Petition /Appointment of Guardian of Person Where Parents/Legal Guardians Are Deceased PC - 508 REV. 10/18 CONNECTICUT PROBATE COURTS CONFIDENTIAL Address where minor resides Address where minor is domiciled (If different) Address where minor is located at time of filing petition (If different) RECEIVED: Instructions : Any adult person may use this form to petition the court to appoint a guardian of the person of aminor has no parent with guardianship rights or court-appointed guardian pursuant to C.G.S.section 45a-616 (a). Type or print the form in ink. Use Second Sheet, PC-180, or an additional sheet, if more space is Probate Court Name District Number In the Matter of Hereinafter referred to as the minor Date of Birth of Minor Petitioner (Name, address and telephone number and relationship to minor, if any) Mother/Parent Deceased on Removed as guardian on Parental rights terminated on ( Provide death certificate or court decree.) Father/Parent ( N ame and, if removed as guardian, address) Deceased on Removed as guardian on Parental rights terminated on ( Provide death certificate or court decree.) Court - appointed Guardian(s) ( N ame and date of court appointment) Deceased on Removed as Guardian on ( American LegalNet, Inc. www.FormsWorkFlow.com Petition /Appointment of Guardian of Person Where Parents/Legal Guardians Are Deceased PC - 508 REV. 10/18 CONNECTICUT PROBATE COURTS CONFIDENTIAL Petition/Appointment of Guardian Where Parents/Legal Guardians Are Deceased PC-508 Page 2 of 2 THE PETITIONER REPRESENTS that: The minor resides, is domiciled or is located within the probate district. The minor has no parent with guardianship rights or court-appointed guardian of the person. To the best of the petitioner222s knowledge and belief, no deceased parent with guardianship rights has designated a guardian of the person of the minor in a will or any nontestamentary document in accordance with C.G.S. section 45a-596. There is no proceeding pending or contemplated in Connecticut or any other state affecting the custody of the minor. There is a proceeding pending, or there has been a past proceeding in Connecticut or another state affecting the custody of the minor. (If checked, complete and attach form JD-FM-164, Affidavit Concerning Children.) Each proposed guardian listed above has the ability to meet, on a continuing day to day basis, the physical, emotional, moral and educational needs of the minor and has established a relationship with the minor as indicated below. (Identify the name of the proposed guardian and provide a description of the relationship with minor.) The appointment of the proposed guardian(s) of the person of the minor is/are in the best interests of the minor. THEREFORE, the petitioner requests that: The court appoint the proposed guardian(s) listed above as guardian(s) of the person of the minor. The representations made in this petition are made under penalty of false statement. Signature of the Petitioner Date If appointed, I/we will accept the position of trust as guardian(s). Proposed Guardian(s) ( N ame, address and telephone number and relationship to minor, if any) Other persons to whom notice should be given (Names, addresses and relationship to the minor) Signature Signature Type or Print Name Type or Print Name Date of Birth Date of Birth American LegalNet, Inc. www.FormsWorkFlow.com Confidential Information/Petition/ Appointment of Guardian Where Parents/Legal Guardians Are Deceased PC - 508CI C ONFIDENTIAL INFORMATION/ CONNECTICUT PROBATE COURTS Petition/Appointment of Guardian Where Parents/Legal Guardians Are Deceased PC - 508C I REV. 10/1 7 FOR COURT USE ONLY Probate Court Name District Number In the Matter of ,a minor child. The social security numbers of the following persons are required in connection with this proceeding. 1)Mother/ Name: Maiden Name: (If applicable) Social Security Number: 2)Father/ Name: Social Security Number: 3)Proposed Guardian(s): a. Name: Maiden Name (If applicable) Social Security Number: b. Name: Maiden Name (If applicable) Social Security Number: American LegalNet, Inc. www.FormsWorkFlow.com