nc110g_001

To keep other people from seeing what you entered on your form, please press the Clear This Form button at the end of the form when finished. PETITION OF (Name of petitioner or petitioners): FOR CHANGE OF NAME CASE NUMBER: NC-110G DECLARATION OF GUARDIAN Attachment Supplemental Attachment to Petition for Change of Name (Form NC-100) (If you are petitioning as a guardian of a minor, you must use a separate supplemental attachment for each minor whose name is to be changed.) of 7. a. Petitioner (name): b. Petitioner's address (street, city, county, and zip code): c. Petitioner is the guardian of the following minor whose name is to be changed: Short of child): Docket No. (1) Name (present nameTitle: (2) Address (street, city, county, and zip code): NOTICE OF APPEARANCE d. Petitioner was appointed guardian of the minor identified in item 7c by (specify): Appearance for (provide name of party): (1) Superior Court of California, County of (name): Juvenile Probate (2) Department (check one): Status of Party: (3) Case number (specify): ( ) Cross-Appellee/Cross Respondent ( ) Appellant/Petitioner ( ) Intervenor ( ) Appellee/Respondent (4) Date of appointment (specify): ( ) Cross-Appellant/Cross-Petitioner ( ) Amicus Curiae ( ) Other (Specify): e. The grandparents of the minor whose name is to be changed are (provide names and addresses, if known): ( ) An (1) Grandfather (name): attorney will argue this appeal. (address): < < < Name of attorney who will argue appeal, if other than counsel of record: Other Federal/State Bar admissions: (month, day, year): (2) Grandmother (name): Date of arguing attorney’s admission to this Court (month, day, year): (address): (3) Grandfather (name):I am a pro se litigant who is not an attorney. ( ) ( ( ( ) I am an incarcerated pro se litigant. ) ) TIME REQUEST (address): Oral argument is not desired. Oral argument is desired. Party requests minutes or multi-co-parties item 7c is likely to remain minutesthebe apportioned as follows: minor reaches under to guardian's care until the request a total of If more than 20 minutes per side is requested, set forth reasons: AVAILABILITY OF COUNSEL/PRO SE LITIGANT I understand that the person who will argue the appeal must be ready at any time during or after the week of argument which appears on the space, check the Continued (if you need additionalscheduling order. box, prepare an Attachment 7f, and attach it to this declaration). g. The minor identified in) item know of nolikely to be returned inconvenient. of his or her parents because (explain): ( I 7c is not dates which would be to the custody ( ) I request that the argument of this appeal not be calendared for the following dates, which are inconvenient. I have included religious holidays. (address): (4) Grandmother (name): f. The minor identified in (explain): the age of majority because COUNSEL OR PRO SE LITIGANT MUST ADVISE THE COURT IN WRITING OF ANY CHANGE IN AVAILABILITY. FAILURE TO DO SO MAY BE CONSIDERED BY THE COURT Attachment MOTIONS FOR to this declaration). Continued (if you need additional space, check the box, prepare anIN DECIDING 7g, and attach it ADJOURNMENT BASED ON UNAVAILABILITY. h. Other relevant information about the guardianship and why the proposed name change is in the best interest of the minor (specify): RELATED CASES ( ( ( ) ) ) This case has not been before this Court previously. This case has been before this Court previously. The short title, docket number and citation are: Continued (if you need additional space, check the box, prepare an Attachment 7h, and attach it to this declaration). Matters related to this appeal or involving the same issue have been or presently are before this Court. The short I declare under penalty of perjury titles, docket numbers and citations are: under the laws of the State of California that the information in the foregoing declaration is true and correct. Signature of counsel of record or pro se litigant: Date: Signature of counsel who will argue the appeal, if different: (TYPE OR PRINT NAME) Type or Print Name Name of Firm: Address: Type or Print Name (SIGNATURE OF PETITIONER) Guardian of (name of minor): Form Adopted for Mandatory Use Judicial Council of California NC-110G [New January 1, 2001] Telephone: Date: Telephone: Date: Code of Civil Procedure, § 1275 et seq. American LegalNet, Inc. www.USCourtForms.com July 2000 SUPPLEMENTAL ATTACHMENT TO PETITION FOR CHANGE OF NAME (Declaration of Guardian) For your protection and privacy, please press the Clear This Form button after you have printed the form. Print This Form Clear This Form