Santa Clara — PB-4013 - Petition for Visitation

Source: https://santaclara.courts.ca.gov/system/files/forms/pb-4013_rem.pdf

ATTACHMENT PB-4013 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address): FOR COURT USE ONLY

To keep other people from

TELEPHONE NUMBER: FAX NUMBER: seeing what you have ATTORNEY FOR: (name): entered, please press the Reset Form button at the SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA end of the form when STREET ADDRESS: 191 North First Street finished. MAILING ADDRESS: 191 North First Street

CITY AND ZIP CODE: San José, CA 95113

BRANCH NAME: Downtown Courthouse – Probate Division

GUARDIANSHIP OF:

MINOR

CASE NUMBER:

PETITION FOR VISITATION

1. Petitioner (name): requests

   the following specific visitation schedule for the minor (name):

2. Petitioner is the minor’s Parent Grandparent Other:

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

4. Petitioner 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 efforts to locate them in Attachment 5).

   other good cause exists to dispense with notice (specify names and reasons in Attachment 5).

PB-4013 REV 1/1/04 PETITION FOR VISITATION Page 1 of 2 (PROBATE)

ATTACHMENT PB-4013 GUARDIANSHIP OF THE PERSON OF (Name): CASE NUMBER:

MINOR

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): j. Additional names and addresses
   (12 years old or older) continued in Attachment 6.

7. Number of pages attached:

Date: ► (SIGNATURE OF ATTORNEY)

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

Date:

....................................................................... ► (TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER)

....................................................................... ► (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:

......................................................................

(DATE) (TYPE OR PRINT NAME) (SIGNA TURE OF GUARDIAN)

......................................................................

(DATE) (TYPE OR PRINT NAME) (SIGNAT URE OF GUARDIAN)

I consent to attend orientation and mediation and waive notice of the petition:

......................................................................

(DATE) (TYPE OR PRINT NAME) (SIGN ATURE OF GUARDIAN)

......................................................................

(DATE) (TYPE OR PRINT NAME) (SIGN ATURE OF GUARDIAN)

PB-4013 REV 1/1/04 PETITION FOR VISITATION Page 2 of 2 (PROBATE) Reset Form