Form 126 Rev. 02/16 The Family Court of the State of Delaware In and For New Castle Kent Sussex County PETITION FOR GUARDIANSHIP OF A MINOR Petitioner Name D.O.B. Street Address P.O. Box Number City/State/Zip Code Phone Number Attorney Name Interpreter needed? Language Yes No Respondent Name D.O.B. Street Address P.O. Box Number City/State/Zip Code Phone Number Attorney Name Interpreter needed? Language Yes No File Number Petition Number 2nd Petitioner (if any) Name D.O.B. Street Address P.O. Box Number City/State/Zip Code Phone Number Attorney Name Interpreter needed? Language Yes No 2nd Respondent (if any) Name D.O.B. Street Address P.O. Box Number City/State/Zip Code Phone Number Attorney Name Interpreter needed? Language Yes No 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Form 126 Rev. 02/16 Guardian Ad Litem (if any) Name D.O.B. Street Address P.O. Box Number City/State/Zip Code Phone Number Attorney Name Interpreter needed? Language Yes No Does this matter relate to a federal immigration case? YES NO IN THE INTEREST OF THE FOLLOWING CHILD(REN): (Complete the table below for each child for which petitioner wants guardianship. Attach additional sheets if necessary.) Child's Name Child's Date of Birth Child's Place of Birth (City, State) Child's Gender (Check one) Male Male Male Female Female Female Petitioner's relationship to the child(ren) (select one relationship from choices below) brother or sister grandparent or great-grandparent aunt or uncle first cousin grandaunt or granduncle half-brother or half-sister non relative other relative: please explain: 1. Complete the table below regarding the child(ren)'s parents (individuals holding parental rights): NAME Address Date of Birth MOTHER FATHER 2. If you do not know the name/address of the child(ren)'s mother and/or father, write in the space provided below what you have done to try to locate him/her/them. 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Form 126 Rev. 02/16 I have attached to this Petition the following affidavits: Affidavit that a Party's Address is Unknown 3. Name(s) of the person(s) or organization holding parental rights of the child(ren): Address of person(s) or organization: 4. Name(s) of the person(s) or organization having the guardianship, care, control or custody of the child(ren): Address of person(s) or organization if address is different from address of Petitioner(s): 5. Name(s) of the person(s) to whom guardianship shall be vested if this Petition is granted Address of person(s) or organization if address is different from address of Petitioner(s): 6. Proposed guardian(s)' relationship to child(ren) if proposed guardian is NOT the Petitioner: 7. Please check all that apply: The following child(ren) is/are not yet 14 years of age or older: OR The child(ren) is/are 14 years of age or older and consents to (agree with) this Petition (Attach Affidavit of Consent executed by each child(ren) who consents) Name(s) of child(ren) 14 years of age or older who consent(s): The child(ren) is/are 14 years of age or older does/do NOT consent to (agree with) this Petition. Name(s) of child(ren) 14 years of age or older who do NOT consent: 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Form 126 Rev. 02/16 8. I am filing this petition because: (Check ALL that apply) The child(ren)'s parent(s) agree that I/we should become the guardian(s) of the child(ren) (Attach an Affidavit of Consent executed by the parent(s) who agree). The child(ren)'s parent(s) are deceased. (Attach a certified copy of the death certificate) The child(ren) is/are dependant, neglected and/or abused based on the following reason(s): NOTICE ­ This request for guardianship, if filed by a non-relative as defined in 10 Del. C. § 901, is subject to an assessment conducted by the Department of Services for Children, Youth and Their Families, as required by 31 Del. C. § 351. WHEREFORE, Petitioner(s) seek appointment as Guardian(s) of the above-named minor child(ren). Petitioner Sworn to subscribed before me: Date 2nd Petitioner (if any) Sworn to subscribed before me: Date Clerk of Court/Notary Public Date Clerk of Court/Notary Public Date 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com