MCSC MF 001 Revised October 2017 Page 1 of 6 Read the Instruction Sheet. Review the Community Resource Sheet and reach out to any available resources. Fill out the Questionnaire. packet) completely. the request. school letters related to proving that the request is a necessary medical or educational expense. medical invoices, be sure adjustments for insurance are clearly delineated. nsure the Petition is notarized. Mecklenburg County Courthouse, Room 3600 ATTN: Judicial Hearing Officers 832 East 4th Street Charlotte , NC 28202 American LegalNet, Inc. www.FormsWorkFlow.com MCSC MF 001 Revised October 2017 Page 2 of 6 INSTRUCTIONS FOR PETITION FOR RELEASE OF MINOR'S FUNDS HELD WITH CLERK $25,000. The goal is to preserve these funds until the minor reaches the age of majority (eighteen-years old). In some counties, the Clerk of Court does not allow for any disbursements under any circumstances prior to the minor reaching the age of majority. educational and medical necessities. Requests related to educational necessities must include a letter from the to medical necessities must include a letter from the medical provider asserting that the request is must include an invoice from the provider. Medical invoices shall include clearly delineated insurance adjustments. In addition to a showing of educational and/or medical necessity, the petitioners (i.e. parents) also need to show why they are financially unable to provide for these necessities and that they have exhausted all other community resources (i.e. resources on the Community Resource List, and other assistance provided by nonprofits and charities) and sources of assistance (i.e. DSS, Medicaid, resources available through the public school system). BEFORE A HEARING IS SCHEDULED you must fully complete the enclosed Questionnaire and Petition, and return them together with the required letters and documentation. Once you have completed the requisite documents you may either return them in person to Suite 3600, or mail them to: Mecklenburg County Courthouse, Room 3600 ATTN: Judicial Hearing Officers 832 East Fourth Street, Charlotte, North Carolina, 28202 Upon receipt of the completed packet, a judicial hearing officer will review the Petition, Questionnaire, and documents, and will either allow or deny a hearing. If a hearing is denied, you will be mailed a copy of the denial stating the reason why. If a hearing is allowed, you will be mailed a notice of the date and time of the hearing. The hearing is an opportunity for the Court to ask questions and receive more information about the request. You must arrive on time, as late arrivals will not be heard. American LegalNet, Inc. www.FormsWorkFlow.com MCSC MF 001 Revised October 2017 Page 3 of 6 QUESTIONNAIRE 1. Your full name as listed on a government-issued identification: 2. The best telephone number to be able to reach you: Type of phone: 3. Your mailing address: 4. Have you asked for assistance from any organization on the Community Resource List? If yes, list the date of your request, the content of your request (what did you ask for?), and the result of your request (what did you receive?). 5. What other community resources (not listed on the Community Resource List) have you asked for assistance? List the date of your request, the content of your request (what did you ask for?), and the result of your request (what did you receive?). 6. Do other sources of support or income exist for the minor (i.e. does the minor received child support, social security benefits, other benefit payments, etc.)? 7. If a hearing is scheduled, is there a day of the week or time of day that works best with your schedule? (Hearings are normally held Monday through Thursday, from 9:00am to 3:30 pm.) American LegalNet, Inc. www.FormsWorkFlow.com MCSC MF 001 Revised October 2017 Page 4 of 6 COMMUNITY RESOURCE LIST Educational Support/School Supplies Communities in Schools 601 E 5th Street, #300 Charlotte, NC 28202 704.335.0601 www.cischarlotte.org 601 E. Fifth Street, Suite 510 Charlotte, NC 28202 704.372.7961 www.cfcrights.org Clothing and Household Goods Assistance League of Charlotte 3405 S. Tryon St. Charlotte, NC 28217 704-525-5000 Beds for Kids 2519 S. Tryon St. Charlotte, NC 28203 980-422-1192 Charlotte Berean Seventh-day Adventist Church 1801 Double Oaks Rd Charlotte, NC 28206-2301 704-377-6313 Crisis Assistance Ministries 500 Spratt Street Charlotte, NC 28206 704. 371.3001 www.crisisassistance.org Goodwill Industries 2901 A Freedom Dr. Charlotte, NC 28208 704-372-3434 Jackson Park Ministries 5415 Airport Rd. Charlotte, NC 28208 704-392-4981 Matthews Help Center 119 N. Ames St. Matthews, NC 28105 704-847-8383 Housing Resources Charlotte Family Housing 300 Hawthorne Ln. Charlotte, NC 28204 704-335-5488 Charlotte Housing Authority 400 E. Blvd. Charlotte, NC 28203 704-336-5183 Community Link 601 E. 5th St. #220 Charlotte, NC 28202 704-943-9490 Crisis Assistance Ministries 500 Spratt Street Charlotte, NC 28206 704. 371.3001 www.crisisassistance.org Jackson Park Ministries 5415 Airport Rd. Charlotte, NC 28208 704-392-4981 American LegalNet, Inc. www.FormsWorkFlow.com MCSC MF 001 Revised October 2017 Page 5 of 6 STATE OF NORTH CAROLINA IN THE SUPERIOR COURT COUNTY OF MECKLENBURG BEFORE THE CLERK FILE No.: IN THE MATTER OF: , Minor Child's Full Name Minor Child. PETITION FOR RELEASE OF MINOR'S FUNDS HELD WITH CLERK N. C. Gen. Stat. 247 7A - 111 et seq. The PETITIONER(s), being duly sworn, deposes and says as follows: 1. My name(s) is/are . 2. I/We am/are the of , who is years old. I am a person who is legally responsible for the care and maintenance of said child. 3. No Guardian is presently appointed to the above-named child in relation to this action. 4. The above-named minor child is an indigent and needy child, and has funds with the Court. 5. The following is a detailed, itemized list of medical and/or educational necessities which the above-named minor child is in need of : 6. is needed from the minor's funds to supply the above necessities for the minor. 7. I have described specific steps that I have taken to access community resources as outlined in the attached questionnaire. These necessities cannot be supplied to the minor either from myself, from family members, or from other sources because: Full names of Petitioner or Petitioners Relationship to Child Minor Child's Full Name Age $ Amount American LegalNet, Inc. www.FormsWorkFlow.com MCSC MF 001 Revised October 2017 Page 6 of 6 8. It is in the best interest of the minor to pay the requested amount for said necessities. Said amount will be used and faithfully applied for the exclusive benefit and maintenance of the said minor/needy child. WHEREFORE, the Petitioner requests this Court withdraw the amount requested from the minor's funds and pay them for the use and benefit of the minor. This the of , 20 . Sworn to and subscribed before me this the Day , 20. Day Month Signature of Petitioner Signature of Person Authorized to Administer Oaths Signature of Petitioner American LegalNet, Inc. www.FormsWorkFlow.com