JD-1799, 05/14 Statement of Guardian ad Litem (Chapters 48 and 938) 24724748.235(3), and 938.235(3), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 1 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE INTEREST OF Name Date of Birth Statement of Guardian ad Litem (Chapters 48 and 938) Case No. I am the court appointed guardian ad litem for the above named child/juvenile and state to the court that I have completed the following duties: 1. MET WITH THE CHILD/JUVENILE I personally, or through a trained designee [Name] , met with the child/juvenile. The date last met with the child/juvenile was [Date] . I was granted leave by the court not to meet with the child/juvenile. I am requesting leave by the court not to meet with the child/juvenile for the following reason(s): 2. ASSESSED CHIL/JUVENILE I personally, or through a trained designee [Name] , assessed the appropriateness and safety of the child/juvenile I was granted leave by the court not to assess the appropriateness and safety of the child/juvenileenvironment. I am requesting leave by the court not to assess the child/juvenile for the following reason(s): 3. INTERVIEWED THE CHILD/JUVENILE The child/juvenile is not old enough to communicate. I personally, or through a trained designee [Name] , interviewed the child/juvenile to determine the child/juvenile I was granted leave by the court not to interview the child/juvenile. I am requesting leave by the court not to interview the child/juvenile for the following reason(s): 4. /JUVENILE The best interests of the child/juvenile are are not substantially inconsistent with the wishes of the child/juvenile. 5. Additional comments: DISTRIBUTION: 1. Court 2. Guardian ad Litem/Attorney 3. Parties Guardian ad Litem Name Printed or Typed Date American LegalNet, Inc. www.FormsWorkFlow.com