Draft Petition for Appointment of SBG by Parent or Legal Guardian

Petition for Appointment of Standby Guardian (By Parent or Legal Custodian)

SUPERIOR COURT OF THE DISTRICT OF COLUMBIA

FAMILY COURT

Domestic Relations Branch

IN RE:

v.

DR

Related Cases:

PETITION FOR APPOINTMENT OF STANDBY GUARDIAN

(By Parent or Legal Custodian)

I, , am the parent or legal custodian in this case and state that:

1. This Court has the authority to decide my petition for appointment of a guardian for minor children because [CHECK ONE]

Home State. The District of Columbia is the child(ren)’s “home state” because the child(ren) currently live(s) in the District of Columbia AND has/have lived in the District of Columbia for at least six months immediately before filing this Petition.

Home State. The child(ren) do not currently live in the District of Columbia, BUT the District of Columbia was the “home state” AND the child(ren) has/have been away from the District of Columbia for less than six months before the filing of this Complaint AND a parent or a person acting as a parent continues to live in the District of Columbia.

Significant Connections. There is no “home state” or the “home state” has declined to exercise jurisdiction on the grounds that the District of Columbia is the more appropriate forum AND the child(ren) and at least one parent or person acting as a parent has a significant connection with the District of Columbia AND there is substantial evidence available in the District of Columbia concerning the child(ren)’s care, protection, training and personal relationships.

More Appropriate Court. All courts with jurisdiction have declined to exercise their jurisdiction in favor of the District of Columbia because this is the more appropriate Court to determine standby guardianship of the child(ren).

No Other Court. There is no other court with jurisdiction to determine standby guardianship of the child(ren).

Temporary Emergency Jurisdiction. The District of Columbia is not the “home state” BUT the child(ren) is/are present in the District of Columbia AND the child(ren) has/have been abandoned OR it is necessary in an emergency to protect the child(ren) because the child(ren), or a sibling or parent of the child(ren), is/are subjected to or threatened with mistreatment or abuse.

2. I state the following about myself:

a. My name is

b. My address is

c. My date of birth is

d. My telephone number is

3. I am asking the court to appoint a standby guardian for my child(ren) because I suffer from a chronic disease, and might not recover. A medical diagnosis was made by on

4. I am asking the court to appoint the following person to serve as Standby Guardian of my children:

a. His/her name is

b. His/her address is

c. His/her date of birth is

d. His/her telephone number is

5. The names and birthdate(s) of my child(ren) is/are:

a.

b.

c.

d.

6. The Standby Guardian’s authority for my child(ren) will not take effect unless one of these triggering events happen:

My written acknowledgment of debilitation and consent to commencement of the standby guardianship; or

A determination by an Attending Clinician that I am physically or mentally unable to care for my child(ren); or

I die prior to the commencement of a judicial proceeding to appoint a guardian of my child(ren).

7. During the last five years, or since birth for child(ren) under five years old, each child has lived at the following address(es) with the following person(s):

8. I state the following about the child(ren)’s mother: [CHECK ONE]

The mother is the custodial parent [GO TO STATEMENT 12]

The mother is a non-custodial parent AND:

a. The mother’s name is

b. The mother’s address or whereabouts: [CHECK ONE]

the mother stays at

the mother’s whereabouts are unknown; her last contact with us was

c. The non-custodial mother: [CHECK ONE]

consents to my appointment as the child(ren)’s guardian.

is deceased, and I have attached the death certificate to this Petition.

has had her parental rights terminated by a judge.

does not consent.

has no known address.

is unknown.

9. I state the following about the child(ren)’s father: [CHECK ONE]

The father is a custodial parent [GO TO STATEMENT 13]

The father is a non-custodial parent AND:

a. The father’s name is

b. The father’s address or whereabouts: [CHECK ONE]

the father stays at

the father’s whereabouts are unknown; his last contact with us was

c. The non-custodial father: [CHECK ONE]

consents to my appointment as the child(ren)’s guardian.

is deceased, and I have attached the death certificate to this Petition.

has had his parental rights terminated by a judge.

does not consent.

has no known address.

is unknown.

10. I state the following about other cases involving the child(ren): [CHECK ONE]

There are no other cases concerning custody of or visitation with the child(ren), and there are no other cases that could affect this proceeding.

The following cases concern custody of or visitation with the child(ren), or involve one or both of the parties: [CHECK ALL THAT APPLY]

custody

abuse/neglect

access to children (visitation)

adoption

child support

divorce

domestic violence (civil)

domestic violence (criminal)

juvenile delinquency

mental health/retardation

paternity

termination of parental rights

11. I state the following about other persons not named as parties to this case: [CHECK ONE]

I do not know of any other person not already named as a party to this case who is physically caring for the child(ren) or who claims a right to legal custody of, physical custody of, or visitation with the child(ren).

The following person(s) not already named as a party to this case is/are physically caring for the child(ren), or claim a right to legal custody of, physical custody of, or visitation with the child(ren):

12. The standby guardian I have named is a fit and proper person to be named as standby guardian of the minor child(ren) AND I believe it is in the best interest of the minor child(ren) that this standby guardian be appointed.

Attachments

13. I have included the following attachment(s), as required by law:

A copy of the Designation.

The birth certificate(s) of the child(ren).

Proof that I am giving notice of this Petition and Hearing to the Defendants.

A consent to the appointment of the standby guardian signed by the other parent or a statement of any known reason explaining why that parent is not or should not be assuming responsibility for the child(ren).

Request for Relief

I RESPECTFULLY REQUEST that the Court appoint the person named in this petition as the Standby Guardian of my child(ren) named in this petition.

I ALSO REQUEST that the Court award any other relief it considers fair and proper.

14. [CHECK ONE]

I do not know of any proceedings in the District of Columbia or in any state or territory involving the same claim or subject matter as this case.

I do know of proceedings in the District of Columbia or in any state or territory involving the same claim or subject matter as this case, as listed on the first page of this Petition (“Related Cases”).

Respectfully Submitted,

I, , solemnly swear or affirm under criminal penalties for the making of a false statement that I have read the foregoing Petition for Appointment of a Standby Guardian and that the factual statements made in it are true to the best of my personal knowledge, information and belief.

RULE 4

CERTIFICATE OF SERVICE

WHEN YOU FILE YOUR PETITION FOR APPOINTMENT OF STANDBY GUARDIAN, THE FAMILY COURT CENTRAL INTAKE CENTER WILL GIVE YOU A SUMMONS THAT YOU MUST SERVE ON THE OTHER PARTY WITH A COPY OF YOUR PETITION.

YOU MUST SERVE THE OTHER PARTY BEFORE THE SUMMONS EXPIRES IN 60 DAYS.

IF YOU ARE UNABLE TO SERVE THE OTHER PARTY WITHIN THE 60 DAYS, YOU CAN ASK THE FAMILY COURT CENTRAL INTAKE CENTER TO GIVE YOU ANOTHER SUMMONS. THE SECOND SUMMONS IS CALLED AN “ALIAS SUMMONS.” YOU MUST ASK FOR THE ALIAS SUMMONS BEFORE THE FIRST SUMMONS EXPIRES.

HERE ARE THE WAYS YOU CAN SERVE YOUR PETITION AND THE SUMMONS:

• by having someone else, who is over 18 years old and not a party to the case (NOT you), hand it to the other party; or

• by having someone else, who is over 18 years old and not a party to the case (NOT you), leave a copy at the other party’s home with a person of suitable age and discretion who lives there; or

• by mailing it to the other party by certified mail, return receipt requested.

IF THE RETURN RECEIPT (“GREEN CARD”) COMES BACK TO YOU, FILE IT WITH THE FAMILY COURT CENTRAL INTAKE CENTER BY ATTACHING IT TO AN “AFFIDAVIT OF RETURN OF SERVICE BY CERTIFIED MAIL.”

AFTER YOU SERVE THE OTHER PARTY, YOU MUST COMPLETE THE CERTIFICATE OF SERVICE PORTION FOUND AT THE BOTTOM OF THE SUMMONS AND FILE IT WITH THE FAMILY COURT CENTRAL INTAKE CENTER.