Form 4A-501. Petition to appoint kinship guardians.

STATE OF NEW MEXICO COUNTY OF _______________ ________________ JUDICIAL DISTRICT _______________________________, Petitioner(s) No. _________________ IN THE MATTER OF THE KINSHIP GUARDIANSHIP OF ____________________________,1 (a) Child(ren) (use initials only), and concerning ____________________________, Respondent #1, ____________________________, Respondent #2. PETITION TO APPOINT KINSHIP GUARDIAN(S)2 Petitioner(s),3 ________________________, request(s) the court to grant an Order Appointing Kinship Guardian(s) of the minor child(ren), ____________________________. The court has jurisdiction of the parties and the subject matter of the cause of action. A. INFORMATION ABOUT PETITIONER(S)3 1. Petitioner #1 Name and address: __________________________________________________________________________ __________________________________________________________________________ 2. Petitioner #2 Name and address: __________________________________________________________________________ __________________________________________________________________________ 3. Petitioner(s) are currently providing adequate care, maintenance, and supervision for ______________________________________________________ (names of minor child(ren)). B. INFORMATION ABOUT THE CHILD(REN)4 1. Child’s Name___________________________________________ a. Address____________________________________________ b. Place and year of birth City____________________________________ State___________________________________ Month and year of birth_____________________________ c. Are Petitioner(s) related to the child? _____ Yes _____ No d. If yes, what is the relationship? ____________________________________________________________________ ____________________________________________________________________ If no, describe Petitioner(s)’s connection with the child. ____________________________________________________________________ ____________________________________________________________________ e. Is the child fourteen (14) years of age or older? _____ Yes _____ No If yes, has the child stated that they want the named Petitioner(s) as the guardian(s)? _____ Yes5 _____ No f. Is the child an enrolled member of an Indian tribe or eligible for membership? _____ Yes _____ No If yes, what tribe is the child enrolled with or eligible to be enrolled with? ___________________________________________________________________ Have you notified the tribe of this Petition? _____ Yes _____ No If yes, list the specific actions you have taken to notify the tribe and the results of those contacts, including the names, addresses, titles, and telephone numbers of the persons contacted. Attach copies of all correspondence with the Indian tribe. ___________________________________________________________________ ___________________________________________________________________ 2. Child’s Name ___________________________________________ a. Address ____________________________________________ b. Place and year of birth City ____________________________________ State ___________________________________ Month and year of birth ________________________________ c. Are Petitioner(s) related to the child? _____ Yes _____ No d. If yes, what is the relationship? ____________________________________________________________________ ____________________________________________________________________ If no, describe Petitioner(s)’s connection with the child. ____________________________________________________________________ ____________________________________________________________________ e. Is the child fourteen (14) years of age or older? _____ Yes _____ No If yes, has the child stated that they want the named Petitioner(s) as the guardian(s)? _____ Yes5 _____ No f. Is the child an enrolled member of an Indian tribe or eligible for membership? _____ Yes _____ No If yes, what tribe is the child enrolled with or eligible to be enrolled with? __________________________________________________________________ Have you notified the tribe of this Petition? _____ Yes _____ No If yes, list the specific actions you have taken to notify the tribe and the results of those contacts, including the names, addresses, titles, and telephone numbers of the persons contacted. Attach copies of all correspondence with the Indian tribe. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ C. INFORMATION ABOUT CHILD’S PARENTS (RESPONDENTS)6 1. Respondent #1 a. _________________________ (name of Respondent-parent if known) is the parent of ___________________________. b. This Respondent-parent is _____ alive ____ deceased (if deceased, provide proof of death) c. If alive, list address (include physical street address, city, state, and zip code): __________________________________________________________________ __________________________________________________________________. Is Respondent #1 an enrolled member of an Indian tribe or eligible for membership in an Indian tribe? _____ Yes _____ No If yes, what tribe is Respondent #1 enrolled with or eligible to be enrolled with? __________________________________________________________________ d. On information and belief, (complete only one choice below) i. Respondent-parent___________________________ (name) consents to the appointment of Petitioner(s) as Kinship Guardian(s).7 Or ii. This legal parent is unable or unwilling to provide adequate care, maintenance, and supervision for the minor child(ren) named in this petition (explain why you think this parent is unable or unwilling to provide care): ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ 2. Respondent #2 a. _________________________ (name of Respondent-parent if known) is the parent of ___________________________. b. This Respondent-parent is _____ alive ____ deceased (if deceased, provide proof of death) c. If alive, list address (include physical street address, city, state, and zip code): __________________________________________________________________ __________________________________________________________________. Is Respondent #2 an enrolled member of an Indian tribe or eligible for membership in an Indian tribe? _____ Yes _____ No If yes, what tribe is Respondent #2 enrolled with or eligible to be enrolled with? __________________________________________________________________ d. On information and belief, (complete only one choice below) i. Respondent-parent___________________________ (name) consents to the appointment of Petitioner(s) as Kinship Guardian(s).7 Or ii. This legal parent is unable or unwilling to provide adequate care, maintenance, and supervision for the minor child(ren) named in this petition (explain why you think this parent is unable or unwilling to provide care): ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ D. FACTS REGARDING REQUEST FOR GUARDIANSHIP 1. Consent to Guardianship a. Does Respondent #1 consent to the guardianship? ____ Yes ____ No If no, has the child(ren) lived with Petitioner(s) without Respondent #1 in the home for ninety (90) days immediately prior to filing this petition? _____ Yes _____ No b. Does Respondent #2 consent to the guardianship? ____ Yes ____ No If no, has the child(ren) lived with Petitioner(s) without Respondent #2 in the home for 90 days immediately prior to filing this petition? _____ Yes _____ No 2. Describe how the child came to reside with you and why you want guardianship. _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ 3. If a Respondent-parent is willing and able to parent the child(ren), are there extraordinary circumstances that justify granting the guardianship?8 _____ Yes (please explain) _____ No ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ E. OTHER INFORMATION 1. Are there any other court cases involving these children? _____ Yes ____ No ____ Unsure If yes, please provide: Case Number ___________________________________________________ Type of case ____________________________________________________ 2. Is there current CYFD involvement?10 _____ Yes _____ No a. If yes, what is the contact information for the CYFD case worker? Name: _____________________________________________________ Position (if known): ___________________________________________ Phone Number and/or email address: _____________________________ b. If yes, does CYFD have legal custody of any of the child(ren) named in this petition? Yes______ No____. If yes, CYFD must be served with a copy of this petition.10 c. If yes, does CYFD consent to this guardianship? ____ Yes _____ No _____ Don’t know (please explain): __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ 3. Has CYFD filed a court case against the parents concerning this child? _____ Yes _____ No 4. Do any other person(s) have or claim to have court ordered custody of the child(ren)?9 _____ Yes _____ No If yes, the name(s), phone number(s), and address(es) are: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ 5. Do any other person(s) have court ordered visitation with the child(ren)?9 _____ Yes _____ No If yes, the name(s), phone number(s), and address(es) are: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ 6. Petitioner(s) are requesting child support from Respondents.11 _____ Yes _____ No 7. Petitioners accept the duties and responsibilities of guardianship, including providing for the care, maintenance, and supervision of the child(ren). 8. No guardian of the child(ren) is currently appointed under a provision of the Uniform Probate Code, Section 45-1-101 NMSA 1978. 9. It is in the best interests of the child(ren) that Petitioner(s) be appointed as kinship guardian(s). WHEREFORE, Petitioner(s) respectfully request(s) an Order Appointing Kinship Guardian(s) of the minor child(ren). VERIFICATION Petitioner #1: I, ________________, Petitioner, affirm under penalty of perjury under the laws of the State of New Mexico that I am the Petitioner in the above-entitled cause; that I have read the Petition to Appoint Kinship Guardian(s); and that the contents of the petition are true and correct to the best of my information and belief. _____________________ Date _______________________________ Signature of Petitioner #1 _______________________________ _______________________________ Address, phone number, and email for Petitioner #1 Petitioner #2: I, ________________, Petitioner, affirm under penalty of perjury under the laws of the State of New Mexico that I am the Petitioner in the above-entitled cause; that I have read the Petition to Appoint Kinship Guardian(s); and that the contents of the petition are true and correct to the best of my information and belief. _____________________ Date _______________________________ Signature of Petitioner #2 _______________________________ _______________________________ Address, phone number, and email for Petitioner #2