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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Code: (Your name) __________________________ (Your address) __________________________ __________________________ (Telephone) __________________________ In Proper Person IN THE _____ JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF _____________________ ) ) ) ) ) ______________________________, ) ) _______________________________, and ) ) ______________________________ ) Minor Children. ) ________________________________________ ) In the Matter of the Guardianship of  the person  the estate  the person and estate CASE NO. ___________________ DEPT. NO.___________________ ADDENDUM TO PETITION FOR GUARDIANSHIP OF A MINOR REQUESTING IMMEDIATE TEMPORARY GUARDIANSHIP _________________________________and_____________________________________ (Name of Petitioner) (Name of Co-Petitioner) Petitioner(s) in this matter, state(s) as follows: 1. A Verified Petition for Guardianship was filed herein on___________________ (Date Petition was filed) by the above-named Petitioner(s) to be appointed guardians of the following minors(s): Name Age Date of Birth ___________________ ___________________ ___________________ ______________________________________________ ______ ______________________________________________ ______ ______________________________________________ ______ 2. This Request For Immediate Temporary Guardianship is made for the following Minor Addendum/Temporary Minor Addendum to Petition 1 of 8 ©2006 Nevada Supreme Court Revised December 14, 2006 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ____________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ _____________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ (If you need more space, you may attach additional pages. Be sure the pages clearly indicate they are a continuation of this portion of the document.) reasons: Check the boxes that apply. More than one box may be checked; however, at least one must be checked to qualify for a temporary guardianship. You must explain, in detail, each statement you checked.  The minor(s) face(s) a substantial and immediate risk of physical harm;  The minor(s) need(s) immediate medical attention;  The minor(s) face(s) a substantial and immediate risk of financial loss; Explain in detail why: _____________________________________________________________________________ ____________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Minor Addendum/Temporary Minor Addendum to Petition 2 of 8 ©2006 Nevada Supreme Court Revised December 14, 2006 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 5. 3. Petitioner(s) (have or have not) ______________ tried in good faith to notify the following people of this Request For Immediate Guardianship: Print “yes” or “no” to ALL of the following questions and fill in the information in the appropriate spaces for those questions you answered with a “yes.” Paragraph 4 is to be answered regarding child #1 only. 4. ________ Mother of the minor child(ren) on __________________ (yes or no) (date contact was made)  In person  By telephone  In writing ________ Father of the minor child(ren) on ___________________ (yes or no) (date contact was made)  In person  By telephone  In writing ________ Maternal Grandparents of the minor child(ren) on __________________ (yes or no) (date contact was made)  In person  By telephone  In writing ________ Paternal Grandparents of the minor child(ren) on ___________________ (yes or no) (date contact was made)  In person  By telephone  In writing _______ Current Legal Guardians of the minor child(ren) on ___________________ (yes or no) (date contact was made)  In person  By telephone  In writing ________ Brothers and/or Sisters of the minor child(ren) who are over the age of 14 (yes or no) years on ___________________ (date contact was made)  In person  By telephone  In writing ________ Current Legal Guardians of any brothers and sisters of the minor child(ren) (yes or no) who are under the age of 14 years on ___________________ (date contact was made)  In person  By telephone  In writing Paragraph 5 is to be answered regarding child #2 only. ________ Mother of the minor child(ren) on ___________________ (yes or no) (date contact was made)  In person  By telephone  In writing ________ Father of the minor child(ren) on ___________________ Minor Addendum/Temporary Minor Addendum to Petition 3 of 8 ©2006 Nevada Supreme Court Revised December 14, 2006 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 (yes or no)  In person (date contact was made)  By telephone  In writing ________ Maternal Grandparents of the minor child(ren) on ___________________ (yes or no) (date contact was made)  In person  By telephone  In writing ________ Paternal Grandparents of the minor child(ren) on ___________________ (yes or no) (date contact was made)  In person  By telephone  In writing _______ Current Legal Guardians of the minor child(ren) on ___________________ (yes or no) (date contact was made)  In person  By telephone  In writing ________ Brothers and/or Sisters of the minor child(ren) who are over the age of 14 (yes or no) years on ___________________ (date contact was made)  In person  By telephone  In writing ________ Current Legal Guardians of any brothers and sisters of the minor child(ren) (yes or no) who are under the age of 14 years on ___________________ (date contact was made)  In person  By telephone  In writing Paragraph 6 is to be answered regarding child #3 only. 6. ________ Mother of the minor child(ren) on ___________________ (yes or no) (date contact was made)  In person  By telephone  In writing ________ Father of the minor child(ren) on ___________________ (yes or no) (date contact was made)  In person  By telephone  In writing ________ Maternal Grandparents of the minor child(ren) on ___________________ (yes or no) (date contact was made)  In person  By telephone  In writing ________ Paternal Grandparents of the minor child(ren) on ___________________ (yes or no) (date contact was made)  In person  By telephone  In writing _______ Current Legal Guardians of the minor child(ren) on ___________________ (yes or no) (date contact was made) Minor Addendum/Temporary Minor Addendum to Petition 4 of 8 ©2006 Nevada Supreme Court Revised December 14, 2006 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28  In person  By telephone  In writing ________ Brothers and/or Sisters of the minor child(ren) who are over the age of 14 (yes or no) years on ___________________ (date contact was made)  In person  By telephone  In writing ________ Current Legal Guardians of any brothers and sisters of the minor child(ren) (yes or no) who are under the age of 14 years on ___________________ (date contact was made)  In person  By telephone  In writing If you answered “no” to any of the questions above, explain why those people have not been contacted prior to the filing of this Request For Immediate Temporary Guardianship. ____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Minor Addendum/Temporary Minor Addendum to Petition 5 of 8 ©2006 Nevada Supreme Court Revised December 14, 2006 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ____________________________________ (Signature of Petitioner) /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// ___________________________________ (Signature of Co-Petitioner) _____________________________________________________________________________ (If you need more space, you may attach additional pages. Be sure the pages clearly indicate they are a continuation of this portion of the pleading.) Dated ______________________________ Dated ______________________________ Minor Addendum/Temporary Minor Addendum to Petition 6 of 8 ©2006 Nevada Supreme Court Revised December 14, 2006 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 STATE OF NEVADA STATE OF NEVADA VERIFICATION OF PETITIONER ) ) COUNTY OF __________________) I, (your name) ______________________________________, being first duly sworn under penalty of perjury, hereby depose and say: That I am the Petitioner in the within action; that I have read the foregoing Addendum to the Petition For Guardianship Requesting Immediate Temporary Guardianship and know the contents thereof; that the same is true of my knowledge except as to those matters therein stated upon information and belief and as to those matters, I believe them to be true. ___________________________________ Petitioner SIGNED and SWORN to before me by (Petitioner’s name) _________________________ on the _____ day of ____________________, _____. _________________________________ NOTARY PUBLIC ACKNOWLEDGMENT OF PETITIONER ) ) COUNTY OF __________________) On this ______day of ________________, _________, before me, the undersigned Notary Public in and for the said County and State, personally appeared (your name) _________________ ___________________________ known to me to be the person described in and who executed the foregoing instrument, and who acknowledged to me that he/she did so freely and voluntarily and for the purposes and uses and purposes therein mentioned. WITNESS my hand and official seal. __________________________________ NOTARY PUBLIC Minor Addendum/Temporary Minor Addendum to Petition 7 of 8 ©2006 Nevada Supreme Court Revised December 14, 2006 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 STATE OF NEVADA STATE OF NEVADA VERIFICATION OF CO-PETITIONER ) ) COUNTY OF __________________) I, (co-petitioner’s name) ______________________________________, being first duly sworn under penalty of perjury, hereby depose and say: That I am the Co-Petitioner in the within action; that I have read the foregoing Addendum to the Petition For Guardianship Requesting Immediate Temporary Guardianship and know the contents thereof; that the same is true of my knowledge except as to those matters therein stated upon information and belief and as to those matters, I believe them to be true. ___________________________________ Co-Petitioner SIGNED and SWORN to before me by (Co-Petitioner’s name) _________________________ on the _____ day of ____________________, _____. _________________________________ NOTARY PUBLIC ACKNOWLEDGMENT OF CO-PETITIONER ) ) COUNTY OF __________________) On this ______day of ________________, _________, before me, the undersigned Notary Public in and for the said County and State, personally appeared (co-petitioner’s name) _____________________________________ known to me to be the person described in and who executed the foregoing instrument, and who acknowledged to me that he/she did so freely and voluntarily and for the purposes and uses and purposes therein mentioned. WITNESS my hand and official seal. __________________________________ NOTARY PUBLIC Minor Addendum/Temporary Minor Addendum to Petition 8 of 8 ©2006 Nevada Supreme Court Revised December 14, 2006
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6/16/2008
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