Fillable Mpc140 Petition For Appt Of Guardian For Minor Fill (Commonwealth of Massachusetts)

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Mpc140 Petition For Appt Of Guardian For Minor Fill (Commonwealth of Massachusetts)

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BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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MPC 140 (5/30/11)
of
page
PETITION FOR APPOINTMENT OF
GUARDIAN OF MINOR
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
In the Interests of:
Last Name
Middle Name
Minor
Division
1.
Information about the Minor:
Last Name
M.I.
First Name
(Zip)
(State)
(City/Town)
(Apt, Unit, No. etc.)
(Address)
Current age
Date of Birth
County of Residence:
3.
Information about the Petitioner(s):
2.
The Petitioner is:
or
the Minor
a person or persons interested in the welfare of the Minor.
Name:
First Name
M.I.
Last Name
(Address)
(City/Town)
(State)
(Zip)
Primary Phone #:
Relationship to Minor:
(Apt, Unit, No. etc.)
Name:
First Name
M.I.
Last Name
(Address)
(City/Town)
(State)
(Zip)
Primary Phone #:
Relationship to Minor:
(Apt, Unit, No. etc.)
4.
Information about the Biological Mother/parent one and Father/parent two:
Last Name
M.I.
Mother's/Parent One Name
Deceased
(Zip)
(State)
(City/Town)
(Apt, Unit, No. etc.)
(Address)
Last Name
M.I.
Father's/Parent Two Name
Deceased
(Zip)
(State)
(City/Town)
(Apt, Unit, No. etc.)
(Address)
5.
Is there a nomination of a guardian by will or other writing signed by a parent or guardian?
Yes
No
If Yes, attach copy of document.
6.
Venue for this proceeding is proper in this county/Division of the Probate and Family Court because
the minor resides in the county/Division.
the guardian was nominated in a will which was or could be probated in this county/Division.
7.
The best interests of the Minor will be served by appointment of a guardian for the Minor.
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MPC 140 (5/30/11)
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page
8.
The minor is unmarried and
parent(s) consent to the appointment of a guardian.
Attach Notarized Consent of Parent(s).
all parental rights have been terminated by
prior court order. Attach a copy of the court order to this Petition.
a signed voluntary surrender. Attach a copy of the surrender to this Petition.
death. If available, attach a copy of the death certificate to this Petition.
Parent or parents are unavailable to exercise their parental rights because: (Briefly explain)
Parent or parents are unfit to exercise their parental rights because: (Briefly explain)
Guardianship has previously been granted to a third party who has died or become incapacitated, and the guardian
has not appointed a successor guardian by will or written instrument. Describe and attach order or any relevant
documents.
9.
11.
Petitioner is requesting the following person be appointed as Guardian:
charges pending for assault resulting in bodily injury to the minor. Petitioner is not being investigated and does not
have charges pending for neglect of the minor.
Petitioner is requesting to be appointed as Guardian and is not currently being investigated nor does he/she have
10.
I request that sureties required on the bond be waived by the court.
He/She has priority for appointment as guardian pursuant to G.L.c. 190B, § 5-207 because the proposed Guardian
is nominated by the Minor and the Minor is 14 years of age or older. Attach Nomination of Minor.
Name:
First Name
M.I.
Last Name
(Address)
(City/Town)
(State)
(Zip)
Primary Phone #:
Relationship to Minor:
(Apt, Unit, No. etc.)
12.
Who, other than you, had primary care and custody of the Minor during the 60 days prior to filing this Petition?
(G.L. c. 190B, §5-206):
No one or
Person listed below
Dates of care
Name:
First Name
M.I.
Last Name
(Address)
(City/Town)
(State)
(Zip)
Primary Phone #:
Relationship to Minor:
(Apt, Unit, No. etc.)
13.
If mother and father are deceased, list brothers and sisters or adult relatives, for example aunt, uncle, grandparent
who can be found:
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MPC 140 (5/30/11)
of
page
Name:
First Name
M.I.
Last Name
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
Primary Phone #:
Relationship to Minor:
Name:
First Name
M.I.
Last Name
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
Primary Phone #:
Relationship to Minor:
14.
Is any person currently acting as a Guardian or Conservator for the Minor in Massachusetts or elsewhere?
No
Yes
If Yes, identify:
Name:
First Name
M.I.
Last Name
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
Primary Phone #:
Relationship to Minor:
If a conservatorship case exists or you are also filing a Petition for Appointment of Conservator, do not complete section
15. Please note that a guardianship case does not provide authority over substantial funds.
15.
Does the Minor have any assets, e.g. bank accounts, property, and anticipated income, e.g. Social Security, interest?
No
Yes
If Yes, identify:
Do not list bank account numbers or Social Security numbers.
Description of Assets, e.g. Bank Accounts, Property
Estimated Value of Property
or Amount of Income
Total
The Petitioner shall provide notice to the parents, Minor if 14 years of age or older, and persons listed in paragraphs
11-13 of the time and place for a hearing on this Petition in accordance with Probate and Family Court Standing
Order 4-09. Notice requirements may be different if an emergency guardianship is sought.
The Petitioner/Co-Petitioners is/are interested in the welfare and best interests of the Minor and request/s that an
appointment of a guardian be made after notice and hearing.
In addition, I/We request that the Court:
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MPC 140 (5/30/11)
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SIGNED UNDER THE PENALTIES OF PERJURY
I affirm or swear under oath that I have read the foregoing petition and that the statements set forth therein are true and correct
to the best of my knowledge.
Signature of Petitioner
Date
Signature of Co-Petitioner (if applicable)
Date
BBO No.:
Primary Phone #:
(Address)
(Apt, Unit, No. etc.)
(City/Town)
(State)
(Zip)
Print Name
Attorney for Petitioner
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Mpc140 Petition For Appt Of Guardian For Minor Fill (Commonwealth of Massachusetts)

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Completed 26 July 2020

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