Free Application for Appointment of Guardian at Litem in Stalking Action for Minor Child and Order - Oregon

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF ___________________

In the Matter of :

_____________________________, Petitioner,

and _____________________________, Respondent.

) ) ) ) ) ) ) ) ) ) )

Case No. ____________________

APPLICATION FOR APPOINTMENT OF GUARDIAN AD LITEM IN STALKING ACTION FOR MINOR CHILD and ORDER Under ORS 30.866

APPLICATION 1. I wish to file a Stalking Petition to protect the following minor Child: Name:____________________________________________________________ Age: __________________ Date of Birth:________________________ I am willing to serve as Guardian ad Litem in this matter and request that I be appointed. I am a suitable person for this appointment because:______________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ I am at least 18 years old and my relationship to the Child is (describe your relationship with the child and how you know the child): ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________
_______________________________________ Signature _______________________________________ Print or Type Name

2.

_________________________________________ Notary Public for _________________/Court Clerk My Commission Expires: ____________________
PAGE 1 of 2 APPLICATION FOR GUARDIAN AD LITEM
Stalking: AppGuardianAdLitem- Ver02 (5/09)

ORDER Application Granted Application Denied
DATE: _________________________ ______________________________________________ CIRCUIT COURT JUDGE

Certificate of Document Preparation. You are required to truthfully complete this certificate regarding the document you are filing with the court. Check all boxes and complete all blanks that apply: I selected this document for myself and I completed it without assistance. I paid or will pay money to __________________ for assistance in preparing this form. ______________________________________________________________________________ Signature of Petitioner Print Name ______________________________________________________________________________
Address or Contact Address City, State, Zip Telephone or Contact Telephone

I certify that this is a true copy: _________________________________ Petitioner's Signature

PAGE 1 of 2 APPLICATION FOR GUARDIAN AD LITEM
Stalking: AppGuardianAdLitem- Ver02 (5/09)