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Annual Report Of Guardian Of Minor Form. This is a Massachusetts form and can be use in Probate And Family Court Statewide.
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Tags: Annual Report Of Guardian Of Minor, MPC 443, Massachusetts Statewide, Probate And Family Court
ANNUAL REPORT OF
GUARDIAN OF MINOR
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
Division
In the Interests of:
Middle Name
First Name
Last Name
Minor
Child's name, date of birth and address:
First Name
Middle Name
(Address)
Last Name
(Apt, Unit, No. etc.)
(Date of Birth)
(City/Town)
(State)
(Zip)
Each guardian's name and address:
1.
M.I.
First Name
(Address)
(Apt, Unit, No. etc.)
Last Name
(City/Town)
(State)
(Zip)
1. Please list the names, ages and relationship to you of all persons currently living in your household:
First Name
M.I.
Last Name
Age
Relationship
1.
2.
3.
4.
5.
6.
2. Have you been investigated for abuse or neglect since the last report or since you were in court?
Yes
No
If YES, please state the date(s), circumstances, investigating agency, outcome and any information regarding court
involvement such as the name of the court and docket number of the case:
3. Has the child moved since your last report or since you were last in court?
Yes
No
If YES, please explain:
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4. Is the child currently in school?
Yes
No
If NO, and the child is over age 6, please explain:
If YES, please answer the following:
What grade is the child in?
How is the child doing in school? Please describe the child's grades and any special services the child is receiving in
school:
5. Has the child's physical, psychological or medical condition changed since the last report?
Has he/she been hospitalized or injured?
Yes
No
Yes
No
Yes
No
If YES, please explain:
6. Does the child have contact with his or her parent(s)?
If YES, how frequently, how recently, is it regular, and what is the quality of the contact?
7. Has the child been involved in any court cases since the last report or since you were
last in court? For example - delinquency or criminal charges, CHINS petition?
If YES, please explain:
8. Please provide any other information you believe will assist the court in reviewing the child's general well being. (Attach
additional pages if needed)
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SIGNED UNDER THE PENALTIES OF PERJURY
I affirm or swear under oath that I have read the foregoing petition and that the statements set forth therein are true and correct
to the best of my knowledge.
Date
Signature of Guardian
Date
Signature of Co-Guardian (if applicable)
Attorney for Guardian:
Print Name
(Apt, Unit, No. etc.)
(Address)
(City/Town)
(State)
(Zip)
Primary Phone #:
BBO No.:
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