Docket No.
Probate and Family Court Department
The Trial Court
Commonwealth of Massachusetts
CJ-P 123 (4/08)
C.G.F
PETITION FOR APPROVAL OF ENTERTAINMENT
CONTRACT FOR A MINOR AND APPOINTMENT
OF A LIMITED GUARDIAN
Division
To the justices of the Probate and Family Court:
RESPECTFULLY represents
1.
(City/Town)
(Zip)
(State)
(Name of Petitioner(s) Please Print)
seeking the Court's approval of an entertainment contract between
(Zip)
(State)
(City/Town)
(Name of Child Please Print)
2.
Date of Birth:
Age:
AND
(Zip)
(State)
(City/Town)
(Name of Contracting Entity Please Print)
3.
If contracting entity is not located in Massachusetts, identity of its agent:
(Zip)
(State)
(City/Town)
(Name Please Print)
4.
The
Division is:
child's residence.
where child is employed/performs (even if he/she is not a resident of Massachusetts).
county of employer's principal place of business if child's residence and performance take place outside of
Massachusetts.
Page 1 of 4
(Title)
Legal Guardian(s)
Parent(s)
Docket No.
Probate and Family Court Department
The Trial Court
Commonwealth of Massachusetts
CJ-P 123 (4/08)
C.G.F
PETITION FOR APPROVAL OF ENTERTAINMENT
CONTRACT FOR A MINOR AND APPOINTMENT
OF A LIMITED GUARDIAN
Division
5.
Brief statement as to terms of child's employment and compensation under the contract:
6.
Location of child's performance(s):
7.
In accordance with G.L. c. 76 § 1, if the child is expected to miss more than fourteen (14) days of school in a six-month
period, tutoring services have been arranged, the cost of which is to be borne by the contracting entity.
Not applicable
(Zip)
(State)
(City/Town)
(Name of Tutor Please Print)
8.
Petitioner(s) assert(s) that the term of this contract shall be limited to:
3 years inclusive of any extensions by options or otherwise.
5 years (television ONLY) inclusive of any extensions by options or otherwise.
9.
Petitioner(s) assert(s) that she/he/they is/are qualified to be appointed limited guardian to oversee the child's funds.
Petitioner(s) offer(s) to serve in that capacity upon the filing of a bond, with or without sureties as required by the Court.
10.
EARNINGS
Fees/Funds Pursuant to G.L. c. 231 § 85P ½
A.
(1.)
Total gross earnings received from any prior contract pursuant to G.L. c. 231 § 85P ½:
$
(2.)
Total funds (child's earnings) deposited to date from any prior contract pursuant to G.L. c. 231 § 85P ½:
$
Current balance in bank/trust account:
(3.)
$
$
Total gross earnings received/to be received from this contract:
(4.)
Percentage of earnings from this contract which shall be deposited for the child until his/her eighteenth birthday:
(5.)
Page 2 of 4
%.
If this is less than 100%, list anticipated expenses:
Docket No.
Probate and Family Court Department
The Trial Court
Commonwealth of Massachusetts
CJ-P 123 (4/08)
C.G.F
PETITION FOR APPROVAL OF ENTERTAINMENT
CONTRACT FOR A MINOR AND APPOINTMENT
OF A LIMITED GUARDIAN
Division
Page 3 of 4
Custodian Information
B.
Please state the interest of petitioner(s) in the contract or in the child's performance under this contract:
(1.)
Please list those who are entitled to child's earnings:
(2.)
Child
Department of Revenue
Other
(if "other" is checked, please explain)
Please indicate the individual or entity who will serve as child's financial advisor and administer the bank/trust
account:
(3.)
(Zip)
(State)
(City/Town)
(Street address)
(Name Please Print)
A bank/trust account used expressly for the deposit of earnings generated under the contract has been
established at:
(4.)
(Name of bank or other financial institution Please Print)
(Zip)
(State)
(City/Town)
(Street address)
in the name of:
If this is a trust account, the trustee is:
(Zip)
(State)
(City/Town)
(Street address)
(Name of trustee Please Print)
whose relationship to the child is:
Please include a specific plan for the protection of earnings:
(5.)
Docket No.
Probate and Family Court Department
The Trial Court
Commonwealth of Massachusetts
CJ-P 123 (4/08)
C.G.F
PETITION FOR APPROVAL OF ENTERTAINMENT
CONTRACT FOR A MINOR AND APPOINTMENT
OF A LIMITED GUARDIAN
Division
CONSENT
11.
Page 4 of 4
I/We have taken the opportunity to read and understand the attached contract and hereby consent to (a) the terms of the
contract, and (b) to setting aside all or a portion of the child's earnings generated under the contract as set forth above,
certifying under the penalties of perjury that the child's earnings shall be distributed to him/her at age eighteen. I/We
understand that if appointed limited guardian(s), I/we have an obligation to file an account annually with the Court in
accordance with G.L. c. 206, § 1.
WHEREFORE your petitioner(s) request(s) that this honorable Court approve the attached contract in accordance with
G.L. c. 231 § 85P ½ and, appoint a limited guardian to oversee the child's funds.
(Signature)
(Print name and relationship to child)
(Signature)
(Print name and relationship to child)
Date
If minor is over the age of fourteen:
Then personally appeared the above-named minor, being over the age of fourteen years, who nominates:
(Name Please Print)
to be his/her limited guardian.
Before me,
NOTARY PUBLIC
(Print name)
My commission expires
INSTRUCTIONS:
1. Please attach a CERTIFIED copy of the child's birth certificate to this petition.
2. Please attach a copy of the proposed contract to this petition.
I/We certify under the penalties of perjury that the information in this petition is true and complete.