Decree And Order Of Appointment Of Guardian Of Minor {MPC 740}

DECREE AND ORDER OF APPOINTMENT OF GUARDIAN of a MINOR In the Interests of: First Name Middle Name Docket No. Commonwealth of Massachusetts The Trial Court Probate and Family Court Division Last Name A MINOR Upon the Petition for Appointment of Guardian of , after hearing on (date) (date) filed , the Court FINDS THAT: is a minor whose date of birth is (date) . (hereinafter referred to as "Parent One") (hereinafter referred to as "Parent Two") is the Minor's is the Minor's Venue is proper. The minor child, who is over age 14, nominated said guardian. Parent One consented to said petition. Parent Two consented to said petition. Parent One, after proper notice, did not object to said petition. Parent Two, after proper notice, did not object to said petition. Parent One's parental rights have been terminated. Parent Two's parental rights have been terminated. Parent One is deceased. Parent Two is deceased. Parent One, after hearing, is found to be currently unfit mother mother father father unavailable to parent said Minor for the following reasons: Parent Two, after hearing, is found to be currently unfit unavailable to parent said Minor for the following reasons: IT IS THEREFORE ORDERED AND DECREED that the following person(s) is/are appointed as Guardian of said Minor 1. Name: First Name M.I. Last Name (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: MPC 740 (5/30/11) American LegalNet, Inc. www.FormsWorkFlow.com page 1 of 3 Docket No. In the Interests of: First Name Middle Name Last Name 2. Name: First Name M.I. Last Name (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: The Court directs the issuance of Letters of Appointment of Guardianship as follows: The Letters shall expire on: the Minor's 18th birthday or (date) The powers and duties of the Guardian are unrestricted, except the Guardian may not consent to extraordinary medical treatment pursuant to G.L. c. 190B, §5-306A The powers and duties of the Guardian are limited by the following restrictions: IT IS FURTHER ORDERED THAT: 1. The Guardian(s) shall notify the Court in writing within 30 days of any changes to his/her home address, or telephone number or of that of the Minor. 2. The Guardian(s) shall, on or before one year from the date of this decree, and annually thereafter, file an Annual Report of Guardian. Failure of the Guardian(s) to do so may result in the revocation of this Decree. 3. The Guardian(s) is/are prohibited from permanently removing the child from the Commonwealth without an order of the Court. 4. The Guardian shall serve: without surety on his,her, or their bond: because the minor has no estate for the following good cause with personal sureties corporate surety on his/her/their bond in the amount of pursuant to G.L. c. 190B, §5-410 5. Parent One shall have the following rights to contact with the minor child: Parent Two shall have the following rights to contact with the minor child: MPC 740 (5/30/11) American LegalNet, Inc. www.FormsWorkFlow.com page 2 of 3 Docket No. In the Interests of: First Name Middle Name Last Name 6. Parent One shall pay child support in the amount of by wage/suspended wage assignment. Parent Two shall pay child support in the amount of by wage/suspended wage assignment. $ $ beginning (date) beginning (date) 7. The parties shall comply with a stipulation or agreement dated which is filed with the Court and expressly made part of this Order. (date) , 8. Other: Date JUSTICE OF THE PROBATE AND FAMILY COURT MPC 740 (5/30/11) American LegalNet, Inc. www.FormsWorkFlow.com page 3 of 3