CIV-010 ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT: APPLICATION AND ORDER FOR APPOINTMENT OF GUARDIAN AD LITEM--CIVIL EX PARTE CASE NUMBER: NOTE: This form is for use in civil proceedings in which a party is a minor, an incapacitated person, or a person for whom a conservator has been appointed. A party who seeks the appointment of a guardian ad litem in a family law or juvenile proceeding should use form FL-935. A party who seeks the appointment of a guardian ad litem in a probate proceeding should use form DE-350/GC-100. An individual cannot act as a guardian ad litem unless he or she is represented by an attorney or is an attorney. 1. Applicant (name): is a. the parent of (name): b. the guardian of (name): c. the conservator of (name): d. a party to the suit. e. the minor to be represented (if the minor is 14 years of age or older). another interested person (specify capacity): f. 2. This application seeks the appointment of the following person as guardian ad litem (state name, address, and telephone number): 3. The guardian ad litem is to represent the interests of the following person (state name, address, and telephone number): 4. The person to be represented is: a. a minor (date of birth): b. an incompetent person. c. a person for whom a conservator has been appointed. 5. The court should appoint a guardian ad litem because: a. the person named in item 3 has a cause or causes of action on which suit should be brought (describe): Continued on Attachment 5a. Page 1 of 2 Form Adopted for Mandatory Use Judicial Council of California CIV-010 [Rev. January 1, 2008] APPLICATION AND ORDER FOR APPOINTMENT OF GUARDIAN AD LITEM--CIVIL Code of Civil Procedure, § 372 et seq. American LegalNet, Inc. www.FormsWorkflow.com CIV-010 PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT: CASE NUMBER: 5. b. more than 10 days have elapsed since the summons in the above-entitled matter was served on the person named in item 3, and no application for the appointment of a guardian ad litem has been made by the person identified in item 3 or any other person. the person named in item 3 has no guardian or conservator of his or her estate. the appointment of a guardian ad litem is necessary for the following reasons (specify): c. d. Continued on Attachment 5d. 6. The proposed guardian ad litem's relationship to the person he or she will be representing is: a. related (state relationship): b. not related (specify capacity): 7. The proposed guardian ad litem is fully competent and qualified to understand and protect the rights of the person he or she will represent and has no interests adverse to the interests of that person. (If there are any issues of competency or qualification or any possible adverse interests, describe and explain why the proposed guardian should nevertheless be appointed): Continued on Attachment 7. (TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY) I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF APPLICANT) CONSENT TO ACT AS GUARDIAN AD LITEM I consent to the appointment as guardian ad litem under the above petition. Date: (TYPE OR PRINT NAME) (SIGNATURE OF PROPOSED GUARDIAN AD LITEM) ORDER EX PARTE THE COURT FINDS that it is reasonable and necessary to appoint a guardian ad litem for the person named in item 3 of the application, as requested. THE COURT ORDERS that (name): is hereby appointed as the guardian ad litem for (name): for the reasons set forth in item 5 of the application. Date: JUDICIAL OFFICER SIGNATURE FOLLOWS LAST ATTACHMENT CIV-010 [Rev. January 1, 2008] APPLICATION AND ORDER FOR APPOINTMENT OF GUARDIAN AD LITEM--CIVIL Page 2 of 2