Page 1 of 14 226 Petition for Appointment of Guardian Including Temporary Guardianship (Child) COURTYour Name: Address: City, State, Zip: Telephone: Email Address: Self-Represented DISTRICT COURT COUNTY, NEVADA 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 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 guardian1.Full legal name:. 2.Date of birth:. 3.Relationship to child in need of a guardian:. 251 2018 Nevada Supreme Court In the Matter of the Guardianship of the: PersonEstatePerson and Estate of: CASE NO.: DEPT: ( name of child who needs a guardian ) A Proposed Protected Minor. 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) 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) ( 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 thechild as a party, witness, or in some other capacity? (check one)No.Yes, I have participated in the following cases concerning the child (provide allspecifics including the state, the court name, the case number and the date of the childcustody 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 thestate, 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 theState 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 orother parties to this case who has custody of the child or who can claim a right to custodyor 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)NoYes 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 unknown father. There is no father listed on the child222s birth certificate. There has never been a court order regarding child support, custody, or a finding of paternity. 32. This parent currently lives at the following address: Address Cit