Fill and Sign the District Court Petition to Seal Records Clark County Form

-1- 1 2 3 4 5 6 7 8 9 10 111213 14 15161718 19 20 21 22 23 24 25 GAL(Your name) (Address) (Telephone) In Proper Person DISTRICT COURT ____________ COUNTY, NEVADA In the Matter of theApplication of (Your name) and (Your spouse’s name) for Change of Name of Themselves andfor the Minor Children (First child’s name)and (Second child’s name) ) )))))))))))))))))))))))) CASE NO:DEPT. NO. APPLICATION FOR APPOINTMENT AS GUARDIAN AD LITEM COMES NOW, Petitioner, (your name) , (checkone) mother/ father of (child(ren)’s name(s)) , pursuant to NRS 12.050, for (check one) his/ her motion to be appointed as Guardian Ad Litem, respectfully shows: -2- 1 2 3 4 5 6 7 8 9 10 111213 14 15161718 19 20 21 22 23 24 25 1.That Petitioner is asking to be appointed Guardian Ad Litem for (first child’sname) , a minor, age born on (date) ,2.That Petitioner is also asking to be appointed Guardian Ad Litem for (secondchild’s name or “N/A”) , a minor, age born on (date) .3.That Petitioner is a competent person, is a resident of Clark County, Nevda, is atleast 18 years old, and is willing to act as Guardian Ad Litem to appear and prosecute said actionfor the name change on behalf of (check one) his/ her child(ren).4.That no general guardian, conservator, o other fiduciary has ever been appointedon behalf of the child(ren) and the child(ren) is/are not ward(s) of any court.WHEREFORE, Petitioner prays to be appointed as the Guardian Ad Litem for (firstchild’s name) and (second child’s name or “N/A”) , to appear and prosecute an action for a change of nameon their behalf and to act for them for the purpose of this action.DATED this day of (month) , (year) . Respectfully submitted:(Your signature) _____________________________(Your name) (Address) (Telephone) In Proper Person -3- 1 2 3 4 5 6 7 8 9 10 111213 14 15161718 19 20 21 22 23 24 25 VERIFICATION STATE OF NEVADA ) ) ss: COUNTY OF CLARK )(Your name) , under penalties of perjury, beingfirst duly sworn, deposes and says:That I am the Petitioner in the above-entitled action; that I have read the foregoingApplication for Appointment as Guardian Ad Litem and know the contents thereof; that the sameis true of my own knowledge, except for those matters therein contained stated upon informationand belief, and as to those matters I believe them to be true.DATED this day of (month) , (year) . By:(Your signature) ________________________(Your name) SUBSCRIBED and SWORN to beforeme this ______ day of(month) ___________, (year) ________._________________________________NOTARY PUBLIC///////////////////// -4- 1 2 3 4 5 6 7 8 9 10 111213 14 15161718 19 20 21 22 23 24 25 ACKNOWLEDGMENT STATE OF NEVADA ) ) ss: COUNTY OF CLARK )On this _____ day of (month) _____________, ___________, before me, theundersigned Notary Public in and for the said County and State, personally appeared (yourname) , known to me to be the person described in and whoexecuted the foregoing Application for Appointment as Guardian Ad Litem, and whoacknowledged to me that (check one) he/ she did so freely and voluntarily and for the usesand purposes therein mentioned.WITNESS my hand and official seal.__________________________________NOTARY PUBLIC/////////////////////////////////