IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT In the Matter of the Protective Proceeding of ) ) ) ) ) ) ) Minor Date of Birth: CASE NO. PETITION FOR APPOINTMENT OF A GUARDIAN FOR A MINOR Petitioner asks the court to appoint a guardian for the minor named above. 1. This is the correct court to hear this matter because: The child has an open CINA matter. Case number (if known) . This is the location where the CINA proceedings are pending. While the CINA proceedings are not in this location, the petitioner resides in this district and: does not know the CINA parties and asks the Alaska Court System to send notice. has filed notice to the CINA parties. Proof of notice is attached to this petition. Proof of consent is attached to this petition. There is no open CINA matter for the child, and this location is where: The person(s) seeking to adopt the child resides or is in the military. The child resides at the time of filing. The agency that has care, custody, or control of the child is located. Petitioner's Full Name Petitioner's Mailing Address (box or street number) (city) 2. Age (state) (ZIP) Petitioner's Daytime Phone Relationship to Minor 3. The minor's mother is If living, mother's name is Mother's Mailing Address living. not living. (box or street number) (city) (state) (ZIP) Mother's Daytime Phone Mother's rights of custody have been terminated by court order. Date of Order Court Location Case Number Attach copy of order if possible. suspended by court order. Date of Order Court Location Case Number Attach copy of order if possible. suspended by the following circumstances (give specific details): [Attach extra page if needed. You can use form TF-941 for this extra page.] Page 1 of 3 PG-610 (2/17)(cs) PETITION FOR APPOINTMENT OF A GUARDIAN FOR A MINOR American LegalNet, Inc. www.FormsWorkFlow.com Probate Rule 15 AS 13.26.132 - .147 4. The minor's father is If living, father's name is Father's Mailing Address living. not living. (box or street number) (city) (state) (ZIP) Father's Daytime Phone Father 's rights of custody have been terminated by court order. Date of Order Court Location Case Number Attach copy of order if possible. suspended by court order. Date of Order Court Location Case Number Attach copy of order if possible. suspended by the following circumstances (give specific details): [Attach extra page if needed. You can use form TF-941 for this extra page.] 5. For the past 60 days, the person who has had principal care and custody of the minor is Mailing Address (box or street number) (city) (state) (ZIP) Daytime Phone Physical Address of Minor (if different) 6. 7. 8. The minor is is not an Indian child as defined by the Indian Child Welfare Act.1 If yes, name of tribe or village (if known) The minor is is not married. The minor's parents are both deceased, and no guardian was named in either parent's will, or neither parent left a will. was appointed as guardian in the will of the mother father, who was the minor's last surviving parent. A copy of the will is attached. However, the guardian has not accepted the appointment. The guardian was given notice of the filing of this petition on: the guardian's appointment was prevented or terminated due to the minor's objection under AS 13.26.126. Has a guardian for the minor been appointed by any court? explain (include court location and case number, if known): No. Yes. If yes, 9. 1 "Indian Child" means any unmarried person who is under age eighteen and is either (a) a member of an Indian tribe or (b) is eligible for membership in an Indian tribe and is the biological child of a member of an Indian tribe." 25 USC �1903(4). Note: "Indian tribe" includes Alaskan Native villages as defined in 43 USC 1602(c). American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 3 PG-610 (2/17)(cs) PETITION FOR APPOINTMENT OF A GUARDIAN FOR A MINOR Probate Rule 15 AS 13.26.132 - .147 10. Are there any other proceedings for the appointment of a guardian pending in any No. Yes. If yes, explain (include court location and case number, if court? known): 11. Are there any other court proceedings involving this minor? explain (include court location and case number, if known): No. Yes. If yes, 12. Petitioner requests that the court appoint the following person as guardian: Petitioner Other Person: Name Phone Mailing Address (box or street number) (city) (state) (ZIP) Age 13. Relationship to Minor I believe the welfare and best interests of the minor will be served by this appointment because Date Signature of Petitioner or Petitioner's Attorney If attorney, print name and bar number: Verification I state on oath or affirm that I have read this petition and that all statements made in it are true to the best of my knowledge and belief. Date Subscribed and sworn to or affirmed before me at on . Date (SEAL) Petitioner's Signature , Alaska Clerk of Court, Notary Public, or other person authorized to administer oaths. My commission expires: American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 3 PG-610 (2/17)(cs) PETITION FOR APPOINTMENT OF A GUARDIAN FOR A MINOR Probate Rule 15 AS 13.26.132 - .147