Fillable Report Of The Guardian Of The Minor Jv 078re (Commonwealth of Massachusetts)

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Report Of The Guardian Of The Minor Jv 078re (Commonwealth of Massachusetts)

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JV-078 (Rev. 03/20/2013) Page 1 of 2
REPORT OF THE GUARDIAN
OF THE MINOR
DOCKET NUMBER
(if known)
Trial Court of Massachusetts
Juvenile Court Department
Guardianship of
CASE NAME DIVISION
ANNUAL REPORT
REPORTING PERIOD:
1. Guardian's Name Telephone Number
Address
Guardian's Name Telephone Number
Address
2. Minor's Name Telephone Number
Mailing Address
Residence Address
Name of Institution (if minor is institutionalized)
3. Has the minor been involved in any court case/proceeding since the last report or since your appointment
as the minor's guardian? Yes No
If yes, please explain
4. Physical health of minor
Significant changes since last report
5. Hospitalization(s) since last report
Surgical procedure(s) since last report
Medication(s) since last report
6. Mental health of minor
Psychiatric treatment(s) since last report
7. Has there been any change of living conditions of the minor since the last report?
Yes No If yes, please explain.
Page 2 of 2JV-078 (Rev. 03/20/2013)
REPORT OF THE GUARDIAN
OF THE MINOR
Guardianship of Minor
CASE NAME
DOCKET NUMBER
(if known)
READ AND NOTED
DATE SIGNATURE OF JUSTICE
8. Has there been any change in the financial status of the minor since the last report?
Yes No Please identify the minor's assets below?
9. Name of present school attended by the minor
Grade Are there any special educational issues that have arisen since the last report? If so,
please explain.
10. Please provide any other information related to the well-being, behaviors, and care of the minor that may
assist the Court to better assess the general welfare of the minor.
11. Have you ever been investigated for abuse or neglect? Yes No
If yes, please explain.
12. Has there been any visitation between the minor and his/her parent(s) and/or sibling(s)? If yes, please
explain.
DATE
DATE SIGNATURE OF CO-GUARDIAN
SIGNATURE OF GUARDIAN
Signed under the pains and penalties of perjury.
Description of Bank Accounts, Property, Social Security
Estimate Value or
Amount of Income
Total
$
$
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Completed 26 July 2020

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