIVISION
CLARK COUNTY, NEVADA
In the matter of (child’s full name):
_
__________________________________,
Child’s Date of Birth: ________________
A Minor Being ______ Years of Age.
CASE NO.: D___________________
DEPT.: A
EX PARTE APPLICATION FOR PERMISSION TO WORK
AND DECLARATION OF PARENT
APPLICATION
(Your name) __________________________________, in Proper Person, the (check
one) mother/ father/ legal guardian of the above-named minor, hereby submits this Ex
Parte Application for Permission to Work pursuant to NRS Chapter 609, and requests that this
Court grant the minor permission to work.
DATED this (day) _____ day of (month) ________________, 20___.
Signature:
Printed Name:
Page 2 of 2 – Ex Parte Application for Permission to Work
DECLARATION OF PARENT
I (your name) _____________________________ state the following facts under penalty
of perjury:
1. I am the (check one) mother / father / legal guardian of (child’s name)
_________________________________.
2. The child resides in Clark County, Nevada.
3. The child is being offered employment by (employer’s name and address)
__________________________________________________________________________.
The child’s direct supervisor will be (supervisor’s name) ___________________________
and his/her telephone number is _______________________. Employment is expected from
(beginning date) _____________ until (approximate ending date) ________________.
4. The child’s duties at work will be
5. The child’s work hours will be
6. The child wants this job because
7. I would like the child to work in this job because
I declare under penalty of perjury under the laws of the State of Nevada that the foregoing is true
and correct.
Signature:
Printed Name:
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EXPA Self-Represented Plaintiff DISTRICT COURT JUVENILE DIVISION CLARK (Family Law Self Help Center)

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Completed 9 February 2021

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