JC-1628, 02/18 Petition to Terminate Guardianship/Revise Guardianship Order Under Chapter 48 Chapter 48, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE INTEREST OF a person under the age of 18 Date of Birth Petition to Terminate Guardianship Revise Guardianship Order (Chapter 48) Case No. I STATE ON INFORMATION AND BELIEF: 1. I, the petitioner, am the child. or Indian custodian. the department. a county department. the person with whom the child is placed and who is nominated aetition. the licensed child welfare agency assigned primary responsibility for providing services to the child under a court order or licensed to accept guardianship. a person representing the interests of the public under 24748.09, Wis. Stats. a person with whom the child has resided who has acted as a parent. 2. County where child currently resides Parent 1 Parent 1 is deceased. Parent 2 Parent 2 is deceased. Person representing the public under 24748.09 , Wis. Stats. [ Name and Address ] Agency primary responsible for providing services t o the child under a court order s [ Name and Address ] 3. These proceedings are are not subject to the uniform child custody jurisdiction and enforcement act under ch. 822. 4. The child is not may be is subject to the federal Indian Child Welfare Act. Tribe/address: 5. I request termination of the guardianship because A. there is good cause for removal of the guardian because the guardian is or has been neglecting, is or has been refusing or is or has been unable to discharge the guardian's trust. B. there has been a termination of parental rights regarding this child and an order has been entered under 24748.427 (3p) or 24748.428 (2) (b), Wis. Stats. American LegalNet, Inc. www.FormsWorkFlow.com JC-1628, 02/18 Petition to Terminate Guardianship/Revise Guardianship Order Under Chapter 48 Chapter 48, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 C. I am the chiparent and there has been a substantial change in circumstances, and I am now willing and able to carry out the duties of a guardian, and termination of this . D. there are other reasons justifying termination of this guardianship. 6. I request revision of the guardianship order because there has been a substantial change in circumstances since the last order affecting guardianship and the proposed revision would be in the best interests of the child. The proposed revision is: . See attached 7. The facts and circumstances which support this request are as follows: See attached 8. I request A. a hearing be scheduled on this Petition. B. the Petition be granted based upon the written waivers of objection signed by all parties entitled to receive notice, which have been filed with the court. Signature of Petitioner Name Printed or Typed Date DISTRIBUTION: 1. Court 2. Parties American LegalNet, Inc. www.FormsWorkFlow.com