Fill and Sign the Nevada Ad Litem Form

- 1 -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 GAL (Your name)       (Address)             (Telephone)       In Proper Person DISTRICT COURT ____________ COUNTY, NEVADA In the Matter of the Application of       (Your name) and       (Your spouse’s name) for Change of Name of Themselves and for 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)       , (check one) mother/ father of (child(ren)’s name(s))             , pursuant to NRS 12.050, for (check one) - 2 -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 his/ her motion to be appointed as Guardian Ad Litem, respectfully shows: 1. That Petitioner is asking to be appointed Guardian Ad Litem for (first child’s name)       , a minor, age       born on (date)       , 2. That Petitioner is also asking to be appointed Guardian Ad Litem for (second child’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 at least 18 years old, and is willing to act as Guardian Ad Litem to appear and prosecute said action for the name change on behalf of (check one) his/ her child(ren). 4. That no general guardian, conservator, o other fiduciary has ever been appointed on 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 (first child’s name)       and (second child’s name or “N/A”)       , to appear and prosecute an action for a change of name on 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 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 VERIFICATION STATE OF NEVADA ) ) ss: COUNTY OF CLARK ) (Your name)       , under penalties of perjury, being first duly sworn, deposes and says: That I am the Petitioner in the above-entitled action; that I have read the foregoing Application for Appointment as Guardian Ad Litem and know the contents thereof; that the same is true of my own knowledge, except for those matters therein contained stated upon information and 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 before me this ______ day of (month) ___________, (year) ________. _________________________________ NOTARY PUBLIC /// /// /// /// /// /// /// - 4 -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 ACKNOWLEDGMENT STATE OF NEVADA ) ) ss: COUNTY OF CLARK ) On this _____ day of (month) _____________, ___________, before me, the undersigned Notary Public in and for the said County and State, personally appeared (your name)       , known to me to be the person described in and who executed the foregoing Application for Appointment as Guardian Ad Litem, and who acknowledged to me that (check one) he/ she did so freely and voluntarily and for the uses and purposes therein mentioned. WITNESS my hand and official seal. __________________________________ NOTARY PUBLIC /// /// /// /// /// /// /// /// /// /// ///