REQUEST FOR VISITATION (GUARDIANSHIP) NOTICE OF HEARING 1. TO: (names) Guardian(s) Mother Father Child Other (specify): 2. A COURT HEARING WILL BE HELD AS FOLLOWS: The parties are required to attend custody mediation services as follows (mediation may be held at a different court, please verify the location of mediation for your case): Date: Time: Dept.: REQUEST FOR VISITATION 3. I, , am the Mother Father Guardian Grandparent Other: of the child. 4. I request that the court make an Order for Visitation or Change an Order for Visitation between the following child(ren) and who is Mother Father Guardian Grandparent Other relative Friend to the child(ren). Write your name, address and telephone number below TELEPHONE NO.: FAX NO. (Optional): E-MAIL ADDRESS (Optional): Self-Represented or Attorney for (name): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA COUNTY OF VENTURA 4353 E. VINEYARD AVENUE OXNARD, CA 93036 JUVENILE/PROBATE COURTHOUSE IN THE GUARDIANSHIP OF: (Name(s)): CASE NUMBER: REQUEST FOR VISITATION (GUARDIANSHIP) Visitation Order Change Visitation Order HEARING DATE AND TIME: DEPT: Date: Time: Courtroom: Address of court: same as noted above other (specify): VN171 Optional Form VN171 (Rev. 01/19) Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com CASE NAME: CASE NUMBER: REQUEST FOR VISITATION (GUARDIANSHIP) 5. I would like to have the following visitation schedule (indicate the visitation schedule you want below): 6. I believe that visitation between the above person and the child(ren) is in the best interests of the child(ren) because (if you have an existing order for visitation, indicate what has changed since the last court order): Continued in Attachment 6 7. The above person222s previous contact with the child(ren) is as follows: 8. The reason no agreement has been reached regarding visitation with the child(ren) is as follows: Continued in Attachment 8 Optional Form VN171 (Rev. 01/19) Page 2 of 3 VN171 American LegalNet, Inc. www.FormsWorkFlow.com CASE NAME: CASE NUMBER: REQUEST FOR VISITATION (GUARDIANSHIP) I declare under penalty of perjury of the laws of the State of California that the foregoing is true and correct. Dated: (Type or Print Your Name) (Signature) Optional Form VN171 (Rev. 01/19) Page 3 of 3 VN171 American LegalNet, Inc. www.FormsWorkFlow.com