Santa Cruz — SUPPR-1074

Source: https://www.santacruz.courts.ca.gov/sites/default/files/pdfs/POST%20%28WEB%29SUPPR%201074%20Petition%20for%20Visitation%2C%20Other%20Contact%2C%20Mod%20of%20Visitation%20Order.pdf

SUPPR 1074 ATTORNEY OR PARTY WITHOUT AN ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY NAME: ADDRESS: CITY, STATE, ZIP:

TELEPHONE NO: FAX NO. (Optional): EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CRUZ 701 Ocean Street, Room 110 Santa Cruz, CA 95060 Santa Cruz Branch GUARDIANSHIP OF:

CASE NUMBER:

PETITION FOR VISITATION OTHER CONTACT MODIFICATION OF VISITATION ORDER

1. I (name) request the following Visitation Other contact such as mail, phone, email (write in type of contact):

with the minor child or children:

based on the following schedule (be specific with times, dates, and duration of visit):

2. I am the minor’s Parent Grandparent Guardian Other

3. Name(s) was appointed guardian of the PERSON on (date): ..

4. I should be granted visitation for the reasons specified below specified in Attachment 4.

5. Notice to the persons identified in Attachment 5 should be dispensed with because: They cannot with reasonable diligence be given notice (specify names and attempt to locate in Attachment 5): Other good cause exists to dispense with notice (specify names and reasons in Attachment 5):

Form Adopted for OPTIONAL USE PETITION FOR VISITATION Page 1 of 2 Superior Court of Santa Cruz County GUARDIANSHIPSUPPR 1074 01/01/20

GUARDIANSHIP OF: CASE NUMBER:

6. The names and residence addresses of the guardian, minor, and minor’s parents, brothers, sisters and grandparents are as follows:

   a. Guardian: f. Maternal grandfather:

   b. Minor: g. Maternal grandmother:

   c. Father: h. Paternal grandfather:

   d. Mother: i. Paternal grandmother:

   e. Brother(s) or Sister(s): (12 years old or older) j. □ Additional names and addresses continued in Attachment 6.

7. Number of pages attached: _____________

   This form must be filed with the- Notice of Hearing-Guardianship or Conservatorship, GC-020

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

Date:

► SIGN

(TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER

► SIGN

(TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER

Consent to Visitation and Waiver of Notice

I consent to the attached visitation schedule and waive notice of the petition:

SIGN

(DATE) (TYPE OR PRINT NAME) (SIGNATURE)

SIGN

(DATE) (TYPE OR PRINT NAME) (SIGNATURE)

SIGN

(DATE) (TYPE OR PRINT NAME) (SIGNATURE)

SIGN

(DATE) (TYPE OR PRINT NAME) (SIGNATURE)

Form Adopted for OPTIONAL USE PETITION FOR VISITATION Page 2 of 2 Superior Court of Santa Cruz County GUARDIANSHIPSUPPR 1074 01/01/20