File No. STATE OF NORTH CAROLINA Film No. County In The General Court Of Justice Superior Court Division Before The Clerk IN THE MATTER OF: Name Of Minor ORDER ON STANDBY GUARDIANS PETITION FOR APPOINTMENT Date Of Application AS GUARDIAN OF MINOR G.S. 35A-1374Name And Address Of Guardian Name And Address Of Guardian Of The Person General Guardian Of The Person General Guardian This matter is before the Court on an application for the appointment of a guardian for the minor named above. This Court has subject matter jurisdiction over this proceeding and personal jurisdiction over the minor, and this county is a proper venue. Upon due notice and hearing, or upon waiver of notice and hearing by all parties entitled thereto and upon their consent, the Court finds from the evidence presented that: 1. The petitioner was duly designated as: standby guardian of the minor named above. alternate standby guardian of the minor named above and all persons designated as standby guardians are unwilling or unable to serve. 2. (Check one option.) a. There has been a written determination of the incapacity of the person who designated the petitioner as standby guardian. b. There has been a written determination of the debilitation of the person who designated the petitioner as standby guardian and that person has consented to the commencement of the standby guardians authority. c. The person who designated the petitioner as standby guardian has consented in writing to the commencement of the standby guardians authority. d. The person who designated the petitioner as standby guardian has died. e. No triggering event for the commencement of the standby guardians authority has occurred. 3. The best interests of the minor child will will not be promoted by the appointment of each of the petitioners as a guardian of the minor. 4. Each petitioner is fit to serve as a guardian of the minor. It is ORDERED that: each person named above is appointed as guardian of the minor to serve in the capacity designated, and letters of appointment shall be issued to each such person when that person properly qualifies to serve. the petition is denied. Date Signature Assistant CSC Clerk Of Superior Court AOC-E-410, New 2/96 1997 Administrative Office of the Courts