Petition for Appointment of Guardian ad Litem

Court Information

Court Name Case Number

Petitioner Information

Petitioner Name Petitioner Address

Minor/Person to be Represented

Name Date of Birth Address

Reason for Appointment

Briefly State the Reason for Request

Proposed Guardian ad Litem

Name Address Relationship to Minor (if any) Qualifications (if applicable)

Declaration

Declaration/Statement in Support

Signature

Petitioner Name (Signature) Date