APPLICATION FOR GUARDIAN AD LITEM IN STALKING ACTION FOR MINOR CHILD - PAGE 1 OF 2 (Stalking 8/2016) IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF In the Matter of : ) Case No. ) ) , ) Petitioner, ) APPLICATION FOR APPOINTMENT ) OF GUARDIAN AD LITEM IN ) STALKING ACTION FOR MINOR and ) CHILD ) Under ORS 30.866 , ) Respondent. ) APPLICATION 1. I wish to file a Stalking Petition to protect the following minor Child: Name: Age: Date of Birth: (See CIF) 2. I am willing to serve as Guardian ad Litem in this matter and request that I be appointed. I am a suitable person for this appointment because: I am at least 18 years old and my relationship to the Child is (describe your relationship with the child and how you know the child): Signature Print or Type Name Notary Public for /Court Clerk My Commission Expires: American LegalNet, Inc. www.FormsWorkFlow.com APPLICATION FOR GUARDIAN AD LITEM IN STALKING ACTION FOR MINOR CHILD - PAGE 2 OF 2 (Stalking 8/2016) Certificate of Document Preparation. You are required to truthfully complete this certificate regarding the document you are filing with the court. Check all boxes and complete all blanks that apply: I selected this document for myself and I completed it without assistance. I paid or will pay money to for assistance in preparing this form. Signature of Petitioner Print Name Address or Contact Address City, State, Zip Telephone or Contact Telephone Use a Safe Contact Address Use a Safe Contact # American LegalNet, Inc. www.FormsWorkFlow.com