VN042 CONFIDENTIAL SUPERIOR COURT COUNTY OF VENTURA STATE OF CALIFORNIA GUARDIANSHIP QUESTIONNAIRE (Probate Code Section 1513) CONFIDENTIAL This information is Confidential and is for the purpose of determining Guardianship only. THIS FORM MUST BE COMPLETED AND RETURNED WITH THE PETITION MINOR'S NAME __________________________________________________ CASE NUMBER _________________ RELATIVE NON-RELATIVE SECTION 1 ­ SOCIAL HISTORY PROPOSED GUARDIAN'S FULL NAME ____________________________________________________________ FORMER/OTHER NAME(S) USED __________________________________________________________________ ADDRESS _______________________________________________________________________________________ OWN RENT OTHER HOW LONG AT PRESENT ADDRESS _______________________________ PREVIOUS ADRESSES FOR PAST 3 YEARS _________________________________________________________ ________________________________________________________________________________________________ TELEPHONE # ( ) _________________________________________ AGE ____________ DATE OF BIRTH _______________ PLACE OF BIRTH ________________________________ DRIVER'S LICENSE # ________________________________ STATE LICENSE ISSUED ______________________ LAST GRADE COMPLETED & SPECIAL TRAINING ___________________________________________________ _________________________________________________________________________________________________ HAVE YOU EVER BEEN ARRESTED FOR AN OFFENSE OTHER THAN A MINOR TRAFFIC VIOLATION? YES NO IF YES, PLEASE GIVE DATE, PLACE AND DETAILS __________________________________________________ _________________________________________________________________________________________________ DESCRIBE ANY MEDICAL PROBLEMS _____________________________________________________________ _________________________________________________________________________________________________ SPOUSE'S FULL NAME ___________________________________________________________________________ FORMER/OTHER NAMES(S) USED _________________________________________________________________ AGE ____________ DATE OF BIRTH _______________ PLACE OF BIRTH ________________________________ DRIVER'S LICENSE # ________________________________ STATE LICENSE ISSUED ______________________ Mandatory Form VN042 Rev. 07/09 GUARDIANSHIP QUESTIONNAIRE CONFIDENTIAL Page 1 of 5 American LegalNet, Inc. www.FormsWorkFlow.com Minors Name: Case Number: EDUCATION, LAST GRADE COMPLETED & SPECIAL TRAINING _______________________________________ __________________________________________________________________________________________________ HAS SPOUSE EVER BEEN ARRESTED FOR AN OFFENSE OTHER THAN A MINOR TRAFFIC VIOLATION? YES NO IF YES, PLEASE GIVE DATE, PLACE AND DETAILS __________________________________________________ _________________________________________________________________________________________________ DESCRIBE ANY MEDICAL PROBLEMS _____________________________________________________________ _________________________________________________________________________________________________ SECTION II ­ MARRIAGES PROPOSED GUARDIAN NEVER MARRIED MARRIED DIVORCED SEPARATED WIDOWED DATE AND PLACE OF PRESENT MARRIAGE _________________________________________________________ NAMES AND AGES OF CHILDREN __________________________________________________________________ PREVIOUS MARRIAGE(S) (List all prior marriages. Use additional paper if necessary.) NAME OF FORMER SPOUSE ________________________________________________________________________ DATE AND PLACE OF MARRIAGE __________________________________________________________________ DATE AND PLACE OF DIVORCE/DEATH ____________________________________________________________ NAMES AND AGES OF CHILDREN FROM FORMER MARRIAGE ________________________________________ ____________________________________________________________________________________________________________ SPOUSE'S PREVIOUS MARRIAGE(S) (List all prior marriages. Use additional paper if necessary.) NAME OF FORMER SPOUSE ________________________________________________________________________ DATE AND PLACE OF MARRIAGE __________________________________________________________________ DATE AND PLACE OF DIVORCE/DEATH ____________________________________________________________ NAMES AND AGES OF CHILDREN FROM FORMER MARRIAGE ________________________________________ ____________________________________________________________________________________________________________ SECTION III- EMPLOYMENT PROPOSED GUARDIAN ­ NAME AND ADDRESS OF EMPLOYER ______________________________________ __________________________________________________________________________________________________ TELEPHONE # ( ) ___________________________________LENGTH OF SERVICE ______________________ POSITION _____________________________________________SUPERVISOR ______________________________ DAYS AND HOURS OF WORK ___________________________ INCOME __________________________________ Mandatory Form VN042 Rev. 07/09 GUARDIANSHIP QUESTIONNAIRE CONFIDENTIAL Page 2 of 5 American LegalNet, Inc. www.FormsWorkFlow.com Minors Name: Case Number: OTHER SOURCE OF INCOME _________________________________________ AMOUNT ____________________ SPOUSE ­ NAME AND ADDRESS OF EMPLOYER _____________________________________________________ __________________________________________________________________________________________________ TELEPHONE # ( ) _________________________________ LENGTH OF SERVICE ______________________ POSITION _____________________________________________SUPERVISOR ______________________________ DAYS AND HOURS OF WORK ___________________________ INCOME __________________________________ SECTION IV - OTHER MEMBERS OF HOUSEHOLD NAME DATE OF BIRTH RELATIONSHIP SCHOOL/OCCUPATION ________________________________ ________________________________ ________________________________ ________________________________ ______________ ______________ ______________ ______________ __________________ ___________________________ __________________ ___________________________ __________________ ___________________________ __________________ ___________________________ SECTION V - CHILD(REN) BEING PLACED UNDER GUARDIANSHIP NAME ________________________________________________ AGE ___________ DOB ______________________ RELATIONSHIP _______________________ HOW AND WHEN DID PROPOSED GUARDIAN GET PHYSICAL CUSTODY OF CHILD? ______________________________________________________________