Form 194 Rev 11/18 1 of 4 The Family Court of the State of Delaware In and For New Castle County Kent County Sussex County MOTION FOR APPOINTMENT OF A GUARDIAN AD LITEM FOR A CHILD LITIGANT Petitioner Respondent Name N ame File Number Address (including apartment) Address (including apartment) Case Number(s) P.O. Box P.O. Box City /State/Zip Code City /State/Zip Code Underlying Petition Type Attorney .Attorney Interpreter needed? Yes No Interpreter needed? Yes No Language: Language: A Proceeding involving having been filed in this Court, Movant (Name of Child Child) requests that the Court a ppoint a Guardian ad Litem for the child litigant and , in support thereof, alleges the following facts in accordance with Family Court Civil Rule 17 (b ) : The PETITIONER RESPONDENT in the above action is a child , being less than 18 years of age at the time of this filing, whose date of birth is . The following persons hold parental or custodial rights or guardianship of the child litigant: Name Holds Parental or custodial rights Guardianship Available to be appointed Has an interest in the case Parental or custodial rights Guardianship Available to be appointed Has an interest in the case Parental or custodial rights Guardianship Available to be appointed Has an interest in the case My relationship to the child is: Custodial Parent Legal Guardian Noncustodial Parent Grandparent Adult Sibling Other: I do not have an interest in the case that is inconsistent with the child222s interest. I wish to be appointed Guardian ad Litem. There is no disinterested custodial parent or legal guardian. Therefore, I request that of Name and date of birth of Person to be appointed Guardian ad Litem Address of Person to be appointed Guardian ad Litem b e appointed Guardian ad Litem. The proposed G uardian ad Litem does not have an interest in this case. The relationship of the proposed Guardian ad Litem to the child is noncustodial parent; grandparent; great - grandparent; adult sibling of th e child ; Other: List Relationship of proposed Guardian ad Litem to the child . I have no appropriate adult to act as Guardian ad Litem on the child 222s behalf and request the Court consider waiving the requirement or appointing an attorney to r epresent the child. American LegalNet, Inc. www.FormsWorkFlow.com Form 194 Rev 11/18 2 of 4 VERIFICATION STATE OF DELAWARE ) ) ss.: COUNTY OF ) , being duly sworn, says: I am the Movant in this action. I have read the above Motion and know to the best of my knowledge t hat the facts contained therein are true. Petitioner Print Name Subscribed and sworn before me this date, Date Clerk of Court / Notary Public Print Name AFFIDAVIT OF MAILING I, the Movant, affirm that a true and correct copy of this Motion was placed in the U.S. Mail , first class postage pre - paid, on the day of , and sent to (check all applicable b oxes) All persons or entities holding parental or custodial rights or guardianship; The child , if age 14 or older, but otherwise, upon the adult with whom the child resides; The proposed Guardia n ad Litem; and All ot her parties or attorneys . List the name and address of all persons to whom you have sent a copy of the Motion: (Name and Address) I do not know the whereabouts of and was unable to mail a copy of the Motion to him/her/them. Movant Print Name Sworn to subscribe d before me this day of , Clerk of Court/Notary Public Print Name American LegalNet, Inc. www.FormsWorkFlow.com Form 192 Rev 11/18 3 of 4 The Family Court of the State of Delaware In and For New Castle Kent Sussex County , ) ) ) ) ) ) ) ) ) Petitioner File No.: v. , Petition No.: Respondent NOTICE OF MOTION TO: PLEASE TAKE NOTICE that the attached Motion is herewith presented to the Court for consideration. If you are opposed to this motion, you must file a written response with the Court within ten (10) days of the service of this motion. If no response is timely filed, the motion may be decided without further opportunity for you to be heard on the matter. Family Court Rules, Rule 7(b)(2). Date Movant/Attorney Print Name Name and address of Movant/Attorney Street Address P.O. Box Number City/State/Zip Code American LegalNet, Inc. www.FormsWorkFlow.com Form 194O Rev 11/18 4 of 4 The Family Court of the State of Delaware In and For New Castle Kent Sussex County ) , ) Petitioner ) File No.: v. ) ) Petition No.: , ) Respondent ) In Re: ) ) ORDER REGARDING MOTION TO APPOINT GUARDIAN AD LITEM Having considered the request of the movant, , IT IS SO OR DERED, this date: that be named Guardian Ad Litem for the child litigant, for the pendency of this petition. The appointment of Guardian Ad Litem is wa i ved and Judge/Commissioner CC: Petitioner Respondent Petitioner Attorney Respondent Attorney DAG PD Other : DCSS FC.Appointed.Attorneys@state.de.us American LegalNet, Inc. www.FormsWorkFlow.com