MPC 240 (5/30/11)
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PETITION FOR REMOVAL OF
GUARDIAN OF MINOR PURSUANT TO
G.L. c. 190B, §5-212
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
In the Interests of:
Last Name
Middle Name
Minor
Division
Petitioner(s),
1.
First Name
Last Name
M.I.
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
Current address
Primary Phone #:
is the Minor (if 14 or more years of age).
is a person interested in the welfare of the Minor. (State nature of interest)
both.
mother
father
Guardian(s),
2.
First Name
Last Name
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
Current address
Primary Phone #:
was appointed on
(date)
3.
Petitioner(s) requests that the court remove the guardian/co-guardians for the following reasons:
The biological parent(s) can resume parental responsibilities. (Explain circumstances)
Address of parent(s) resuming responsibility
Primary Phone #:
(Zip)
(State)
(City/Town)
(Apt, Unit, No. etc.)
(Address)
Last Name
M.I.
First Name
The Minor was adopted.
Other: (Attach additional sheets or documents, if necessary)
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MPC 240 (5/30/11)
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4.
Petitioner requests that
First Name
Last Name
be appointed as successor Guardian(s) (Petitioner is not required to nominate a successor).
5.
Petitioner requests a hearing be scheduled on this matter.
The Minor (if 14 years of age or older), guardian, and the parents of the minor, provided that the parental rights have not
been terminated or a voluntary surrender has not been signed, are required by law to be given notice of the time and
place of hearing on this Petition.
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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