Fillable Petition For Appointment Of Guardian Of A-minor Jv 075re (Commonwealth of Massachusetts)

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Petition For Appointment Of Guardian Of A-minor Jv 075re (Commonwealth of Massachusetts)

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BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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JV-075 (Rev. 03/18/2013)
PETITION FOR APPOINTMENT
OF GUARDIAN OF A MINOR
(SEPARATE PETITION FOR EACH CHILD)
DOCKET NUMBER
Trial Court of Massachusetts
Juvenile Court Department
NAME OF MINOR ADDRESS
D.O.B.
14 years or older
GENDER
Male Female
PETITIONER AND PROPOSED GUARDIAN(S)
NAME OF PETITIONER ADDRESS RELATIONSHIP TO MINOR
_____________________________
_____________________________
_____________________________
NAME OF PROPOSED CO-GUARDIAN ADDRESS
RELATIONSHIP TO MINOR
_____________________________
_____________________________
_____________________________
NAME OF PROPOSED CO-GUARDIAN ADDRESS
RELATIONSHIP TO MINOR
_____________________________
_____________________________
_____________________________
NAME OF PARENT ADDRESS TELEPHONE NO(S).
NAME OF PARENT ADDRESS TELEPHONE NO(S).
1. The petitioner(s) respectfully request that the above named proposed guardian(s) be appointed guardian(s) of
the minor and alleges to this Court that appointment of a guardian(s) of the minor is necessary because:
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
ADDRESS RELATIONSHIP TO MINOR
RELATIONSHIP TO MINOR
_____________________________
_____________________________
_____________________________
ADDRESSNAME OF PETITIONER
PARENT(S)
If minor's parents are deceased, list siblings or adult relatives.
NAME
Telephone Number
Telephone Number
Telephone Number
Telephone Number
Home:
Work:
Cell:
Home:
Work:
Cell:
JV-075 (Rev. 03/18/2013)
Page 2
Guardianship of , Minor
DOCKET NUMBER
2. The petitioner alleges that the best interests of the child will be served by appointment of a guardian(s)
pursuant to G.L. c. 190B, Article V.
3. The minor's parent(s) consent(s) does not consent to the appointment of the proposed guardian(s).
(Attach the parent(s)' notorized consent if either one or both parents consent to the appointment.)
4. The minor's estate does does not exceed $100.00.
5. The minor does does not have any assets, e.g. bank accounts, property, any anticipated income,
e.g. Social Security, interest. (If the minor has assets, identify below.)
6. The minor is is not entitled to benefits, estate, or income paid or payable by or through the U.S.
Veterans Administration.
7. Is the minor eligible for membership in an American Indian tribe/band? Yes No If yes, which
tribe/band?
I declare under the penalties of perjury that the statements set forth in this petition are true and correct to the
best of my knowledge.
Description of Bank Accounts, Property, Social Security
Estimate Value or
Amount of Income
$
$
Total
DATE SIGNATURE OF PETITIONER
DATE SIGNATURE OF PETITIONER
PROPOSED GUARDIAN(S) CONSENT TO APPOINTMENT
I/we agree to serve as guardian/co-guardians of the minor if appointed by the Court and agree to serve by the
terms of the appointment.
NOTARIZATION
DATE SIGNATURE OF PROPOSED CO-GUARDIAN
DATE SIGNATURE OF PROPOSED CO-GUARDIAN
Signed and made oath before me on
that this affidavit is his/her free act and deed.
Signed and made oath before me on
that this affidavit is his/her free act and deed.
Print Name
My Commission Expires
Notary Public
Print Name
My Commission Expires
Notary Public
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Petition For Appointment Of Guardian Of A-minor Jv 075re (Commonwealth of Massachusetts)

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Completed 26 July 2020

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