Free State of Minnesota - Minnesota

State of Minnesota
County

District Court
Judicial District: Court File Number: Case Type: Juvenile

Select County

In the Matter of the Welfare of the Child(ren) of: Parent Parent
To:

Legal Custodian Legal Custodian

Notice of Motion and Motion to Intervene as a Party

The Court The Parties or, if represented, their attorneys

Please take notice that pursuant to Rule 23.02 of the Rules of Juvenile Protection Procedure, on ______________________ at ______ o'clock __.m. at the Date Time Name of Building courthouse or government center located at Street Address in the City of __________________________, Minnesota, I will ask the court for an order City granting me permission to intervene as a party in this matter. 1. My name is: First Name My address is: Street Address City 2. State Apt. No. Zip Code Last Name

,

My relationship to the child(ren) is as follows (explain your relationship to the child(ren), such as foster parent, adoptive parent, relative, school district, friend of the family):

3.

I wish to intervene as a party, and my intervention is in the best interests of the child(ren), because (explain why you want to become a party and why that would be best for the child(ren) involved):

4.

At the hearing on this matter other parties will have the right to object to my intervention as a party.

Dated: Petitioner `s Signature

CHP402

State

ENG

Rev 7/04-D

www.courts.state.mn.us/forms

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