MPC 241 (5/30/11)
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PETITION TO RESIGN
AS GUARDIAN OF A MINOR
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
In the Interests of:
Last Name
Middle Name
Ward/Minor
Division
I/We, is/are the petitioner(s) who was/were appointed by this court to be the guardian(s) of the above named minor,
represent(s) that I/we cannot continue to serve as guardian(s).
1.
First Name
M.I.
Last Name
(Address)
(Apt, Unit, No. etc.)
(State)
(Zip)
Primary Phone #:
First Name
M.I.
Last Name
(Address)
(Apt, Unit, No. etc.)
(State)
(Zip)
Primary Phone #:
and
I/We, resign as guardian(s) of the minor and respectfully ask this court to accept my/our resignation,
2.
and appoint some other suitable person to serve as guardian with custody of the minor.
The parent(s) can now resume parental responsibilities.
Last Name
M.I.
First Name
Name of Parent 1:
Last Name
M.I.
First Name
Name of Parent 2:
Other
(Zip)
(State)
(Apt, Unit, No. etc.)
(Address)
(Zip)
(State)
(Apt, Unit, No. etc.)
(Address)
I/We, request that
Last Name
M.I.
First Name
be appointed as
Guardian(s). (Petitioner is not required to nominate a Successor.)
3.
4.
Petitioner requests that 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.
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MPC 241 (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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