Ventura — Request for Visitation (Guardianship)

Ventura — Request for Visitation (Guardianship)¶

VN171

Write your name, address and telephone number below FOR COURT USE ONLY

TELEPHONE NO.: FAX NO. (Optional):

E-MAIL ADDRESS (Optional):

Self-Represented or Attorney for (name):

SUPERIOR COURT OF CALIFORNIA COUNTY OF VENTURA 4353 E. VINEYARD AVENUE OXNARD, CA 93036 JUVENILE/PROBATE COURTHOUSE

IN THE GUARDIANSHIP OF: CASE NUMBER: (Name(s)):

REQUEST FOR VISITATION HEARING DATE AND DEPT:
TIME:
(GUARDIANSHIP)
Visitation Order Change Visitation Order

NOTICE OF HEARING

TO: ______________________________________________________________________________ (names)

Guardian(s) Mother Father Child Other (specify):______________________________
A COURT HEARING WILL BE HELD AS FOLLOWS:

Date: _____________________ Time: _________________ Courtroom: ___________________ Address of court: same as noted above other (specify):__________________________________

The parties are required to attend custody mediation services as follows (mediation may be held at a different

court, please verify the location of mediation for your case):

Date: __________________ Time: _____________ Dept.:______________________

REQUEST FOR VISITATION

I, ______________________________________, am the Mother Father Guardian Grandparent

Other: ____________________________________ of the child.
I request that the court make an Order for Visitation or Change an Order for Visitation between the following

child(ren) ______________________________________ and ___________________________________ who is

Mother Father Guardian Grandparent Other relative Friend to the child(ren).

REQUEST FOR VISITATION Optional Form Page 1 of 3

VN171 (Rev. 01/19) (GUARDIANSHIP)

VN171

CASE NAME: CASE NUMBER:

I would like to have the following visitation schedule (indicate the visitation schedule you want below):
I believe that visitation between the above person and the child(ren) is in the best interests of the child(ren)

because (if you have an existing order for visitation, indicate what has changed since the last court order):

Continued in Attachment 6
The above person’s previous contact with the child(ren) is as follows:
The reason no agreement has been reached regarding visitation with the child(ren) is as follows:

Continued in Attachment 8

Optional Form REQUEST FOR VISITATION Page 2 of 3 VN171 (Rev. 01/19) (GUARDIANSHIP)

VN171

CASE NAME: CASE NUMBER:

I declare under penalty of perjury of the laws of the State of California that the foregoing is true and correct.

Dated: _________________

_______________________________ _______________________________________
(Type or Print Your Name) (Signature)

Optional Form REQUEST FOR VISITATION Page 3 of 3 VN171 (Rev. 01/19) (GUARDIANSHIP)