PR-E-LP-026 Page 1 of 3 PR-E-LP-026 (Revised 09/27/2017) REQUEST FOR COURT ORDERED VISITATION www.saccourt.ca.gov Mandatory ATTORNEY, OR PARTY IF NO ATTORNEY: State Bar No.: Name: Address: City/State/Zip: TELEPHONE NO.: ATTORNEY FOR: (Name) SUPERIOR COURT OF CALIFORNIA, COUNTY OF SACRAMENTO STREET ADDRESS: 3341 POWER INN ROAD MAILING ADDRESS: Same CITY & ZIP CODE: Sacramento, California 95826 GUARDIANSHIP OF THE PERSON ESTATE OF: (Name) , a Minor(s) Hearing Date: Time: Dept. REQUEST FOR COURT ORDERED VISITATION Probate Case Number: Child222s Name Address Telephone No. Date of Birth 1. 2. 3. 2. Date of last Mediation (if applicable): 3. Petitioner is the minor222s parent Other (indicate relationship): 4. I request the following: Adopt agreement reached in Family Court Services on (date): . Adopt modified agreement reached in Family Court Services on (date): . Modify existing order issued on (date): . Make a referral to Family Court Services for Child Custody Recommending Counseling. 1. Petitioner (name): Address: Telephone No.: Relationship to Minor: Requests a visitation order in regards to the following minor(s): American LegalNet, Inc. www.FormsWorkFlow.com PR-E-LP-026 Page 2 of 3 PR-E-LP-026 (Revised 09/27/2017) REQUEST FOR COURT ORDERED VISITATION www.saccourt.ca.gov Mandatory GUARDIANSHIP OF: Case Number: 5. The facts in support of the requested visitation are as follows: 6. Demographic information: Mother222s Information Name: DOB: Street Address: City/State/Zip: Phone Number: Attorney Name: Street Address: City/State/Zip: Phone Number: Father222s Information Name: DOB: Street Address: City/State/Zip : Phone Number: Attorney Name: Street Address: City/State/Zip: Phone Number: Legal Guardian(s) Information Name: DOB: Street Address: City/State/Zip: Phone Number: Attorney Name: Street Address: City/State/Zip: Phone Number: Legal Guardian(s) Information Name: DOB: Street Address: City/State/Zip: Phone Number: Attorney Name: Street Address: City/State/Zip: Phone Number: American LegalNet, Inc. www.FormsWorkFlow.com PR-E-LP-026 Page 3 of 3 PR-E-LP-026 (Revised 09/27/2017) REQUEST FOR COURT ORDERED VISITATION www.saccourt.ca.gov Mandatory I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Signature of Attorney Date: Signature of Petitioner Type or print name Date: Signature of Petitioner Type or print name American LegalNet, Inc. www.FormsWorkFlow.com