CIVIL FORMS Supreme Court
Approved
4-981 October 14,
2004
[ NEW MATERIAL ]
4-981
[Simplified petition, Kinship
Guardianship Act, Sections
40-10B-1 to 40-10B-14 NMSA 1978] 1
STATE OF NEW MEXICO
COUNTY OF _______________
___________________ JUDICIAL DISTRICT
No. ____________
_____________________________, Petitioner 2
v.
_______________ and ______________, Respondents 3
IN THE MATTER OF THE KINSHIP GUARDIANSHIP
OF ______________________, born ___________ 4
PETITION FOR ORDER APPOINTING
KINSHIP GUARDIAN 5
1. INFORMATION ABOUT THE PETITIONERS (the persons filing this
petition requesting to be appointed to serve as a Kinship guardian.)
A. The [petitioner is] [petitioners are] are the child's 2
:
[ ] maternal [grandparents] [grandparent] (child's mother's
parents);
[ ] paternal [grandparents] [grandparent] (child's father's
parents);
[ ] aunt;
[ ] uncle;
[ ] brother;
[ ] sister;
[ ] a family member: ___________________________ ( describe
the family relationship);
[ ] an adult with whom the child has a significant bond:
_____________________________________ ( describe the
relationship)
B. The petitioner or petitioners reside at:
CIVIL FORMS Supreme Court
Approved
4-981 October 14,
2004
[ NEW MATERIAL ]
__________________________________ (street address)
__________________________________ (city, state, zip code)
__________________________________ (telephone)
__________________________________ (fax number, if any)
C. Venue is proper because the child or children reside in this county or
this county is the legal residence of the child or children.
(Check applicable alternative.)
D. [ ] The above named child has lived with the petitioner or
petitioners for ninety (90) or more days immediately preceding
the filing of this petition.
[ ] Each respondent has consented to the appointment of kinship
guardians. The consent forms are attached to this petition. 6
E. The petitioner or petitioners accept the duties and responsibilities of
guardianship, including providing for the care, maintenance and
supervision of the child.
F. The above child is not an Indian child and is not subject to provisions
of the federal Indian Child Welfare Act. 5
2. REQUEST FOR COURT TO NAME PETITIONERS AS
KINSHIP GUARDIANS OF A MINOR CHILD
The petitioners request the court to enter an order appointing the
[petitioner] [petitioners] as [guardian] [guardians] of the following child of
___________________ 7
(father) and ___________________ 7
(mother) , who are
the respondents in this case: (List the name and the date of birth of the child
and each address of the child for the last five (5) years. Use a separate sheet if
necessary.) 8
Name: _____________________________ (last name, first and middle)
Date of birth: ______________________
Place of birth: __________________________________
Present address:
________________________________ (street)
________________________________ (city)
________________________________ (state and zip code)
Next previous address:
________________________________ (street)
________________________________ (city)
CIVIL FORMS Supreme Court
Approved
4-981 October 14,
2004
[ NEW MATERIAL ]
________________________________ (state and zip code)
Next previous address:
________________________________ (street)
________________________________ (city)
________________________________ (state and zip code)
3. INFORMATION ABOUT THE CHILD'S PARENTS
A. Information about mother:
(Check each applicable statement.)
[ ] _________________________ (mother's name) is the mother of
the child. Her current address is _______________________
(City, county and state and zip code) .
[ ] The mother is living and has consented in writing 9
to [my]
[our] appointment as kinship guardian. ( Attach consent form
signed by child's mother. )
[ ] The mother is deceased. (Attach death certificate to this
Petition.)
[ ] The mother is living but her parental rights have been
terminated by an earlier court order. (Attach a copy of the
court order to this Petition.)
B. Information about father:
(Check each applicable statement.)
[ ] _________________________ (father's name) is the father of
the child. His current address is ________________________
(City, county and state and zip code) .
[ ] The father is living and has consented in writing 6
to [my] [our]
appointment as kinship guardian. ( Attach consent form signed
by child's father. )
[ ] The father is deceased. (Attach death certificate to this
petition.)
[ ] The father is living but his parental rights have been
terminated by an earlier court order. (Attach a copy of the
CIVIL FORMS Supreme Court
Approved
4-981 October 14,
2004
[ NEW MATERIAL ]
court order to this petition.)
[ ] Although the petitioner believes __________________ (name of
alleged father) of the child, he has not acknowledged that he is
child's father.
[ ] The name of the father of the child is not known by the
petitioners because: (explain) ___________________________.
4. INFORMATION ABOUT OTHER CASES (complete if applicable)
A. The following divorce, separation, order of protection, child support,
paternity, abuse or neglect 10
cases have been previously filed involving
the above parents:
(complete if known)
Type of Case Year Filed Case Number Where Filed
__________ __________ ___________ __________
__________ __________ __________ __________
B. (Complete if applicable.) The following persons, other than the
petitioner or petitioners or the parents of the [child] [children], have
or claim to have custody of the [child] [children] or visitation rights to
the [child] [children]:
(List names of each guardian, custodian or person with visitation rights
and circle applicable claim.)
_________________________ (name ) [guardian] [custody] [visitation]
_________________________ (name ) [guardian] [custody] [visitation]
_________________________ (name ) [custody] [visitation]
5. CHILD OVER FOURTEEN (14) YEARS OF AGE OR MARRIED
(complete if applicable)
____________________ (name of child) was born on ________________ (date
of birth) and at the time of the hearing on this petition will be at least
fourteen (14) years of age.
__________________ (name of child) :
(check if applicable)
[ ] has signed an affidavit nominating _______________________ (name
of person nominated) to be appointed as guardian. A copy of the
signed nomination is attached and made a part of this petition. 11
[ ] has been served with a copy of this petition and a copy of the
nominating petition, but has failed or refused to sign the nomination
form.
CIVIL FORMS Supreme Court
Approved
4-981 October 14,
2004
[ NEW MATERIAL ]
[ ] is married.
[ ] is not married.
6. CHILD SUPPORT
(check applicable alternative)
[ ] [I] [We] request that the court enter a child support order ordering
______________________ (name of parent or parents) to pay child
support 12
.
[ ] [I] [We] do not request child support.
STATE OF NEW MEXICO }
}ss
COUNTY OF ________________ }
The [petitioner was sworn and states] [petitioners were sworn and state]: [I] [We]
have read this petitioner and it is true to the best of [my] [our] knowledge and
belief. [I] [We] understand that [I] [We] can be punished both civilly and
criminally if any information in this petition is false.
_________________________
Date
________________________________
Signature of Petitioner
________________________________________
Signed and sworn before me on this ____ day of ______________, ______.
Notary public
_________________________________
My commission expires: _______________________.
USE NOTES
1. Civil Forms 4-981 to 4-991 NMRA may be used in the district courts of this
State by persons who are representing themselves in uncontested kinship
guardianship proceedings. Civil Forms 4-981 to 4-991 NMRA are not
required to be used. Parties represented by an attorney may use other forms
CIVIL FORMS Supreme Court
Approved
4-981 October 14,
2004
[ NEW MATERIAL ]
that serve the same purpose.
2. The petitioner must be a spouse, parent, stepparent, godparent, brother,
sister, stepbrother, stepsister, half - brother, half - sister, uncle, aunt, niece,
nephew, first cousin or any person denoted by the prefix "grand" or
"great", the spouse or former spouse of the child or an adult with whom the
child has a significant bond. See Section 40-10B-5 NMSA 1978 for persons
who may file as a petitioner pursuant to the Kinship Guardianship Act.
3. Unless the child's parent is deceased or the parent's parental rights have
been terminated, the parent must be joined as a respondent. This petition
must be served on each parent of the child in the manner provided by Rule
1-004 NMRA for personal service to Rule 1-004 NMRA, unless:
(a) a consent form has been signed by the parent;
(b) the parent is deceased and a death certificate is attached to this
petition at the time it is filed;
(c) the parent's rights as a parent have been terminated by a court order
and a copy of the order is attached to this petition at the time it is
filed.
Civil Form 4-982 NMRA, "Kinship Guardianship Summons" has been
provided for use with this petition.
4. Insert the name or the initials of the minor child and the child's birthdate.
This form may be modified to include additional minor children. The name
of a child shall not be made available to the public on the internet.
5. This form cannot be used without revision if the child is an Indian child. In
these cases, the form of the petition and the manner of notice must comply
with federal law. The Indian Child Welfare Act, 25 U.S.C. Section 1901 et
seq., defines "Indian child" as follows:
"Indian child" means any unmarried person who is under age
eighteen and is either (a) a member of an Indian tribe or (b) is eligible
for membership in an Indian tribe and is the biological child of a
member of an Indian tribe.
(25 U.S.C. Section 1903(4)). If the child is enrolled or is eligible for
enrollment in an Indian tribe, the form of the petition and the manner of the
notice must comply with federal law. The parent or Indian custodian of an
Indian child may have the right to have the child returned upon demand as
may be determined by tribal law or custom.
6. See Forms 4-985 or Form 4-986 NMRA for parental consent forms.
CIVIL FORMS Supreme Court
Approved
4-981 October 14,
2004
[ NEW MATERIAL ]
7. If the parent is deceased, insert "deceased" instead of address and check the
"deceased" box. A copy of the death certificate must be attached to this
petition.
8. Section 40-10A-209 NMSA 1978 of the Uniform Child-Custody Jurisdiction
Enforcement Act requires the first pleading of every custody action to give
information under oath as to the child's present address, the places where
the child has lived within the last (five) 5 years and the names and present
addresses of the persons with whom the child has lived during that period.
9. Attach a copy of each parent's Verified Parental Consent to Appointment of
Guardian and Waiver of Service of Process to this petition. See Civil Forms
4-985 and 4-986 NMRA.
10. If an abuse or neglect or other proceeding has been filed by the Children,
Youth and Families Department, that department must file a consent to the
appointment of petitioners as Kinship Guardians. Attach a copy of such
consent to this petition.
11. If the child is fourteen (14) years of age or older, the child must be served
with a copy of this Petition or a copy of the Nomination of Guardian Form,
Civil Form 4-983 NMRA, must be attached to this Petition at the time it is
filed.
12. The child's mother may be ordered to pay child support. The respondent
named as the child's father may be ordered to pay child support if the
respondent father has admitted paternity or paternity has been established
by another proceeding. See Civil Forms 4A-331 and 4A-332 NMRA for a
petition to establish paternity and a final decree of paternity.
[Provisionally approved, effective August 15, 2003 until August 31, 2004; approved
effective October 14, 2005.]
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