ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): FOR COURT USE ONLY Telephone No.: E-Mail Address (Optional): ATTORNEY FOR (Name): Fax No. (Optional): Bar No: SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE Central Justice Center 700 Civic Center Dr. West Santa Ana, CA 92701-4045 GUARDIANSHIP OF , MINOR DECLARATION OF NON-COMPLIANCE (Guardianship) CASE NUMBER: filed on (date) did not comply with the terms of the Guardianship Settlement Agreement as follows: Therefore, I ________________________________ request that the guardianship matter be set for hearing. 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) Approved for Optional Use L-2664 (New February 2017) _______________________________ (SIGNATURE OF DECLARANT) DECLARATION OF NON-COMPLIANCE (Guardianship) American LegalNet, Inc. www.FormsWorkFlow.com