Superior Court of California, County of San Mateo Family Court Services 400 County Center, 6th Floor, Redwood City, CA 94063 Tel: (650) 261-5080 Fax: (650) 261-5142 GUARDIANSHIP INFORMATION SHEET Please limit your answers to the space provided Court #______________ Your name: ______________________________________________________________________ Other names you have used:_________________________________________________________ Birthdate:________________________ Birthplace:________ ________________Age: ___________ Social security number: _________________Driver's license number: _____________________ Home address: ___________________________________________________________________ City_______________________________________ State_______ Zip Code__________________ Mailing address: ___________________________________________________________________ City_______________________________________ State _______Zip Code___________________ Telephone #: home: _________________________ work / message: _________________________ Attorney's Name: _________________________________________________________________ Address:_________________________________________________________________________ City_________________________________________State______Zip Code___________________ Telephone number: _________________________Fax number:_____________________________ Your relation to the minor(s):________________________________________________________ Children involved in this matter: Name: _________________________________dob: ________________ age: _________________ Address:___________________________________________________ school: _______________ Name: ________________________________dob: ________________ age: __________________ Address:___________________________________________________ school: ________________ Name: ________________________________ dob: ________________ age: _________________ Address: ___________________________________________________ school: _______________ Residence: How long in you present address ?_________ Do you rent or own?_________ How many persons live in the house?_____ How many bedrooms? _______Are you planning to move?_____________ List all persons residing in your current residence and their relationship to you: ________________________________________________________________________________ Your employment information: Employer: ____________________________Address: ____________________________________ Date employed: ________________ Days/hours of work: ________________________________ Job title: ____________________________ Monthly income ______________________________ Marital Status: ( circle one ) Single Married Divorced Separated Widowed Living together Name of spouse/domestic partner: _____________________________ length of relationship_______ List names and ages of children of this relationship: ________________________________________ Other marriages Name of spouse/domestic partner:_____________________________________________________ Marriage date:_______________________________ Divorce date:___________________________ Children from those marriages:________________________________________________________ Health Are you presently receiving medical treatment? ( ) No ( ) Yes: briefly describe__________________ ________________________________________________________________________________ FCS-8 ( Rev. 11-10 ) Page 1 of 2 www.sanmateocourt.org American LegalNet, Inc. www.FormsWorkFlow.com SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN MATEO Domestic Violence: Where there is a history of domestic violence and /or a restraining order in effect, the protected person may request separate mediation under Family Code 3181 and/or bring a support person under Family Code 6303. If you have a copy of the current restraining order, please provide a copy to the mediator. Please describe:__________________________________________________________________ _______________________________________________________________________________________ Information pertaining to the child(ren) involved in this case: Who has custody of the children?_____________________________________________________ Who supports the children?__________________________________________________________ Are the children seeing the parent(s) ( )No ( ) Yes, if so, what is the visitation schedule _________ ________________________________________________________________________________ ________________________________________________________________________________ Are there any current charges of child physical abuse, sexual abuse or neglect?_________________ ________________________________________________________________________________ Is there any history or current issue with drugs or alcohol?__________________________________ Are there any problems relating to the safety of the children?________________________________ Has Child Protective Services been involved?____________________________________________ _________________________________________________________________________________ Has a dependency petition (W &I 300) been filed?_________________________________________ Current situation: Please limit your answers to the space provided Briefly describe situation and background: ______________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Please list some reasonable solutions to the situation:______________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ _____________________________________________________