MPC 340 (5/30/11) MVER
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VERIFIED MOTION FOR APPOINTMENT OF
TEMPORARY GUARDIAN FOR A MINOR
G.L. c.190B, §5-204
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
Minor
on Petition filed
Last Name
First Name
Middle Name
Division
Now comes the moving party
First Name
Last Name
Middle Initial
who states as follows:
1. An emergency exists requiring the appointment of a Temporary Guardian as any delay in the appointment will cause
immediate and substantial harm to the health, safety or welfare of the Minor, and no other person has authority to
act in the circumstances.
2. The nature of the circumstances requiring the appointment of a Temporary Guardian are:
3. The particular harm sought to be avoided is:
4. The actions which need to be taken by a Temporary Guardian to avoid the harm are:
WHEREFORE, PETITIONER REQUESTS THAT THIS HONORABLE COURT:
Appoint
1.
First Name
Last Name
Middle Name
as Temporary Guardian(s) of the Minor to serve sureties for the following reasons:
with
without
the minor has no estate
other:
The moving party further seeks specific court authorization:
2.
In addition, I request that the Court:
3.
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MPC 340 (5/30/11) MVER
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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 moving party
Date
BBO No.:
Primary Phone #:
(Address)
(Apt, Unit, No. etc.)
(City/Town)
(State)
(Zip)
Print Name
Attorney for moving party:
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