COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : : Plaintiff(s) -against- Calendar No. JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... SUPERIOR COURT OF WASHINGTON THE PEOPLE OF THE STATE OF NEW YORK COUNTY OF TO In re Parentage: GREETINGS: NO. Petitioner, ORDER APPOINTING GUARDIAN AD WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before LITEM ON BEHALF OF MINOR , the Honorable at the Court Respondent (ORAPGL) located at County of and in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Respondent. and Use this form to appoint a guardian ad litem for the child(ren). To appoint a guardian ad litem for a minor or incapacitated respondent, usewith this subpoena is punishable as a contempt of court and will make you liable to Your failure to comply form WPF PS 10A.0850. the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a I. BASIS result of your failure to comply. 1.1 BASIS FOR THE APPOINTMENT. Witness, Honorable , one of the Justices of the Court in County, day of , 20 This appointment is being made pursuant to RCW 26.26 Parentage Act. 1.2 CHILDREN TO WHOM THE ORDER APPLIES. (Attorney must sign above and type name below) [ ] _____________________________ [Name of party] [ ] the court moved for appointment of a guardian ad litem for the following minor child(ren) in this action: Attorney(s) for Age Name Office and P.O. Address ORD APPOINTING GAL (ORAPGL) - Page 1 of 4 WPF PS 10B.0850 (7/2003) - RCW 26.26.555 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) II. FINDINGS Calendar No. : JUDICIAL SUBPOENA -against: 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 Defendant(s) : ...................................................... IT IS ORDERED THAT: 3.1 APPOINTMENT OF GUARDIAN AD LITEM. THE PEOPLE OF THE STATE OF NEW YORK _________________________________________________ [Name] is appointed as guardian ad TO 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. GREETINGS: The guardian ad litem shall investigate and report factual information to the court concerning WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before parenting arrangements for the child(ren), and shall represent the child(ren)’s best interests. The , the Honorable at the Court guardian ad litem may make recommendations based upon an independent investigation regarding located at County of the best interests of the child(ren). The guardian ad litem shall report a child(ren)’s expressed in room preferences regarding the parenting plan to the court, together o'clock in the relative to whether any , on the day of , 20 , at noon, and at any recessed with the facts or adjourned date, to testify and give evidence as a witness in this action on the part of the 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] is punishable as a contempt of provided will make you liable to Your failure to comply with this subpoena and at least 60 days before trialcourt and that an extension behalf granted by the court. This report shall include recommendations and bases sustained as a the party on whose may be this subpoena was issued for a maximum penalty of $50 and all damagesfor those recommendations. result of your failure to comply. [ ] other:Honorable Witness, Court in County, , one of the Justices of the day of , 20 3.3 OTHER DUTIES. 3.4 Other duties of the guardian ad litem include appearing(Attorney must hearings and type name below) at all court sign above 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). Attorney(s) for 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, Office and P.O. Address including authorization to speak with interested persons, from the following sources: law enforcement agencies; Child Protective Services (or the equivalent out-of-state agency); health care ORD APPOINTING GAL (ORAPGL) - Page 2 of 4 WPF PS 10B.0850 (7/2003) - RCW 26.26.555 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : providers; mental health care providers; child care providers; theJUDICIAL SUBPOENA Department of Social and Health Plaintiff(s) Services (or the equivalent agency in another state); and educational institutions. -against: 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 Defendant(s) : . . . . . . . . pursuant .to .RCW .13.50.050(7).. .All .information obtained from sealed 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 PEOPLEcourtTHE STATE OF NEW YORK The OF clerk shall provide certified copies of this order to the guardian ad litem upon request and without charge. TO 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. GREETINGS: 3.5 PAYMENT OF FEES AND COSTS. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before The guardian ad litem fee is $___________ per hour up to $_____________, the maximum the , the Honorable at the Court guardian ad litem may charge without additional court review and approval. located at County of in room The fees , on costs of the guardian ad litem shall be paid as follows: in the day of , 20 , at o'clock noon, and at any recessed and the or adjourned date, to testify and give evidence as a witness in this action on the part of the [] ____ % by mother, ______% by _______________________________, ____ % by _______________________________________. [] Other: Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a The total amount awarded shall be at the discretion of the court up to the maximum amount result of your failure to comply. 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. Guardians ad litem who are not volunteers shall Witness, Honorable , one of the Justices of the provide the parties with an itemized accounting of their time and billing for services each month. Court in County, day of , 20 3.6 CONSENT OF CHILDREN OVER TWELVE TO INVESTIGATION. [] [] 3.7 Does not apply. (Attorney must sign above and type name below) ________________________________________________________________ [Name] 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 Attorney(s) for the child(ren) in the past[ ] has [ ] has not been given by the child. AUTHORIZATION FOR RELEASE OF INFORMATION. [] [] Does not apply. Office and P.O. Address Each party’s signature hereunder constitutes an authorization for release of information by that party to the agencies listed in paragraph 3.4, above. ORD APPOINTING GAL (ORAPGL) - Page 3 of 4 WPF PS 10B.0850 (7/2003) - RCW 26.26.555 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : TERMINATION OF APPOINTMENT. Plaintiff(s) : JUDICIAL SUBPOENA -againstThe appointment terminates: 3.8 Calendar No. : [] [] : Upon entry of the final parenting plan or residential schedule. Other: : Defendant(s) : ...................................................... 3.9 OTHER: THE PEOPLE OF THE STATE OF NEW YORK TO Dated: Judge/Commissioner GREETINGS: Presented by: Approved for entry: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Notice of presentation waived: , the Honorable at the Court located at County of inSignature room , on the day of , 20 Signature o'clock in the , at noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Print or Type Name Print or Type Name Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a ACCEPTED UPON APPROVAL damages sustained as a maximum penalty of $50 and all BY THE COURT result of your failure to comply. Witness, Honorable Court in County, day of , one of the Justices of the Guardian Ad Litem , 20 Signatures of the Parties: (Attorney must sign above and type name below) Mother’s Signature Father’s Signature Child’s Signature Attorney(s) for Child’s Signature (See Paragraph 3.6) (See Paragraph 3.6) Office and P.O. Address ORD APPOINTING GAL (ORAPGL) - Page 4 of 4 WPF PS 10B.0850 (7/2003) - RCW 26.26.555 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com