EXHIBIT G. SUPPLEMENT TO EMANCIPATION PETITION SUPPLEMENT TO EMANCIPATION PETITION Please answer each of the questions fully and attach, as exhibits to the petition, such additional information as is requested, or that you feel would be helpful to the court's determination of this petition. All answers should be typed or legibly printed or written in ink. Please use additional pages if the spaces provided are insufficient for the answer. PERSONAL DATA 1. Provide your name, date of birth and social security number. 2. Provide a list of the names, addresses and telephone numbers of your parents or guardians and your siblings. 3. Provide the names, birth dates and present addresses of your children, if any. 4. Explain how long you have lived in Washington State. 5. Describe your general health including any major illnesses, accidents or disabilities you have incurred up to this point in your life. 6. List the names, addresses and telephone numbers of the persons with whom you have resided for the past three years. American LegalNet, Inc. www.USCourtForms.com EDUCATIONAL INFORMATION 1. Explain how much education you have received and what is the last grade you completed in school. 2. Attach a copy of school transcript. 3. Describe what future education plans you presently have, if any. 4. Describe the clubs and activities you may have been involved in during the past two years, whether these were school related or not. FINANCIAL INFORMATION 1. List the name, address and telephone number of your present employer, if any, and describe your responsibilities at work. 2. List the names, addresses and telephone numbers of your previous employers and include the dates during which you were employed by each of these persons or businesses. 3. Attach a copy of a completed financial certificate to the petition. 4. Describe how you intend to meet your financial needs if emancipated. American LegalNet, Inc. www.USCourtForms.com 5. If an attorney is helping you with this process, explain how that attorney is being paid. CRIMINAL HISTORY 1. List all of the crimes or traffic offenses for which you have received convictions or diversions. 2. Attach a copy of your criminal history, or a certificate from the juvenile court which states that you do not have any criminal history. 3. Describe what criminal charges, if any, may be pending against you at this time, including pending court hearings or financial obligations. REFERENCES 1. Provide the names, addresses and telephone numbers of three adult references who support your petition. These references should not include your parents or guardians. STATEMENT OF GOALS 1. Provide a brief statement of your personal goals for the future and how you plan to achieve them. 2. Describe how you intend to pay for medical and dental care if you are emancipated. American LegalNet, Inc. www.USCourtForms.com I declare under penalty of the laws of the State of Washington that the foregoing is true and correct. SIGNED at ________________________ on ________________________ (city and state) (date) (Signature) American LegalNet, Inc. www.USCourtForms.com