Declaration of Guardian (California)
This is a declaration of guardian of a minor (California). The form provided here is simply a sample of what the actual form looks like.
SUPPLEMENTAL ATTACHMENT TO PETITION FOR CHANGE OF NAME
(Declaration of Guardian)
Supplemental Attachment to Petition for Change of Name (Form NC-100)
PETITION OF (Name of petitioner or petitioners): ______________________
CASE NUMBER: __________________________
DECLARATION OF GUARDIAN
(If you are petitioning as a guardian of a minor, you must use a separate supplemental attachment for each minor whose name is to be changed.)
7.a. Petitioner (name): __________________________
b. Petitioner's address (street, city, county, and zip code): __________________________
c. Petitioner is the guardian of the following minor whose name is to be changed:
(1) Name (present name of child): __________________________
(2) Address:
Street __________________________
City __________________________
County __________________________
Zip Code __________________________
d. Petitioner was appointed guardian of the minor identified in item 7c by (specify):
(1) Superior Court of California, County of (name): ____________________
(2) Department (check one): ____ Juvenile ____ Probate
(3) Case number (specify): __________________________
(4) Date of appointment (specify): __________________________
e. The grandparents of the minor whose name is to be changed are (provide names and addresses, if known):
(1) Grandfather (name): __________________________
(address):
Street __________________________
City __________________________
State __________________________
Zip Code __________________________
(2) Grandmother (name): __________________________
(address):
Street __________________________
City __________________________
State __________________________
Zip Code __________________________
(3) Grandfather (name): __________________________
(address):
Street __________________________
City __________________________
State __________________________
Zip Code __________________________
(4) Grandmother (name): __________________________
(address):
Street __________________________
City __________________________
State __________________________
Zip Code __________________________
f. The minor identified in item 7c is likely to remain under the guardian's care until the minor reaches the age of majority because (explain):
__________________________
____ Continued (if you need additional space, check the box, prepare an Attachment 7f, and attach it to this declaration).
g. The minor identified in item 7c is not likely to be returned to the custody of his or her parents because (explain):
__________________________
____ Continued (if you need additional space, check the box, prepare an Attachment 7g, and attach it to this declaration). Other relevant information about the guardianship and why the proposed name change is in the best interest of the minor (specify):
__________________________
____ Continued (if you need additional space, check the box, prepare an Attachment 7h, and attach it to this declaration).
I declare under penalty of perjury under the laws of the State of California that the information in the foregoing declaration is true and correct.
Date: __________________________
__________________________ (TYPE OR PRINT NAME)
__________________________ (SIGNATURE OF PETITIONER)
Guardian of (name of minor): __________________________