IN THE SUPERIOR COURT OF WASHINGTON, COUNTY OF PIERCE Cause No. ORDER APPOINTING GUARDIAN AD LITEM ON BEHALF OF MINOR (ORAPGL) 1. BASIS 1.1 BASIS FOR THE APPOINTMENT. This appointment is being made pursuant to: [ [ [ 1.2 ] RCW 26.09 Dissolution ] RCW 26.26 Parentage Act ] RCW 26.50 Domestic Violence CHILDREN TO WHOM THE ORDER APPLIES. The [ ] father [ ] mother [ ] court moved for appointment of a guardian ad litem for the following minor child(ren) in this action: Name: Age: _________________________________________________ __________________ _________________________________________________ __________________ _________________________________________________ __________________ _________________________________________________ __________________ _________________________________________________ __________________ Page 1 of 4 American LegalNet, Inc. www.USCourtForms.com II. FINDINGS After reviewing the case record to date and the basis for the motion, the court FINDS that the motion should be granted because appointment of a guardian ad litem is in the best interest of the child(ren). III. ORDER IT IS ORDERED THAT: 3.1 APPOINTMENT OF GUARDIAN AD LITEM. __________________________________________________is appointed as guardian ad litem for the above-named minor child(ren) of the parties and shall receive copies of all pleadings and notice of all court proceedings regarding the child(ren). 3.2 DUTIES OF THE GUARDIAN AD LITEM The guardian ad litem shall investigate and report factual information to the court concerning parenting arrangements for the child(ren), and shall represent the child(ren)’s best interests. The guardian ad litem may make recommendations based upon an independent investigation regarding the best interests of the child(ren). The guardian ad litem shall report a child(ren)’s expressed preferences regarding the parenting plan to the court, together with the facts relative to whether any preferences are being expressed voluntarily and the degree of the child(ren)’s understanding. The guardian ad litem shall make a full and complete written report to the court and counsel/ parties on or before____________________ [Date] and at least 60 days before trial provided that an extension may be granted by the court. This report shall include recommendations and bases for those recommendations. [ ] Other: 3.3 OTHER DUTIES. Other duties of the guardian ad litem include appearing at all court hearings and pretrial conferences within the scope of appointment unless excused by the court and assisting the parties and counsel in reaching a resolution of the matters involving said child(ren). 3.4 GUARDIAN AD LITEM ACCESS TO CHILD(REN), RECORDS AND INFORMATION To facilitate reasonable investigation of information pertaining to the best interest of the child(ren), the guardian ad litem shall have access to the child(ren) and to all records and information, including authorization to speak with interested persons, from the following sources: law enforcement agencies; Child Protective Services (or equivalent out-of-state agency); health care providers; mental health care providers; child care providers; the Department of Social and Health Services (or the equivalent agency in another state); and educational institutions. These agencies may withhold or blackout portions of requested information as warranted by law or by court order. The guardian ad litem shall maintain the confidentiality of information except as necessary to fulfill his or her duties as guardian ad litem. Within the scope of appointment, the guardian ad litem shall have access to all Superior Court and Juvenile Court files, including any sealed/confidential portions thereof, other than records sealed pursuant to RCW 13.50.050(7). All information obtained from sealed Page 2 of 4 American LegalNet, Inc. www.USCourtForms.com or confidential files shall remain sealed or confidential, and the guardian ad litem shall inform the court if the guardian ad litem report contains sealed or confidential information. The court clerk shall provide certified copies of this order to the guardian ad litem upon request and without charge. Upon good cause shown, the guardian ad litem or the parties may move that the court make confidential any reports or documents placed in the court file by the guardian ad litem. 3.5 PAYMENT OF FEES AND COSTS The guardian ad litem fee is $75 per hour up to $500, the maximum the guardian ad litem may charge without additional court review and approval. The fees and costs of the guardian ad litem shall be paid as follows: [ ]________% by father and ________% by mother ________% by other _________________. [ ] Other: The Clerk of the Court is hereby authorized to disburse funds collected in this case to the above named guardian ad litem. The total amount awarded shall be at the discretion of the court up to the maximum amount allowed after the guardian ad litem files an itemized statement of time with the court, along with a specific request for fees and a proposed Order. Guardian ad litems who are not volunteers shall provide the parties with an itemized accounting of their time and billing for services each month. 3.6 CONSENT OF CHILDREN OVER TWELVE TO INVESTIGATION [ ] Does not apply. [ ] ____________________________________________________________________________ has/have reached the age of twelve. Written consent for the guardian ad litem to consult with and obtain information from medical, psychiatric, or other experts who have served the child(ren) in the past [ ] has [ ] has not been given by the child. 3.7 AUTHORIZATION FOR RELEASE OF INFORMATION [ ] Does not apply. [ ] Each party’s signature hereunder constitutes an authorization for release of information by that party to the agencies listed in paragraph 3.4, above. 3.8 TERMINATION OF APPOINTMENT. The appointment terminates: [ ] [ ] Upon entry of the final parenting plan or residential schedule. Other: ____________________________________________________________________________. 3.9 OTHER: Page 3 of 4 American LegalNet, Inc. www.USCourtForms.com Dated:_____________________________ ______________________________________ Judge/Commissioner Presented by: Approved for entry: Notice of presentation waived: __________________________________ Signature _______________________________________ Signature __________________________________ Print or Type Name _______________________________________ Print or Type Name ACCEPTED UPON APPROVAL BY THE COURT ________________________________________ Guardian Ad Litem Signatures of Parties: _________________________________ Mother’s signature ________________________________ Father’s signature _________________________________ Child’s signature (See paragraph 3.6) ________________________________ Child’s signature (See paragraph 3.6) Page 4 of 4 American LegalNet, Inc. www.USCourtForms.com