251 2018 Nevada Supreme Court Page 1 of 4 226 Petition for Visitation / Contact Your Name: Address: City, State, Zip: Telephone: Email Address: Self-Represented DISTRICT COURT PETITION FOR VISITATION / CONTACT Petitioner(s), (first Petitioner222s name) and (second Petitioner222s name or 223n/a224 if only one Petitioner) , respectfully represent the following to this Honorable Court: 1.Relationship to the Protected Person.Petitioner(s) are the: ( check and complete one of the following) Parent(s).Grandparent(s) on the ( check one) mother222s / of the protected person. In the Matter of the Guardianship of the: PersonEstatePerson and Estate of: CASE NO.: DEPT: ( name of person who has a guardian ) A Protected Person. American LegalNet, Inc. www.FormsWorkFlow.com 251 2018 Nevada Supreme Court Page 2 of 4 226 Petition for Visitation / Contact 2. Denial / Unreasonable Restriction of Visitation / Contact. ( check all that apply and explain) The guardian(s) have denied me visitation and/or contact with the protected person. I have not had contact with the protected person since (date you last had any contact with the protected person) . The guardian(s) have unreasonably restricted my visitation and/or contact with the protected person. (Explain the unreasonable restriction of visitation or contact) 3. Visitation. The petitioner(s) reasonably believe that a guardian has committed an abuse of discretion in restricting the relative or person of natural affection222s access to the protected person. The petitioner(s) request the guardian to grant the relative or person of natural affection access to the protected person, pursuant to S. B. 433, 2017 Leg., 79th Sess. (Nev. 2017). The court may award rights of visitation between a protected minor and his or her parents or relatives who are within the fourth degree of consanguinity, pursuant to Assemb. B. 319, 2017 Leg., 79th Sess. (Nev. 2017). 4. Visitation Schedule / Contact Desired. I would like the court to grant me visitation and/or contact with the protected person as follows (describe in detail the visitation schedule or contact you would like to have with the protected person): American LegalNet, Inc. www.FormsWorkFlow.com 251 2018 Nevada Supreme Court Page 3 of 4 226 Petition for Visitation / Contact Based on the above, Petitioner(s) request that the above visitation and/or contact be granted, and for such other and further relief as the court may deem just and proper. Date: Date: (First Petitioner222s signature) (Second Petitioner222s signature) (First Petitioner222s printed name) (Second Petitioner222s printed name) American LegalNet, Inc. www.FormsWorkFlow.com 251 2018 Nevada Supreme Court Page 4 of 4 226 Petition for Visitation / Contact VERIFICATION I, (name of first Petitioner) , under penalty of perjury, state that I am the Petitioner in the within action; that I have read the foregoing Petition and know the contents thereof; that the same is true of my knowledge except as to those matters therein stated upon information and belief and as to those matters, I believe them to be true. I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct. PETITIONER222S SIGNATURE VERIFICATION I, (name of Co-Petitioner; if none, write 223N/A224) , under penalty of perjury, state that I am the Co-Petitioner in the within action; that I have read the foregoing Petition and know the contents thereof; that the same is true of my knowledge except as to those matters therein stated upon information and belief and as to those matters, I believe them to be true. I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct. CO-PETITIONER222S SIGNATURE American LegalNet, Inc. www.FormsWorkFlow.com