251 2018 Nevada Supreme Court Page 1 of 14 226 Petition for Appointment of Guardian Including Temporary Guardianship (Child) COURT CODE: 3450 Your Name: Address: City, State, Zip: Telephone: Email Address: Self-Represented IN THE FAMILY DIVISION OF THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF WASHOE In the Matter of the Guardianship of the: Person Estate Person and Estate of: ( name of child who needs a guardian) A Proposed Protected Minor. CASE NO.: DEPT: PETITION FOR APPOINTMENT OF GUARDIAN(S) OVER CHILD INCLUDING REQUEST FOR TEMPORARY GUARDIANSHIP Petitioner (proposed guardian222s name) and Co-Petitioner (proposed co-guardian222s name; if only one guardian, write 223N/A224) would like to be appointed the Guardian(s) over the above-named child. In accordance with 2017 Nevada Laws Ch. 172 (A.B. 319), Petitioner(s) respectfully represents the following to this Honorable Court: Petitioner222s Information (the first proposed guardian) 1. Full legal name: . 2. Date of birth: . 3. Relationship to child in need of a guardian: . American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 14 226 Petition for Appointment of Guardian Including Temporary Guardianship (Child) 4. Residence address: Address City, State, Zip Code Mailing address (if different than residence address): Address City, State, Zip Code 5. Qualifications. (Answer each item listed; 223Has224 answers must be explained) The Petitioner: ( check one for each) has has not been convicted of a crime of moral turpitude, a crime involving domestic violence or a crime involving the abuse, neglect, exploitation, isolation or abandonment of a child, his or her spouse, his or her parent or any other adult. Explain if Yes: has has never been convicted of a felony. Explain if Yes: Petitioner was convicted of (describe conviction) Petitioner ( check one) was / was not placed on parole and ( check one) has has not filed for bankruptcy within the past 7 years. is is not a party to pending criminal or civil litigation. Explain if Yes: American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 14 226 Petition for Appointment of Guardian Including Temporary Guardianship (Child) Co-Petitioner222s Information (the second proposed guardian) Not Applicable (check if there is only one proposed guardian, and go to page 4) 6. Full legal name: . 7. Date of birth: . 8. Relationship to child in need of a guardian: . 9. Residence address: Address City, State, Zip Code Mailing address (if different than residence address): Address City, State, Zip Code 10. Qualifications. (Answer each item listed; 223Has224 answers must be explained) The Co-petitioner: ( check one for each) has has not been convicted of a crime of moral turpitude, a crime involving domestic violence or a crime involving the abuse, neglect, exploitation, isolation or abandonment of a child, his or her spouse, his or her parent or any other adult. Explain if Yes: has has never been convicted of a felony. Explain if Yes: The Petitioner was convicted of (describe conviction) The Petitioner ( check one) was / was not placed on parole and ( check one) has has not filed for bankruptcy within the past 7 years. is is not a party to pending criminal or civil litigation. Explain if Yes: American LegalNet, Inc. www.FormsWorkFlow.com Page 4 of 14 226 Petition for Appointment of Guardian Including Temporary Guardianship (Child) Child222s Information 11. Child222s full legal name: . 12. Child222s date of birth: ; current age: . The child will become 18 years old on (date) . 13. Petitioner(s) believe the child ( check one) will / will not need a guardian when the child turns 18 years old. If yes, explain why a guardian will still be needed: . 14. The child has been a resident of the State of (state) since (date) . 15. The child currently lives at the following address: Address City, State, Zip Code The child has lived at the above address since (date) . 16. The child has lived at the following places with the following people within the last 5 years (list the places the child has lived in the last 5 years): Time Period (mo/yr 226 mo/yr) Name of Person the Child Lived With: City and State i.e., 5/17 - 9/17 Sue Jones (grandma) Las Vegas, NV - - - - - The names and current addresses of each non-parent the child lived with during the last five years are: American LegalNet, Inc. www.FormsWorkFlow.com Page 5 of 14 226 Petition for Appointment of Guardian Including Temporary Guardianship (Child) 17. Participation in Other Cases. Have you ever participated in any case concerning the child as a party, witness, or in some other capacity? ( check one) No. Yes, I have participated in the following cases concerning the child (provide all specifics including the state, the court name, the case number and the date of the child custody order, if any): 18. Knowledge of Other Cases. Do you know of any other case that could affect this case, such as other custody cases, domestic violence cases, protection order cases, or adoptions / terminations? ( check one) No. Yes, the following cases that could affect this case (provide all specifics including the state, the court name, the parties involved, the case number and the type of case): 19. Current Custody Case: Is there a custody order concerning the child? ( check one) No. Yes, there is a current order concerning custody of the child. The order is from the State of and was filed on (date) . If the order was not registered with this Court, a copy of the order will be filed with this Petition. 20. Persons Who Can Claim Custody / Visitation. Is there anyone other than yourself or other parties to this case who has custody of the child or who can claim a right to custody or visitation with the child? ( check one) No. Yes, the following people have custody or can claim custody/visitation of the child: (list names and addresses of anyone who claims custody/visitation rights): American LegalNet, Inc. www.FormsWorkFlow.com Page 6 of 14 226 Petition for Appointment of Guardian Including Temporary Guardianship (Child) 21. The child is currently under the care of (name and address of person caring for the child): Name Address City, State, Zip Code The person above is caring for the child because (explain why the child is under the care of the person above): 22. Does the child receive Medicaid, or has this child ever received Medicaid? ( check one) No Yes 23. Is the child a member of a federally recognized tribe? ( check one) No Yes, the tribe is (write tribe222s name) 24. Is the child a citizen of another country? ( check one) No Yes, the child is a citizen of (write country name) 25. Is the child a party to any pending criminal or civil lawsuit? ( check one) No Yes (explain) 26. Are you seeking guardianship in order to initiate litigation? ( check one) No Yes (explain) American LegalNet, Inc. www.FormsWorkFlow.com Page 7 of 14 226 Petition for Appointment of Guardian Including Temporary Guardianship (Child) Child222s First Parent 27. The first parent is (name) . ( check if applicable) This parent is deceased. *File a copy of the death certificate with this Petition.* This parent222s parental rights over the child were terminated by a court order. *File a copy of the termination order with this Petition.* 28. This parent currently lives at the following address: Address City, State, Zip Code Mailing address (if different than residence address): Address City, State, Zip Code 29. Consent ( check one): This parent agrees to this proposed guardianship and will file a proper notarized consent. This parent does not consent to the proposed guardianship, or cannot be located to consent. 30. This parent is unable to care for the child because (explain): American LegalNet, Inc. www.FormsWorkFlow.com Page 8 of 14 226 Petition for Appointment of Guardian Including Temporary Guardianship (Child) Child222s Second Parent 31. The second parent is (name) . ( check if applicable): This parent is deceased. *File a copy of the death certificate with this Petition.* This parent222s parental rights over the child were terminated by a court order. *File a copy of the termination order with this Petition.* This parent is an unkn