PP-101 (T) (Rev. 7-1-06) STATE OF MAINE COUNTY PROBATE COURT DOCKET NO. In Re: PETITION FOR APPOINTMENT Minor OF TEMPORARY GUARDIAN FOR MINOR (18-A M.R.S.A. 001 5-207) 1. Name, address and telephone number of petitioner: 2. Name, address and telephone number of nominee to become temporary guardian: (If same as item 1, enter "same.") 3. Date of birth of person listed in item 2, and relationship of such person to the minor: 4. Name and legal residence of minor: 5. Current location of minor: (If same as item 4, enter 223same.224) 6. Date of birth of minor: 7. Names and addresses of all persons who must be notified and the relationship of each person to the minor: (Use separate sheet if necessary.) the following must be notified: the minor if 14 or over who has not otherwise consented or waived notice; the person who has had principal care and custody of the minor during 60 days immediately preceding date of petition; any living parent of minor; and any other interested party as directed by the Judge of Probate. NAME ADDRESS RELATIONSHIP PP-101(T) (Rev. 7-1-06) American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 NOMINATION AND CONSENT OF MINOR 8. I, , being 14 years of age or older do hereby nominate to be my Guardian and consent to his/her appointment as such without the necessity of hearing. Dated: (signature of minor) 9. State here the reasons why a temporary guardian is necessary. 10. State here the qualifications of the proposed guardian and why his/her appointment will be in the best interest of the minor. 11. Has the nominee attached an acceptance of appointment? Yes No. If no, state when it is to be filed. WHEREFORE, the Petitioner respectfully requests this Honorable Court grant the Petition for Appointment of Temporary Guardian of the minor. Dated Petitioner or Attorney 223Every pleading of a party represented by an attorney shall be signed by at least one attorney of record in his individual name.224 See Rule 11. Name, address, and telephone number of attorney Attorneys appearing for other parties petitioner, if any. Name of attorney Name of party MARP American LegalNet, Inc. www.FormsWorkFlow.com