MARIN COUNTY SUPERIOR COURT Court Investigator's Office PROPOSED GUARDIAN INFORMATION FORM Important Information Regarding Your Filing - Please Read Everyone requesting a guardianship must do the following: 1) Complete and sign the following forms: a. b. c. d. e. f. 2) Petition for Appointment of Guardian of the Person (Form GC-210(P)) or Petition for Appointment of Guardian of Minor (Form GC-210); Guardianship Petition ­ Child Information Attachment (Form GC-210(CA); Declaration Under Uniform Child Custody, Jurisdiction and Enforcement Act (UCCJEA)(Form FL-105/GC-120); Confidential Guardian Screening Form (Form GC-212); Notice of Hearing - Guardianship or Conservatorship (Form GC-020); The attached questionnaire. After you have completed and signed the above forms, make two copies of each of the forms listed in a. through e. above and file them with the Marin Superior Court Clerk's Office at 3501 Civic Center Drive, Room 113, San Rafael, CA 94903. You should make a copy of the attached questionnaire for your records, but you only need to bring the original to the Court Clerk's Office. There are additional forms you will need to complete and bring to court before your hearing. They include: a. b. c. Order Appointing Guardian of Minor (Form GC-240); Letters of Guardianship (Form GC-250); Duties of Guardian (Form GC-248) 3) 4) The Court Clerk will set a court date and forward all of your paperwork to the agency that will conduct the investigation and prepare the report for the court. If you are related to the child the investigation is conducted by the Court Investigator and if you are not related to the child, the investigation is conducted by Marin County Children and Family Services. They are located at: Marin County Superior Court Court Investigator's Office 3501 Civic Center Drive, Room 116 San Rafael, CA 94903 (415) 444-7090 (415) 444-7091, Fax Marin County Children & Family Services Adoptions, Foster Care Licensing & Guardianship Unit 3250 Kerner Blvd. San Rafael, CA 94903 (415) 473-2200 PR007 (Rev. 6/25/15) PROPOSED GUARDIAN INFORMATION FORM Page 1 of 12 American LegalNet, Inc. www.FormsWorkFlow.com PROPOSED GUARDIAN INFORMATION FORM INSTRUCTIONS Please read these instructions carefully. If there is to be more than one guardian, each guardian must complete a separate copy of the questionnaire. All proposed guardians are required to complete this questionnaire. The information you provide will be used to prepare the report to the judge on your suitability as a guardian. This form is also available on the court's website at: www.marincourt.org. Each guardian is expected to answer all questions honestly. On the last page you are required to sign the form and declare, under penalty of perjury, that all the information you have provided is true and correct. When completing this form please keep in mind that the term "proposed guardian" refers to the person who wants to become the guardian. The term "proposed ward" or "ward" refers to the child you are asking to become the guardian for. The term "petitioner" refers to the person who signed the petition asking the court to appoint a guardian. If you are asking to be appointed solely as guardian of the estate, a telephone interview will be conducted by the court investigator. You only need to fill out Section I and V only. The cost of the investigation is $150.00. If you are asking to be appointed as guardian of the person (or person and estate), a home visit is required. Everyone who lives in the home must be present during the home visit. After this form is received, a court investigator or social worker will contact you to make an appointment. If the form is not received promptly, your court hearing may be delayed. There is a fee for the Court Investigation. It is currently $625.00 and can be paid from the estate of the ward, if there is one, or by the proposed guardian or the parents. The fee may be waived under certain circumstances based on financial inability to pay. To obtain this waiver, you must file an Application for Waiver of Court Fees and Costs (also known as an IFP waiver) through the Clerk's Office. In some cases you may make arrangements for monthly payments through Marin Court Accounting Department, (415) 444-7020. Please keep in mind: 1. ALL QUESTIONS MUST BE ANSWERED. 2. IF YOU NEED ASSISTANCE IN FILLING OUT THE FORMS OR HAVE QUESTIONS ABOUT THE LEGAL REQUIREMENTS, PLEASE VISIT THE COURT'S LEGAL SELF-HELP SERVICES WEBPAGE AT: http://www.marincourt.org/legal_self_help_services.htm PR007 (Rev. 6/25/15) PROPOSED GUARDIAN INFORMATION FORM Page 2 of 12 American LegalNet, Inc. www.FormsWorkFlow.com YOU MUST ANSWER ALL QUESTIONS. (Write in "n/a" if a question does not apply to your situation.) CASE NO. HEARING DATE: CHILD(REN) NEEDING GUARDIAN ("proposed ward"): Name Name Name Date of Birth Date of Birth Date of Birth More children listed on back NAME(S) OF PROPOSED GUARDIAN(S): Name Name How are you related to the proposed ward?: Will you or anyone else in the home require an interpreter? Yes No Language: SECTION I SOCIAL HISTORY OF PROPOSED GUARDIAN (Probate Code § 1513(a)(1)): This information is about the person who wants to be guardian. Please provide the information for each proposed guardian. Attach additional pages if necessary. Name Address Home No. Date of Birth Work No. Place of Birth City Cell No. State Zip Code Marital Status: Married Widowed Single Separated Divorced Domestic Partnership If married or separated, what is the name of your spouse? Were you previously married or living with someone in a long-term, live-in relationship? Yes No If yes, provide name(s) and date(s) of event (divorce, separation or death) that ended the relationship: Name Name Name Date of Event Date of Event Date of Event PR007 (Rev. 6/25/15) PROPOSED GUARDIAN INFORMATION FORM Page 3 of 12 American LegalNet, Inc. www.FormsWorkFlow.com Provide the names of your children (even if they are adults and not living with you): Name Name Name Name D.O.B. D.O.B. D.O.B. D.O.B. Address Address Address Address Arrested? Yes Yes Yes Yes No No No No Arrested? Arrested? Arrested? More children listed on back YOUR HEALTH CONDITION: Please describe any current physical or mental health problems. Are you being treated by a doctor or other health care practitioner? If yes, why? Please list any medications you are currently taking and what they are for: Name of Medication Name of Medication Name of Medication Reason Reason Reason Yes No Have yo