1 Code: 4050 2 Name: ___________________________________ Address: _________________________________ _________________________________ Telephone No. ____________________________ 3 4 5 6 7 Name: ___________________________________ Address: _________________________________ _________________________________ Telephone No. ____________________________ Appearing in Proper Person 8 IN THE FAMILY DIVISION 9 OF THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA 10 IN AND FOR THE COUNTY OF WASHOE 11 12 In the Matter of the Guardianship of: 13 ________________________________________ 14 ________________________________________ 15 ________________________________________ Minor Child(ren) _____________________________________________/ Case No. ________________________ Dept. No. ________________________ 16 17 STIPULATION TO EXTEND GUARDIANSHIP BEYOND AGE 18 YEARS 18 IT IS HEREBY AGREED between _____________________________________________ (Name of guardian) 19 20 and ________________________________________ guardian(s) of the minor ward above-named, (Name of second guardian, if appropriate) 21 22 and the minor ward _____________________________________, that the guardianship entered on (Name of minor ward) 23 24 __________________________ be extended for ________________________________________ (Date guardianship entered) Number of days or months to be extended) 25 26 until the date of __________________________________. (Date guardianship will terminate) 27 28 /// Revised 2005 American LegalNet, Inc. www.FormsWorkflow.com 1 The basis for this stipulation is that the minor, namely ______________________________ (Name of minor ward) 2 3 will become 18 years of age on ___________________________________ and will graduate from (Date ward will become 18 years old) 4 5 high school on ______________________________________. (Date ward will graduate from high school) 6 7 This Stipulation and Agreement is entered into under the provisions of NRS 159.191. 8 DATED this _______ day of ________________________, 20______. 9 10 11 ____________________________________ (Signature of guardian) _________________________________________ (Signature of additional guardian, if appropriate) 12 13 14 SUBSCRIBED and SWORN to before me SUBSCRIBED and SWORN to before me 15 this ___ day of _________________, 20____. this ___ day of _________________, 20____. ____________________________________ NOTARY PUBLIC ____________________________________ NOTARY PUBLIC 16 17 18 19 20 ___________________________________________________ (Signature of ward) 21 22 23 SUBSCRIBED and SWORN to before me 24 this _______ day of ________________________, 20______. 25 26 ____________________________________ NOTARY PUBLIC 27 28 Revised 2005 American LegalNet, Inc. www.FormsWorkflow.com 1 SECOND JUDICIAL DISTRICT COURT COUNTY OF WASHOE, STATE OF NEVADA 2 3 AFFIRMATION Pursuant to NRS 239B.030 4 The undersigned does hereby affirm that the preceding document, 5 6 7 (Title of Document) 8 9 filed in case number: 10 Document does not contain the social security number of any person 11 -OR- 12 Document contains the social security number of a person as required by: 13 A specific state or federal law, to wit: 14 ______________________________________________________ (State specific state or federal law) 15 16 -or- 17 For the administration of a public program 18 -or- 19 For an application for a federal or state grant 20 -or- 21 Confidential Family Court Information Sheet (NRS 125.130, NRS 125.230 and NRS 125B.055) 22 23 24 Date: (Signature) 25 26 (Print Name) 27 28 (Attorney for) Affirmation Revised December 15, 2006 American LegalNet, Inc. www.FormsWorkflow.com