Nh Petition Guardianship Form PDF Details

The NH Petition for Guardianship of a Minor is a comprehensive document designed to navigate the legal framework for establishing guardianship within New Hampshire. This form meticulously gathers critical information required by the judicial system to make informed decisions regarding the welfare of minors. It asks for detailed data about the petitioner, including their relationship to the minor, contact information, and any attorneys involved. Additionally, it requires information about the minor, including age, legal name, residence, and the status of the minor’s parents, specifying if both are deceased and detailing any living relatives. It uniquely considers the potential guardians’ relationship to the minor, their personal details, and their living situation, ensuring a thorough evaluation process. Further, the form addresses the minor's past living arrangements and any relevant legal proceedings in other states, aligning with the Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) to prevent jurisdictional conflicts. Other considerations include emergency situations, like a parent being an activated member of the Armed Services, and protective measures for the minor’s health, safety, or liberty. Additionally, it touches on potential adult cohabitants, contemplating their influence on the minor's environment and requiring criminal and DHHS record releases. Furthermore, the form probes into financial matters such as existing child support orders and the minor's entitlement to benefits, ensuring a holistic view of the minor's needs. This form plays a pivotal role in protecting the interests of minors by meticulously collecting comprehensive information to assist the court in its decision-making process.

QuestionAnswer
Form NameNh Petition Guardianship Form
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other namesguardianship nh expedited hearing form, dhhs nh guardianship, filing for guardianship in nh, form nhjb 2162 p petition for guardianship of minor

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THE STATE OF NEW HAMPSHIRE

JUDICIAL BRANCH

http://www.courts.state.nh.us

Court Name:

Case Name:

Case Number:

(if known)

PETITION FOR GUARDIAN OF MINOR

Guardianship is requested for:

Person

Estate

Person and Estate

 

1.

Petitioner name:

 

 

 

 

 

 

 

 

 

 

 

Relationship to minor:

 

 

 

 

 

 

 

 

 

 

 

Mailing address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

City

 

 

 

 

State

Zip code

 

Telephone:

 

 

E-mail:

 

 

 

 

 

 

 

 

Petitioner name:

 

 

 

 

 

 

 

 

 

 

 

Relationship to minor:

 

 

 

 

 

 

 

 

 

 

 

Mailing address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

City

 

 

 

 

State

Zip code

 

Telephone:

 

 

E-mail:

 

 

 

 

 

 

 

2.

Attorney name:

 

 

 

 

 

Telephone:

 

 

 

Firm name:

 

 

 

 

 

 

Bar ID #:

 

 

 

Mailing address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

City

 

 

 

 

State

Zip code

3.The minor is the age of fourteen years or older: Minor's legal name:

Date of birth: Mailing address:

Yes

No

 

 

 

 

Street

 

City

 

State

Zip code

4. Information about the minor's parents:

 

 

 

 

 

Father name:

 

 

 

Date of birth:

 

 

Mailing address:

 

 

 

 

 

 

 

 

 

Street

 

City

 

State

Zip code

Telephone:

 

 

E-mail:

 

 

 

 

Mother name:

 

 

 

Date of birth:

 

 

Mailing address:

 

 

 

 

 

 

 

 

 

Street

 

City

 

State

Zip code

Telephone:

 

 

E-mail:

 

 

 

 

NHJB-2162-FPe* (01/01/2018)

Page 1 of 6

Case Name:

Case Number:

PETITION FOR GUARDIAN OF MINOR

5.

Check here if both parents are deceased: If both parents are deceased provide the name, mailing

 

address and relationship to the minor of any adult sibling, aunt, uncle or adult child of the deceased

 

parents. Skip this question if either parent is not deceased.

 

 

 

Name

 

Mailing Address

Relationship

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Attach a separate sheet if necessary.

6.List names and addresses of any person(s) nominated as guardian(s) of the person and/or the estate of the minor in the will of a deceased parent.

Name:

Relationship to minor:

Mailing address:

 

 

 

 

Street

 

 

 

 

City

State

Zip code

Name:

 

 

 

 

 

 

 

 

Relationship to minor:

 

 

 

 

 

 

 

 

Mailing address:

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

 

 

City

State

Zip code

7. Is this guardianship petition being filed for the child of an activated member of the Armed

 

Services?

Yes

No

 

 

8. Proposed guardian name:

 

 

 

 

 

 

 

Date of birth:

 

 

 

 

 

 

 

 

Relationship to minor:

 

 

 

 

 

Occupation:

 

 

Mailing address:

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

 

 

City

State

Zip code

Telephone:

 

 

E-mail:

 

 

 

Proposed guardian name:

 

 

 

 

 

 

 

Date of birth:

 

 

 

 

 

 

 

 

Relationship to minor:

 

 

 

 

 

Occupation:

 

 

Mailing address:

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

 

 

City

State

Zip code

Telephone:

 

 

E-mail:

 

 

 

NHJB-2162-FPe* (01/01/2018)

Page 2 of 6

Case Name:

Case Number:

PETITION FOR GUARDIAN OF MINOR

Questions 9 – 14 are required under RSA 458-A, the Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA).

It is important that you answer these questions with as much detail and accuracy as possible. Lack of adequate information could significantly delay orders being issued in your case.

There are several situations that might result in New Hampshire exercising jurisdiction over child/ren. The continuous presence of the child/ren in New Hampshire for six (6) months is not the only basis for jurisdiction. In some emergency situations, the court may be able to exercise jurisdiction on a temporary basis.

9.List the places where the minor child has lived in the last five (5) years and the names of the people they lived with at that time, if you know. Start with where the child lives now and work backward in time.

Dates

From/To

Town/City, State

Parent(s)/Caretaker

Current Address/Contact Address

10. Are there any person(s), not a party to this proceeding, who have physical custody of the child or

who claim to have custody, physical custody or parenting time rights? Yes No If yes, list name(s) and address(es) of person(s):

Name

Current Address

11. Check one of the following:

I/We have not participated in any court case(s) concerning the custody, visitation, parenting time or placement of the child in this or any other state.

OR

I/We have participated in court case(s) concerning the custody, visitation, parenting time or placement of the child in this or any other state. I/We have participated in the following:

Name of Court

State

Case No.

Date of Court Order

NHJB-2162-FPe* (01/01/2018)

Page 3 of 6

Case Name:

Case Number:

PETITION FOR GUARDIAN OF MINOR

12. Are there any actions for enforcement, or proceedings relating to domestic violence, domestic relations, protective orders, marriage dissolution, paternity, legitimation, custody, parental rights and responsibilities, termination of parental rights, adoption, juvenile, or other proceedings in any court in any state affecting this child named in this petition or parents of the child?

Yes

No If yes, complete the following:

Name of Court

State

Case No.

Type of Court Case

13.List the names and addresses of any persons having the principal care and custody of the minor during the 60 days preceding the filing of this petition.

Name:

Relationship to minor:

Mailing address:

 

 

Street

City

State

Zip code

Name:

 

 

 

 

Relationship to minor:

 

 

 

 

Mailing address:

 

 

 

 

 

Street

City

State

Zip code

14.This question is optional. You may skip this question if it does not apply to your circumstance. NOTE: If you complete this question, you will be required to print, notarize and upload this Petition before submitting it to the Court.

I am alleging, under oath, that this minor’s or my health, safety, or liberty would be jeopardized by the disclosure of certain identifying information set forth in this Petition. To support my allegation, I state as follows:

The answers on this Petition that I do not want to disclose are: (Check all that apply)

3

9

10

11

12

13

14

17

15. Is this an EX PARTE request?

Yes

No

If yes, petitioner must complete the EX PARTE (Emergency) Motion form

16. Are there any adults, other than the proposed guardian, who will be living in the same home as the

minor?

Yes

No

If yes, provide their name(s):

If yes, you must provide the court with a completed Criminal Record Release Authorization form and a DHHS Record Release Authorization form for each of those adults within 10 days of the filing of this petition.

NHJB-2162-FPe* (01/01/2018)

Page 4 of 6

Case Name:

Case Number:

PETITION FOR GUARDIAN OF MINOR

17. Are there any pending adoption, juvenile, domestic violence, marriage dissolution, domestic relations, paternity, legitimation, custody or other proceedings affecting minor or parents of this

minor?

Yes

No

Unknown (If yes, attach a separate sheet identifying and explaining each.)

18. Is an adoption of the minor by the proposed guardian(s) contemplated?

Yes

No

Unknown

19. Is the minor entitled to receive local, state or federal benefits and/or entitlements?

Yes

No

Unknown

 

 

20. Is there an existing child support order for this child?

Yes

No

If yes, is support collected by the Bureau of Child Support Services?

Yes

If no, are you seeking a child support order as part of this guardianship?

Unknown

No

Unknown

Yes

No

Unknown

21. Is there an existing court visitation order or custody order for this child?

Yes

No

Unknown

 

If yes, attach a copy of that order to this petition.

 

22. Is there any reason that this child should not visit with his/her parents? Yes

No

If yes, state clearly and specifically any reason(s). Attach a separate sheet if needed.

Unknown

23.Is this guardianship being sought by the Department of Health and Human Services as part of a permanency plan pursuant to the Adoption and Safe Families Act of 1997?

Yes

No

Unknown

24. Is the child an American Indian child as defined by the Indian Child Welfare Act?

Yes

No

Unknown

If yes, the name and address of the tribe are:

Is the tribe recognized by the federal government as eligible for federal services or certain Alaskan

 

native corporations as defined in 43 U.S.C. §1602(c)?

Yes

 

No

25.

If this guardianship is for an estate, provide the probable value and brief description/general

 

character of the minor’s real and personal property below:

 

 

 

 

 

 

BRIEF DESCRIPTION/GENERAL CHARACTER

 

 

 

VALUE

 

Real Property:

 

 

 

$

 

 

Personal Property:

 

 

 

$

 

 

Debts of Minor (if any):

 

 

 

$

 

26.

Is this petition filed in conjunction with a settlement of minor's action, per RSA 464-A:42?

 

Yes

 

No

 

 

 

 

If yes, attach a copy of the petition or proposed petition seeking approval and all supplemental documentation that is to be filed with the Superior Court or District Division.

NHJB-2162-FPe* (01/01/2018)

Page 5 of 6

Case Name:

Case Number:

PETITION FOR GUARDIAN OF MINOR

27. Guardianship requested:

temporary

not temporary/enduring

28.As required by RSA 463:5, V, a statement must be included describing specific facts concerning actions or omissions or actual incidents involving the minor which are claimed to demonstrate that guardianship is in the best interests of the minor.

I acknowledge that I have a continuing duty to inform the court of any court action in this or any other state that could affect the child in this case.

Verification: I verify the truth and accuracy of all facts alleged within this document to the best of my belief and further verify that all facts contained in this document are alleged in good faith. By affixing my electronic signature to this document I acknowledge my understanding that any false statements made in this document are punishable as perjury which may include a fine or imprisonment or both.

/s/

Name of Filer

 

 

Signature of Filer

Date

 

 

 

 

 

Law Firm, if applicable

Bar ID # of attorney

Telephone

 

 

 

 

 

 

 

Address

 

 

 

E-mail

 

 

 

 

 

 

 

City

State

Zip code

 

 

 

Verification: I verify the truth and accuracy of all facts alleged within this document to the best of my belief and further verify that all facts contained in this document are alleged in good faith. By affixing my electronic signature to this document I acknowledge my understanding that any false statements made in this document are punishable as perjury which may include a fine or imprisonment or both.

/s/

Name of Filer

 

 

Signature of Filer

Date

 

 

 

 

 

Law Firm, if applicable

Bar ID # of attorney

Telephone

 

 

 

 

 

 

 

Address

 

 

 

E-mail

 

 

 

 

 

 

 

City

State

Zip code

 

 

 

NHJB-2162-FPe* (01/01/2018)

Page 6 of 6

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