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1 IN THE CHANCERY COURT OF _______________________ COUNTY, MISSISSIPPI IN THE MATTER OF THE TEMPORARY GUARDIANSHIP OF _______________________, A MINOR, AND _____________________, A MINOR CAUSE NO. _______________ PETITION FOR APPOINTMENT OF TEMPORARY GUARDIANS FOR MINORS Comes now ___________________________ (Petitioner), an adult resident citizen of _________________________________________________________ (street address, city, state and zip code) , and respectfully petitions this court, and for cause of petition would show unto the Court the following matters and facts, to-wit: 1. Petitioner is the __________________ (relation to minors) of ________________ ___________ (minor), who was born on _______________________ (date of birth), and _______________________________ (minor), who was born on ___________________ (date of birth) . Both minors presently reside with their mother, ______________________ (mother’s name) , at ______________________________________________________ (street address, city, state, zip code) . 2. The biological father of ________________________ (minor) is _________________________________ (father’s name), who resides at ____________ _____________________________________________________ (street address, city, state, zip code) . Said father and mother of ______________________________ (minor) never married. 3. The biological father of ________________________________ (minor) is not listed on the birth certificate of said minor child, has never acknowledged paternity, given financial or any other support to said minor child, voluntarily left the child in the custody of _______________________________ (mother’s name), the child's mother, and expressed an intent not to have anything to do with said child at the time of birth or in the future. The whereabouts of said biological father is unknown. Said mother and said biological father never married. 4. Petitioner resides at __________________________________________________ 2 (street address, city, state, zip code) at the present time with her husband, ______________________________________ (husband’s name). There are no persons, other than those mentioned above, who are interested in this proceeding. 5. _____________________________________ (mother’s name), the mother of said minor children, is ______________ years of age and recently joined the United States Job Corps program in order to get her high school diploma or GED. ______________________ (mother’s name) has also joined the United States Army in order to better herself and become a better mother and provider to her said two children. During the time of her first enlistment with the Military, she has asked her _______________ (relationship to mother) , the Petitioner, and the Petitioner's husband, to serve as temporary guardians of her two minor children. 6. Petitioner and her husband are parents of two children of their own Petitioner's husband __________________________ (husband’s name), is a member of the United States Army. Both Mr. and Mrs. __________________ (last name of petitioner and husband) are in excellent health, would be very capable and loving temporary guardians of these two minor children and are fit and proper persons to be appointed temporary guardians of the person and estate of the said minors. Said minors ___________________ (minor) and ____________________________ (minor) have no known health problems and appear to be in excellent health. 7. On or about _______________________ (date), Petitioner and her husband ______________________________ (husband’s name), will be moving to ___________ __________________, (city and state), and desire permission to carry said minors with them to their new residence. In accordance with § 93-13-63 of the Mississippi Code of 1972, as amended, Mr. and Mrs. ________________ (last name of petitioner and husband) will qualify as temporary guardians of said minors _______________________ (minor) and _________________________ (minor) pursuant to the laws of the State of Kansas. Neither minor owns any personal or real property or has any cash assets. Petitioner therefore requests that bond be waived. WHEREFORE, Petitioner prays that: 1. This Court issue a decree appointing _________________________ (Petitioner) 3 and her husband _____________________________ (husband’s name), as temporary guardians of _________________________ (minor) and ________________________ (minor) until such time as the mother of said minors, ________________________ Petitioner) , requests in writing that full custody be returned to her. 2. That ________________________ (Petitioner) and her husband _____________ ______________ (husband’s name) , as temporary guardians of ____________________ (minor) and _______________________ (minor), be granted authority to move said minors with them in _____________ (month) of ____________ (year) to their new residence in ______________________ (city and state), with the understanding that they will qualify as temporary guardians of said minors pursuant to the laws of the State of Kansas. 3. That no bond be required. 4. And if Petitioner has prayed for wrong or improper relief, then she prays for such other, further, or general relief as she may be entitled to in the premises. Petitioner Of Counsel: _________________________ (MSB No. ___________) Attorney at Law ____________________________________ (street address) __________________________ (city, state and zip code) Phone: 601-______-_______ Fax: 601-_______-_________ 4 STATE OF MISSISSIPPI COUNTY OF ________________Personally appeared before me, the undersigned authority at law in and for the aforesaid jurisdiction, __________________________ (Petitioner), who, after being first duly sworn, stated that the matters and things set forth in the above and foregoing Petition are true and correct as therein stated. Petitioner SWORN to and subscribed before me, this the ___ day of ______________, 20____. Notary Public My Commission Expires: _____________________

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