VN234 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address) ATTORNEY FOR (Name): Telephone Number: PLAINTIFF DEFENDANT FOR COURT USE ONLY SELF-REPRESENTED SUPERIOR COURT OF CALIFORNIA, COUNTY OF VENTURA 4353 E. VINEYARD AVE., OXNARD, CA 93036 IN THE MATTER OF THE GUARDIANSHIP OF: CASE NUMBER: REQUEST FOR EX PARTE HEARING ON PETITION FOR TEMPORARY GUARDIANSHIP; ORDER [Probate Code §2250; Calif. Rules of Court, rules 7.1012, 3.1203 Ventura Cty. Sup. Court Rule 10.01(C)] [Fill out and file this form if you want an ex parte/emergency hearing. The judge will decide whether to allow an ex parte/emergency hearing based upon what you state in this form. If the judge grants your request and you are ordered to give notice verbally, you must give verbal notice of the date, time and location of the ex parte hearing no later than 10:00 a.m. the court day before the hearing, unless the judge excuses that requirement. You must also file a completed proof of notice with the court.] 1. I, ______________________________________________________________ (petitioner’s name) am requesting the court to schedule an ex parte/emergency hearing to appoint a temporary guardian. 2. The proposed ward is currently living with me and has been living with me since _____________________________________ (date). 3. A Ventura County social worker has instructed me to obtain a guardianship immediately or the children will be placed into foster care. The social worker’s name is ____________________________________________________________. 4. The mother has signed the consent form agreeing to this guardianship. 5. Although the mother has not signed the consent form, I believe the mother will agree to this guardianship. 6. The father has signed the consent form agreeing to this guardianship. 7. Although the father has not signed the consent form, I believe the father will agree to this guardianship. Optional Form VN234 (01/11) REQUEST FOR EX PARTE HEARING ON PETITION FOR TEMPORARY GUARDIANSHIP Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com VN234 8. The ex parte hearing is necessary because immediate and substantial harm will come to the proposed ward for the following reasons: (check all that apply) The proposed ward will suffer immediate and substantial harm if appointment of the temporary A. guardian is delayed during the five-day required notice period because (describe in detail all facts to support why delay will cause substantial harm to the minor child(ren)): _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ ____________________________________________________ continued on attachment A B. One or more persons entitled to notice might cause harm to the proposed ward, including abduction because: (describe in detail who might cause harm and why you believe she/he may cause harm to the proposed ward if she/he is given notice of the petition to appoint a temporary guardian)) _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ ______________________________________________________ continued on attachment B C. The proposed ward's custodial parent has died or is incapacitated and the petitioner's is the custodial parent's nominee: (state who is/was the child(ren)’s custodial parent, whether that parent has died or is incapacitated; if incapacitated describe in what way, and identify and attach the document in which the custodial parent nominated the petitioner to be guardian) _______________________________________________________________________________ _______________________________________________________________________________ _____________________________________________________ Optional Form VN234 (01/11) continued on attachment C REQUEST FOR EX PARTE HEARING ON PETITION FOR TEMPORARY GUARDIANSHIP Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com VN234 D. There is a medical emergency that is immediate and substantial and treatment (1) is reasonably unavailable and (2) cannot be deferred for the notice period because of the proposed ward's pain or extreme discomfort or a significant risk of harm: (describe in detail all facts that support this contention) _______________________________________________________________________________ _______________________________________________________________________________ ______________________________________________________ continued on attachment D E. Other (state in detail facts that support any other reason why an ex parte/emergency temporary guardianship hearing should be scheduled): _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _____________________________________________________ 9. continued on attachment E I request the court find good cause to make the following orders regarding notice of the request for temporary guardianship: no notice of any kind be given to: _______________________________________________________________________________ _______________________________________________________________________________ only telephone notice of the ex parte hearing be given to: _______________________________________________________________________________ _______________________________________________________________________________ other orders requested regarding notice: _______________________________________________________________________________ _______________________________________________________________________________ I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Dated: ___________________ at _________________________________________________________ ___________________________________ (Print name) Optional Form VN234 (01/11) ______________________________________________ (Signature) REQUEST FOR EX PARTE HEARING ON PETITION FOR TEMPORARY GUARDIANSHIP Page 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com VN234 ORDER Good cause has not been shown. The request for an ex parte hearing for temporary guardianship is denied. _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Good cause has been shown. The request for an ex parte hearing for temporary guardianship is granted. _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Dated: __________________________ _________________________________________________ Judge Optional Form VN234 (01/11) REQUEST FOR EX PARTE HEARING ON PETITION FOR TEMPORARY GUARDIANSHIP Page 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com