4A-517. Kinship guardianship information sheet.
KINSHIP GUARDIANSHIP INFORMATION SHEET.
NOTE TO CLERK: DO NOT FILE THE INFORMATION SHEET
Type or print responses. Use only for kinship guardianship cases.
1. Petitioner’s attorney information. (Complete only if Petitioner has an attorney.)
Petitioner’s name: |
________________________________________________________ |
Attorney’s name: |
________________________________________________________ |
Attorney’s address: |
________________________________________________________ |
City: |
________________________________________________________ |
State: |
________________________________________________________ |
Zip code: |
________________________________________________________ |
Telephone: |
________________________________________________________ |
Email address: |
________________________________________________________ |
2. Information regarding Petitioner(s) and Respondent(s). There may be multiple petitioners and respondents. Fill out the information for each petitioner and respondent. (Do not use an attorney’s mailing address. Use a separate sheet if necessary.)
Petitioner 1 |
Petitioner 2 (if applicable) |
Name: _______________________________ |
Name: ______________________________ |
(Last name, first, middle) |
(Last name, first, middle) |
Other names (e.g., maiden name): |
Other names (e.g., maiden name): |
_______________________________________ |
____________________________________ |
Address: ______________________________ |
Address: ____________________________ |
City: ____________________________ |
City: ____________________________ |
State: ___________________________ |
State: ___________________________ |
Zip code: ________ |
Zip code: ________ |
Email address: _________________________ |
Email address: _______________________ |
Date of birth: ______________________ |
Date of birth: ______________________ |
Social Security number: ____________ |
Social Security number: _____________ |
Respondent 1 |
Respondent 2 |
Name: _______________________________ |
Name: _______________________________ |
(Last name, first, middle) |
(Last name, first, middle) |
Other names (e.g., maiden name): |
Other names (e.g., maiden name): |
_______________________________________ |
_____________________________________ |
Address: ______________________________ |
Address: _____________________________ |
City: ____________________________ |
City: ____________________________ |
State: ___________________________ |
State: ___________________________ |
Zip code: ________ |
Zip code: ________ |
Email address: _________________________ |
Email address: ________________________ |
Date of birth: ______________________ |
Date of birth: ______________________ |
Social Security number: ____________ |
Social Security number: _____________ |
Respondent 3 (if applicable) |
Respondent 4 (if applicable) |
Name: _______________________________ |
Name: _______________________________ |
(Last name, first, middle) |
(Last name, first, middle) |
Other names (e.g., maiden name): |
Other names (e.g., maiden name): |
_______________________________________ |
_____________________________________ |
Address: ______________________________ |
Address: _____________________________ |
City: ____________________________ |
City: ____________________________ |
State: ___________________________ |
State: ___________________________ |
Zip code: ________ |
Zip code: ________ |
Email address: _________________________ |
Email address: ________________________ |
Date of birth: ______________________ |
Date of birth: ______________________ |
Social Security number: ____________ |
Social Security number: _____________ |
3. Minor children. (Provide the date of birth and social security number for each minor child. Use a separate sheet if necessary.)
Name: _______________________________ |
Name: ______________________________ |
(Last name, first, middle) |
(Last name, first, middle) |
Date of birth: ______________________ |
Date of birth: ______________________ |
Social Security number: ____________ |
Social Security number: _____________ |
Name: _______________________________ |
Name: ______________________________ |
(Last name, first, middle) |
(Last name, first, middle) |
Date of birth: ______________________ |
Date of birth: ______________________ |
Social Security number: ____________ |
Social Security number: _____________ |
Name: _______________________________ |
Name: ______________________________ |
(Last name, first, middle) |
(Last name, first, middle) |
Date of birth: ______________________ |
Date of birth: ______________________ |
Social Security number: ____________ |
Social Security number: _____________ |
[Adopted by Supreme Court Order No. 22-8300-020, effective for all pleadings and papers filed on or after December 31, 2022.]