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Declaration Of Proposed Guardian PGF-1 - California
| Declaration Of Proposed Guardian Form. This is a California form and can be used in Probate San Francisco Local County . |
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1 2 3 4 5 6 7 Proposed Guardianship of 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 PGF-1 (Revised 2/11) - CONFIDENTIAL - SUPERIOR COURT OF CALIFORNIA COUNTY OF SAN FRANCISCO Case No.: Confidential Declaration of Proposed Guardian (name of the child (ren)): Please complete the following questions for each person applying for guardianship. (1) Why can't the parents care for the child(ren)? (2) Do the parents agree that you can be the guardian? Yes Not sure No If No, or Not sure, explain: (3) Your full legal name: Your date of birth: / / -CONFIDENTIAL- 1 American LegalNet, Inc. www.FormsWorkFlow.com 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 26 27 28 Your education (last grade completed): Your current job title : Are you in good health: If No, explain: Yes No (4) Are you already a guardian to any other child(ren)? Yes No If Yes, list the county where you are a guardian and the names of the child(ren) you are guardian to: (5) Tell us about everyone who lives in your household, or has frequent contact with the child(ren) . If you need more room, list additional names and information on a separate sheet of paper and attach after the last page of the declaration: Complete Legal Name Date of Birth Relationship Social Security No. Driver's License No. (6) Who has/have the child (ren) lived with since birth? List addresses; relationship, and dates. PGF-1 (Revised 2/11) CONFIDENTIAL- 2 American LegalNet, Inc. www.FormsWorkFlow.com 1 2 3 4 5 6 (7) Does/do the child(ren) have any special emotional, psychological, educational Yes No or physical needs? If Yes, explain, what the needs are and what you would do to meet the needs: (8) 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 (11) (10) (9) Will the child(ren) need day care? Yes No If Yes, give information about the child (ren)'s day care provider: Name of day care provider: Day care address: Day care Telephone number: Is/are the child(ren) in school? Yes No If Yes, give information about the child's school: Name of school: School address: School Telephone number: Will the child(ren) have his or her own room in your house? Yes No If No, explain who the child will share a room with. Will you get or ask for financial support to help take care of the child(ren)? Yes No If Yes, explain type of financial support. PGF-1 (Revised 2/11) CONFIDENTIAL- 3 American LegalNet, Inc. www.FormsWorkFlow.com 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 26 27 28 (12) Do you or does anyone in your home have an arrest record? Yes No If yes, say what the charges were, the date and place of offense, and how the case ended, such as "guilty", or "case dismissed". (13) Is/are the child(ren) involved in any other court case? This can be in Juvenile Yes No Court, Family Court or any other court. If Yes, please state which Court, and why. (14) Have you, or anyone who lives with you, had any contact with Child Yes No Protective Services of the Department of Human Services? If Yes, explain: (15) Where does/do the child(ren) get health care? Name of the child(ren)'s doctor or clinic: (16) Please attach a copy of the child(ren)'s birth certificate. I declare under penalty of perjury under the laws of the State of California that the above information is true and correct. Dated: Signed: Your name (Type or print) PGF-1 (Revised 2/11) CONFIDENTIAL- 4 American LegalNet, Inc. www.FormsWorkFlow.com
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