In the matter of First, middle, and last name Last four digits of SSN , a minor þ USE NOTE: If a parent is incarcerated and under the jurisdiction of the Michigan Department of Corrections, the petitioner must comply with MCR 2.004(B). 1. þ I, en-USName (type or print)en-US , am interested in the welfare of the minor and make this þ petition as þ en-USRelationship to minor (i.e. grandparent, aunt or uncle, friend, limited guardian, etc.)en-US . 2. þ The minor was born en-USDate , is þ þ female, þ þ male, is unmarried, resides in en-USCounty þ at þ en-USAddress City/Township State Zipen-US , þ and is presently located in en-USCountyen-US at en-USAddress (if different than above)þ en-USCity/Township State Zip . þ þ þ þ The minor is a citizen of the following foreign country: en-US en-US . 3. þ þ The minor is not an Indian child as defined in MCR 3.002(12). þ þ It is unknown whether the minor is an Indian child as defined in MCR 3.002(12).4. þ The persons interested in this proceeding are: en-USNAMEen-USRELATIONSHIPen-USADDRESS AND TELEPHONE NUMBERen-USParent/DOB en-US en-USStreet addressen-USCityen-USStateen-USZipen-USTelephone no.en-USParent/DOB en-US en-USStreet addressen-USCityen-USStateen-USZipen-USTelephone no.en-USConservatoren-USStreet addressen-USCityen-USStateen-USZipen-USTelephone no.en-USGuardianen-USAmerican LegalNet, Inc. www.FormsWorkFlow.com File No. 4. en-US(continued)en-US If neither parent is living, the names and addresses of the minor222s grandparents and nearest of kin who are adults are: en-USNAMEen-USRELATIONSHIPen-USADDRESS AND TELEPHONE NUMBERen-USStreet addressen-USCityen-USStateen-USZipen-USTelephone no.en-USNone of these persons are under any legal incapacity except en-USName, incapacity, and representative of the person, if anyen-US . 5. An action within the jurisdiction of the family division of circuit court involving the family or family members of the minor has been previously filed in en-US Court, Case Number en-US , was assigned to Judge en-US , and þ þ remains þ is no longer þ pending. 6. þ The minor is in need of a guardian because a. the parental rights of both parents or of the surviving parent have been terminated or suspended by þ death. þ a previous court order other than an order appointing a limited disappearance. þ guardian of the minor. confinement in a place of detention. þ judgment of divorce or separate maintenance. judicial determination of mental incompetency. en-USOR b. the parent permits the minor to reside with another person and does not provide the other person with legal authority for the care and maintenance of the minor and the minor is not residing with a parent at this time. en-US en-USOR c. the biological parents of the minor were never married to each other and en-US , the custodial parent þ died þ en-US has disappeared since en-US en-US , and the other parent has not been granted legal custody by court order. The proposed guardian is related to the minor within the fifth degree by marriage, blood, or adoption. 7.A temporary guardian is necessary because en-US .en-USI REQUEST: 8. þ en-USNameen-US, whose address and telephone number are en-USAddress þ en-USCity/TownshipStateZipTelephone no.en-US , be appointed guardian of the minor. 9. The court order the parent(s) to provide reasonable support for þ parenting time with þ contact with the minor. en-USI declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best of en-USmy information, knowledge, and belief. en-USDate en-USDate en-USSignature of petitioner en-USSignature of petitioner en-USAddress en-USAddress en-USCity, state, zipTelephone no. en-USCity, state, zipTelephone no. 10. I am 14 years of age or older. I nominate en-USNameen-US as my guardian, who lives at en-USAddressCityStateZipen-US . en-USDate en-USSignature of minor en-USAttorney signature en-USAddress en-USAttorney name (type or print)Bar no. en-USCity, state, zipTelephone no. American LegalNet, Inc. www.FormsWorkFlow.com