H1539B3311A06458 BIL:NLG 04/12/18 #90 A06458
AMENDMENTS TO HOUSE BILL NO. 1539
Sponsor: REPRESENTATIVE TOOHIL
Printer's No. 3311
Amend Bill, page 15, line 8, by inserting after "GUARDIAN."
The petition, which shall require the notarized signature of
the petitioner, shall be provided by the court in the following
form:
Petition for Temporary Guardianship without Consent of Parent
I, . . . . . . . . . . . . . . . . . . . . . . . . . .
(Insert Name, Address and Telephone Number of Family Member
Petitioning for Temporary Guardianship and Relationship to
Minor), HEREBY DECLARE MY INTENT TO BE APPOINTED TEMPORARY
GUARDIAN OF . . . . . . . . . . . . . . . . . . . . . . . .
(Insert Name(s), Address(es) and Telephone Number(s) of Minor(s)
for whom the appointment of temporary guardian is being sought)
AS A RESULT OF EMERGENCY MEDICAL INTERVENTION RESULTING FROM
ABUSE OF DRUGS OR ALCOHOL BY . . . . . . . . . . . . . . . . . .
. . . . . (Insert Name, Address and Telephone Number),
FATHER/MOTHER TO . . . . . . . . . . . . . . . . . . .(Insert
Name(s) of Minor(s)), ON . . . . . . . . . . . (Insert
approximate date of the event).
I HAVE NOTIFIED THE CHILD(REN)'S OTHER PARENT,. . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . (Insert Name,
Address and Telephone Number), OF MY INTENT TO PETITION THIS
COURT FOR TEMPORARY GUARDIANSHIP.
I UNDERSTAND THAT FILING THIS PETITION DOES NOT REVOKE THE
PARENTAL RIGHTS OF THE MINOR'S PARENT(S) NOR DOES IT GRANT ME
ANY PARENTAL RIGHTS.
I UNDERSTAND THAT MY RIGHTS AND RESPONSIBILITIES AS A
TEMPORARY GUARDIAN TOWARD THE MINOR CHILD(REN) NAMED ABOVE WILL
BECOME EFFECTIVE UPON THE COMPLETION OF A HEARING AND RENDERING
OF A DECISION BY THE COURT.
I UNDERSTAND THAT FILING FEES AND OTHER COSTS ASSOCIATED WITH
THESE PROCEEDINGS MAY BE WAIVED IF I DEMONSTRATE THE FEES AND
OTHER COSTS WOULD CONSTITUTE A FINANCIAL BURDEN TO ME AND MY
FAMILY.
I HEREBY SWEAR OR AFFIRM THAT THE INFORMATION CONTAINED
HEREIN IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
. . . . . . . . . . . . . . . . . . . . . . . . . .
(DATE) (SIGNATURE OF PETITIONER)
2018/90BIL/HB1539A06458 - 1 -
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