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                       F L -9 35ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address) or GOVERNMENTAL AGENCYFO R C O URT U SE O NLYT E LE PH O NE N O .:F A X N O . ( O ptio nal) :E -M AIL A D DR ESS ( O ptio nal) :A TTO RNEY F O R ( N am e):S U PER IO R C O UR T O F C ALIF O RN IA , C O UNTY O FSTR EET A D DR ESSM AIL IN G A D D RESSC IT Y A N D Z IP C O DEBR AN CH N AM EC HIL D 'S N AM E:PETIT IO NER :RESPO NDEN T:O TH ER P AR EN T:APPLICATION AND ORDER FOR APPOINTMENT OF GUARDIAN AD LITEM OF MINOR-FAMILY LAWCASE NUMBERSEX P A RTEN O TE : T his f o rm i s f o r u se i n f a m ily l a w p ro ceed in gs w it h t h e e x cep tio n o f d is so lu tio n p ro ceed in gs. F or a p poin tm en t o f a g u ard ia n a d l it e m i n c iv il p ro ceed in gs, u se f o rm 9 82(a )(2 7). F or a p poin tm en t o f a g uard ia n a d l it e m i n p ro bate pr o ceed in gs, u se f o rm D E-3 50/G C-1 00.1. I (name):am t h ea.a tto rn ey f o r(1 )m in or.(2 )p are nt o f t h e m in or.(3 )o th er in te re ste d p e rs o n ( s p ecif y n am e a nd r e la tio nsh ip ):b .pare nt o f t h e m in or.c .o th er in te re ste d p e rs o n.d.m in or ( a nsw er a ll t h at a pply t o y o u): (1 ) M y d a te o f b ir th is ( s p ecif y ):(2 ) I liv e w it h m ymoth erfa th erle gal g uard ia noth er ( s p ecif y n am e a nd r e la tio nsh ip ):( 3 ) M y m oth er's n a m e is ( s p ecif y ):, a nd h er a ddre ss is :(4 ) M y f a th er's n a m e is ( s p ecif y ):, a nd h is a ddre ss is :(5 )I h ave a le gal g uard ia n. M y le gal g u ard ia n's n am e is ( s p ecif y ):, a nd h iso r h er a d dre ss is :T he g uard ia nsh ip w as e sta blis h ed in : C ounty , c a se n o. ( if k n ow n): 2. I a sk t h e c o urt t o a ppoin t t h e f o ll o w in g p ers o nas g uard ia n a d lit e m f o r t h e m in or ( s ta te n am e, a ddre ss, a nd t e le phone n o.) - 3 . T he r e la tio nsh ip o f t h e p ers o n lis te d in it e m 2 t o t h e m in or isa .p are ntb.o th er ( s p ecif y ):4 . A ppoin tm ent o f a g uard ia n a d lit e m is n ece ssa ry b eca use ( s p ecif y ):C ontin ued o n A tta ch m ent 4 ( d escrib e in d eta il, a tta ch a ddit io nal p ages if n ece ssa ry ).P age 1 o f 2Form Approved for Optional Use Judic ia l C ouncil o f C alif o rn ia FL -9 35 [N ew J a nuary 1 , 2 004)A PPLIC ATIO N A ND O RDER F O R A PPO IN TM EN T O F GUARDIA N A D L IT E M O F M IN O R-F A M IL Y L A WCode of Civil Procedure, 373 Fam ily C ode, § 7 635ele ctr o nic f o rm  2 004 WWW.LawCA.com La w P ublis h ers         C HIL D 'S N AM E:CASE N UM BER SP ETIT IO NER :RESPO NDEN T:O TH ER P AR EN T:5 . T he p ro pose d g uard ia n a d lit e m is f u lly c o m pete nt t o u nders ta nd a nd p ro te ct t h e r ig hts o f t h e m in or a nd h as n o in te re sts c o nflic tin g wit h t h ose o f t h e m in or.D ate :(T Y PE O R P R IN T N AM E)(S IG NATU RE O F A PPLIC AN T)CONSENT TO ACT AS GUARDIAN AD LITEMI c o nse nt t o t h e a ppoin tm ent a s g u ard ia n a d lit e m a nd a gre e t o a ssu m e t h e r e sp onsib ilit ie s.D ate :(T Y PE O R P R IN T N AM E)(S IG NATU RE O F P R O PO SED G UAR DIA N )C O NSEN T T O G UARDIA N B Y M IN O R 1 4 Y EA RS O F A G E O R O LD ERI, ( n am e):y e ars o f a ge a nd h ere by n om in ate( n am e):, a m ( s p ecif y a ge): to b e m y g uard ia n a d lit e m t o r e pre se nt m y in te re sts f o r t h ere aso ns s e t f o rth in it e m s 4 a nd 5 o f t h is a pplic a tio n.D ate :(T Y PE O R P R IN T N AM E)(S IG NATU RE O F P ETIT IO NER )O RDEREX P A RTETH E C O URT F IN DS It is r e aso nable a nd n ece ssa ry t o a p poin t a g uard ia n a d lit e m f o r t h e p ers o n n am ed in t h e a pplic a tio n, a s r e queste d a bove .T H E C O URT O RDER S t h at ( n am e):lit e m o f ( n am e):is h ere by a ppoin te d g uard ia n a d for t h e p urp ose s h e re in above s e tfo rth in it e m 4 o f t h e p etit io n.A pplic a tio n f o r A pp oin tm ent o f G uard ia n a d L it e m f ile d ( d ate ):a .is d enie d.b.is g ra nte d.c.is s e t f o r h earin g o n ( d ate ):a t ( tim e):D ate :JU DIC IA L O FFIC ERSIG NATU RE F O LLO W S L A ST A TTA C HM EN TFL-935 [New January 1, 2004]A PPLIC ATIO N A ND O RDER F O R A PPO IN TM EN T O F GUARDIA N A D L IT E M O F M IN O R-F A M IL Y L A WPage 2 o f 2e le ctr o nic f o rm  2 004 WWW.LawCA.com La w P ublis h ers