Fillable PETITION TO APPOINT CUSTODIAL GUARDIAN FOR A MINOR (Vermont Judiciary)

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PETITION TO APPOINT CUSTODIAL GUARDIAN FOR A MINOR (Vermont Judiciary)

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700-00070C – Petition to Appoint Custodial Guardian for a Minor (06/2020) Page 1 of 5
STATE OF VERMONT
SUPERIOR COURT
PROBATE DIVISION
Unit
Docket No.:
In re Guardianship of :
PETITION TO APPOINT CUSTODIAL GUARDIAN FOR A MINOR
I ask the court to appoint a guardian for the minor child,
In support of this request, I state under oath:
1. Reason for Guardianship
The minor is a child in need of guardianship for the following reasons: (check all that apply)
☐ No parent objects and the transfer of custody is in the best interest of the minor and is not solely
for the purpose of establishing a residence for school purposes.
☐ One or both parents are under guardianship.
☐ One or both parents are incompetent or unsuitable to have custody of the minor.
☐ The minor has no living parent authorized to act as guardian.
☐ The parent of the minor resides outside the state and has so resided for three years and has not
contributed to the minor’s support during that time, and the minor has resided in the state three
years prior to the date of appointment.
Describe the specific reasons why a guardianship is necessary:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2. Information about the Minor: (You must provide the Court with a copy of the child’s birth certificate
when you file the petition.)
Name of Minor
DOB
Grade
Current Address where Minor resides
Town
State
Zip
Current Mailing Address if different
Phone Number
3. During the last five (5) years the minor has resided at the following addresses: (Begin with the
address listed above. List all household members .)
Address
Include Street, City/Town and State
Dates From When
to When
Names of all persons residing in
the household with the child
700-00070C – Petition to Appoint Custodial Guardian for a Minor (06/2020) Page 2 of 5
4. Is the child:
A member of a federally recognized Indian tribe? ☐Yes ☐No
Eligible for membership in a federally recognized Indian tribe and the biological child of a member of
an Indian tribe? ☐Yes ☐No
5. Is the child in school? ☐Yes ☐No
If yes, indicate the name and location of the school:
The child’s current grade level is:
6. Information about the parents of the minor (If either parent is deceased, you must provide a copy of
the death certificate.)
a.
Name of Parent #1
DOB
Deceased
☐Yes
☐
No
Age
Mailing Address for Parent #1
Town
State
Zip
Residential Address if different
Town
Phone Number
b.
Name of Parent #2
DOB
Deceased
☐Yes
☐
No
Age
Mailing Address for Parent #2
Town
State
Zip
Residential Address if different
Town
Phone Number
c. If you cannot provide a valid name and/or address for one or both parents, please describe in detail
the efforts that have been made to locate the parent or parents. If the identity of the father is
unknown, provide all of the information you can about potential fathers and any prior paternity
proceedings.
d. Parents’ Position Regarding Guardianship
Parent #1 is in agreement with guardianship for minor: ☐Yes ☐No ☐Don’t Know
Parent #2 is in agreement with guardianship for minor: ☐Yes ☐No ☐Don’t Know
7. Status of Legal Custody of Minor
a. The following person or person(s) currently has/have parental rights and responsibilities (legal
custody) for the minor:
Name(s)
Relationship to Minor
Mailing Address
Legal custody was granted by a court?
☐
Yes
☐
No
Name and address of court
b. There is a pending proceeding involving custody, parental rights and responsibilities or parent child
contact (visitation): ☐Yes ☐No
If yes, provide the name and address of the court and the docket number of the case:
700-00070C – Petition to Appoint Custodial Guardian for a Minor (06/2020) Page 3 of 5
PLEASE PROVIDE COPIES OF ANY COURT ORDERS WITH YOUR FILING
8. Other legal proceedings involving the minor child, parent or proposed guardian (check all that apply.
For each proceeding, check the person or persons involved in the proceeding)
☐ Juvenile delinquency ☐minor ☐parent ☐guardian
☐ CHINS (Child in Need of Care or Supervision)
Abuse/Neglect or Unmanageable
☐minor ☐parent ☐guardian
☐ Domestic Violence
(relief from abuse or restraining order) ☐minor ☐parent ☐guardian
☐ Divorce ☐minor ☐parent ☐guardian
☐ Paternity ☐minor ☐parent ☐guardian
☐ Adoption ☐minor ☐parent ☐guardian
☐ Conviction for a crime ☐minor ☐parent ☐guardian
☐ Other Court proceeding ☐minor ☐parent ☐guardian
Specify type of proceeding:
9. Is DCF (Department for Children and Families) involved with this child? ☐Yes ☐No
If yes, provide the name of the DCF social worker, if known:
10. Is there an existing child support order for this child? ☐Yes ☐No
If the guardianship is approved, does the proposed guardian expect to receive child support or financial
benefits for the child? ☐Yes ☐No
11. Is the child a recipient of social security benefits? ☐Yes ☐No
If yes, provide the name of the representative payee, if known:
12. Is there an existing parent child contact (visitation) order that affects the child? ☐Yes ☐No
If yes, either attach a copy of the most recent court order or provide information about the order
including the schedule of contact, the name of the person entitled to contact and whether the contact
currently takes place:
13.
Is there any reason why the child should not have contact with the parents? ☐Yes ☐ No
If yes, describe the reasons in detail:
700-00070C – Petition to Appoint Custodial Guardian for a Minor (06/2020) Page 4 of 5
14. Information about Proposed Guardian and Co-Guardian, if any:
Guardian
Name of proposed guardian
DOB
Mailing Address
Town
Zip
Phone Number
Relationship between proposed guardian and minor child:
Relative
☐
☐
Friend/Neighbor
☐Other
If there is a proposed co-guardian, provide information below about that person
Co-Guardian
Name of proposed co-guardian
DOB
Mailing Address
Town
Zip
Phone Number
Relationship between proposed co-guardian and minor child
☐
Relative
☐
Friend/Neighbor
☐ Other
15. List all persons residing in the proposed guardian’s home and the relationship of those persons to the
minor child:
Name of Household Member
Relationship to Child
Add an additional page if necessary
16. Change of School
Does the proposed guardian intend to change the child’s school? ☐Yes ☐No ☐Don’t Know
If yes, provide the name and address of the school the child will attend
17. Answer the following questions by checking the box if the statement is true.
If your answer to any of the questions is yes, please explain your answer on an additional page.
a. I have participated as a party, witness, or in some other way in a court case about the custody of
this child either in Vermont or another state. ☐Yes ☐No
b.
I have information about a custody case concerning this child that is now pending in a Vermont
court or a court in another state. ☐Yes ☐No
c.
I have knowledge about a person who is not a party to this case who has physical custody of this
child or who claims to have custody or visitation rights to this child ☐Yes ☐No
d. If you answered yes to any of the questions above, please explain:
700-00070C – Petition to Appoint Custodial Guardian for a Minor (06/2020) Page 5 of 5
THEREFORE, I/we request that the court appoint a guardian for the minor child. By signing this petition,
I/we certify that I/we have read the petition and that to the best of my/our knowledge, information and
belief, the facts set forth in the petition are true and that the petition is not filed for any improper purpose
such as to harass or cause unnecessary delay or needless litigation.
Date
Signature of Petitioner
Petitioner’s Mailing Address
Petitioner’s Phone Number
Subscribed and sworn before me on:
Date
My commission expires on:
Date of Expiration
Signature of Notary
Attachments
Filing fee payable to the Vermont Superior Court, Probate Division
List of Interested Persons
A copy of the birth certificate of the minor child*
A consent to the guardianship signed by Parent #1
A consent to the guardianship signed by Parent #2
A consent to the guardianship signed by the proposed guardian
Copies of any court orders that currently affect the child
If either parent is deceased, a copy of the death certificate*
Guardian’s Consent to Background Checks
*Check with the probate court where you will file the petition to see if the court requires that birth certificates and death
certificates be certified.
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PETITION TO APPOINT CUSTODIAL GUARDIAN FOR A MINOR (Vermont Judiciary)

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Completed 30 July 2020

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