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Fill and Sign the Ju 030710 Statement and Certification of Proposed Guardian Dclr Washington Form

Fill and Sign the Ju 030710 Statement and Certification of Proposed Guardian Dclr Washington Form

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SUPERIOR COURT OF WASHINGTON COUNTY OF _______________________ JUVENILE COURT GUARDIANSHIP OF: D.O.B.: NO: STATEMENT AND CERTIFICATION OF PROPOSED GUARDIAN (DCLR) I. STATEMENT The undersigned STATES that: 1. I am proposed as guardian for ___________________________________________________. 2. I am over twenty-one. 3. I am of sound mind. 4. I have never been convicted of a felony or misdemeanor involving moral turpitude. 5.  I am a resident of the state of Washington.  I am not a resident of the state of Washington. I have appointed __________________ (Name) as resident agent to accept service of process with respect to these proceedings. Dated:___________________________ _____________________________________________ Signature II. CERTIFICATION I certify under penalty of perjury under the laws of the state of Washington that the foregoing statement is true and correct. Dated at __________________________________ ( Place), Washington on _______________________(Date). _____________________________________________ Signature _____________________________________________ Type or Print Name _____________________________________________ Address _____________________________________________ _____________________________________________ Telephone STATEMENT AND CERTIFICATION OF PROPOSED GUARDIAN (DCLR) - Page 1 of 1 WPF JU 03.0710 (9/2000) - RCW 13.34.236

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