GC-210(CA) Guardianship Petition--Child Information Attachment Case Number: Guardianship of (all children's names): This child's name: Fill out a separate copy of this form for each child for whom you want the court to appoint a guardian. This form is attached to the Petition, item 2 of form GC-210, or item 8 of form GC-210(P). The Petition asks for the appointment of a guardian of this child's (specify): 1 Tell the court about this child a. Child's full legal name: First Middle Last person estate Date of birth: person and estate Month/Day/Year b. Child's current address: c. (If the Petition to which this form is attached asks for the appointment of a guardian of this child's estate only, skip this item 1c, select item 8 a on page 5, and answer the rest of the items in this form. If the Petition asks for the appointment of a guardian of this child's person or this child's person and estate, complete the steps described here. Ask the child, if he or she is old enough, and the child's parents or any other legal guardian, and any Indian custodian, whether the child is or may be an Indian (Native American) child. You may not rely merely on your own knowledge and belief about the child. If possible, ask these persons before you file your petition, including this form, so you can use the information you receive to answer questions (1) and (2) below. Answer those questions, item 8 on page 5, and the rest of the items in this form.) (For more information about your duties concerning a child who is or may be an Indian child involved in a guardianship of the person under the Indian Child Welfare Act ("ICWA") (25 U.S.C. § 1901 et seq.) and California law, including making the inquiry described above and completing this form, see the Information Sheet on Indian Child Inquiry Attachments and Notice of Child Custody Proceeding For Indian Child (form ICWA-005-INFO).) (1) Is this child a member of, or eligible for membership in, one or more Indian tribes recognized by the federal No Not sure Yes (specify tribe or tribes): government? (If you checked "Yes" to item (1), this guardianship case is subject to ICWA. If you checked "Not sure" or "No" to item (1), answer item (2).) (2) Do you know or have reason to know (within the meaning of Prob. Code, §§ 1460.2(a), Welf. & Inst. Code, § 224.3(b), and Cal. Rules of Court, rule 7.1015), whether this child is or may be an Indian child? No Yes (If you checked "Yes" to either item (1) or (2), you must file and serve a Notice of Child Custody Proceeding for Indian Child (form ICWA-030), in addition to service of any other notices required in this case. For information about what is "reason to know whether the child is or may be an Indian child" and the notice requirement, including who must be served, how to serve them, and how to prove to the court that you have done so, and how to fill out and file the Notice, see the Information Sheet on Indian Child Inquiry Attachments and Notice of Child Custody Proceeding For Indian Child (form ICWA-005-INFO).) d. Is this child married? Yes No Never married If you checked "No," was this child formerly married but the marriage was dissolved or ended in divorce? No Yes (The court cannot appoint a guardian of the person for a minor child who is married or whose marriage was dissolved or ended in divorce.) Judicial Council of California www.courts.ca.gov Revised July 1, 2012, Mandatory Form Probate Code, §§ 1449, 1459.5, 1510; Cal. Rules of Court, rule 7.1015 Guardianship Petition--Child Information Attachment (Probate--Guardianships and Conservatorships) GC-210(CA), Page 1 of 5 American LegalNet, Inc. www.FormsWorkFlow.com Guardianship of (all children's names): This child's name: 1 Tell the court about this child (continued) e. Is this child receiving public assistance? Type of Aid Social Security Dept. Veterans Affairs Benefits Case Number: Yes No Unknown (If you checked "Yes," fill out below.) Type of Aid Other (explain): Other (explain): Monthly Benefit $ $ Monthly Benefit $ $ TANF (Temporary Asst. for Needy Families) $ f. Name and address of the person with legal custody of this child: g. (Check this box and fill out below if the person the child lives with is not the person with legal custody.) Name and address of the person this child lives with (has the care of the child): h. (Check this box if this child has been involved in an adoption, juvenile court, marriage dissolution (divorce), domestic relations, custody, or other similar court case.) Describe the court case below: Type of Case Court District or County and State Case Number (if known) i. (Check this box if this child is in or on leave from an institution supervised by the California Department of Developmental Services or the California Department of Mental Health.) Write the name of the institution here: 2 List the names and addresses of this child's relatives and other persons shown below: Relationship Father Mother Grandfather (Father's father) Grandmother (Father's mother) Grandfather (Mother's father) Grandmother (Mother's mother) Name Home Address (Street, City, State, Zip) Revised July 1, 2012 Guardianship Petition--Child Information Attachment (Probate--Guardianships and Conservatorships) GC-210(CA), Page 2 of 5 Guardianship of (all children's names): This child's name: 2 Names and addresses of this child's relatives and other persons (continued): Relationship Brother/Sister Brother/Sister Brother/Sister Brother/Sister Brother/Sister Brother/Sister Brother/Sister Name Case Number: Home Address (Street, City, State, Zip) (Check here if this child has additional brothers or sisters, including half-brothers and half-sisters, and list their names and addresses on a separate sheet of paper. Write "Form GC-210(CA)," the name of this child, and "Item 2:--Other Siblings" at the top of the paper and attach it to this form.) Spouse (Guardianship of the estate only) Person nominated as guardian of this child (Other than a proposed guardian listed in 3 ) 3 Information about the proposed guardian: a. Name (name all proposed guardians if more than one): b. Relationship(s) to the child named in 1 (check all that apply): Relative (specify relationships of all proposed guardians to the child): Not a relative (explain interest in or connection to this child ): Revised July 1, 2012 Guardianship Petition--Child Information Attachment (Probate--Guardianships and Conservatorships) GC-210(CA), Page 3 of 5 Guardianship of (all children's names): This child's name: