Nevada > County > Washoe > District Court > Family
Affidavit Of Consent To Guardianship By Minor Over 14 Years Of Age 3635 - Nevada
| Affidavit Of Consent To Guardianship By Minor Over 14 Years Of Age Form. This is a Nevada form and can be used in Family District Court Washoe County . |
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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 Code: 3635 Name: ___________________________________ Address: _________________________________ _________________________________ Telephone No. ____________________________ Appearing in Proper Person IN THE FAMILY DIVISION OF THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF WASHOE COUNTY In the Matter of the Guardianship of the Person of: ________________________________________ Case No. ________________________ ________________________________________ Dept. No. ________________________ ________________________________________ Minor child(ren), ward(s). _____________________________________________/ AFFIDAVIT OF CONSENT TO GUARDIANSHIP BY MINOR OVER 14 YEARS OF AGE STATE OF NEVADA ) ) ss. COUNTY OF _______________________ ) I, _______________________________________, being first duly sworn under penalties of (Name of person making this Affidavit) perjury, state: 1. I am _________ years old and was born on __________________________________. (Age) (Date of birth) I currently reside at _____________________________________________________ (Full address of current residence) 2. with __________________________________ and ______________________________________ (Names of adults with whom you reside) /// Revised 2005 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 3. That I have been living with ___________________________________________ and (Names of adults with whom you reside) ___________________________________ since ________________________________________ (Date you went to live at that address) 4. That it is my desire to have ____________________________________________ and (Name of guardian you wish to have appointed) ______________________________________________________ appointed as my guardian(s). (If there will be two guardians, the second name goes on this line) 5. That I believe it is in my best interests to be in the care and custody of those guardians whom I have named. 6. To my knowledge, the following person, agency or institution has been awarded custody of me by a Court of competent jurisdiction: _____________________________________ (If a Court has awarded any person or any ________________________________________________________. agency custody of you, please state who was awarded custody) DATED this _______ day of ________________________, 20______. ____________________________________________ (Your Signature) ____________________________________________ (Print Your Name) ____________________________________________ (Address) ____________________________________________ (City, State, Zip) ____________________________________________ (Telephone No.) SUBSCRIBED and SWORN to before me this _______ day of ________________________, 20______. ________________________________________ NOTARY PUBLIC Revised 2005 2 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 SECOND JUDICIAL DISTRICT COURT COUNTY OF WASHOE, STATE OF NEVADA AFFIRMATION Pursuant to NRS 239B.030 The undersigned does hereby affirm that the preceding document, (Title of Document) filed in case number: Document does not contain the social security number of any person 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 -ORDocument contains the social security number of a person as required by: A specific state or federal law, to wit: ______________________________________________________ (State specific state or federal law) -orFor the administration of a public program -orFor an application for a federal or state grant -orConfidential Family Court Information Sheet (NRS 125.130, NRS 125.230 and NRS 125B.055) Date: (Signature) (Print Name) 27 28 (Attorney for) Affirmation Revised December 15, 2006 American LegalNet, Inc. www.FormsWorkflow.com
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