IDesILaytags78 13020291821m`b4j7 BHAp:T4, tZ &,28>DJPV\bhntz6`Submit 6 d ox. U1)PQTEXTtt6d|riptsddxts and fills1)6$Ό April 2000criptsddxts a64*40980670010765030gust 19jB"X  p ,f @@@@@@ @@@@@ (fppfppffp˨ffppgc fϬffpfp cfpи pHf\pbfHffp:<fpf@@@@@  @@X  b f @@@1)PQTEXTttxt December 1997ptsddxts aN68-@!@@!1&@XXjdVXXdJp?dHPV 3Submit ta VersD <2dm0n7o>pEqLrSsZtAuHvaewhxoyvz}{|}~f O %h,3:ijk$l*VCell1Cell2Cell3Cell5Cell6Cell7Cell8Cell9Cell10Cell11Cell12Cell13Cell14Cell15Cell16Cell19Cell20Cell21Cell22Cell23Cell24Cell25Cell26Cell27Cell28Cell29Cell30Cell31Cell33Cell34Cell36Cell37Cell38Cell39Cell40Cell41Cell42Cell43Cell44Cell45Cell46Cell47Cell48Cell49Cell50Cell51Cell52Cell17Cell18Cell35  BH"r 2000ptsddxts and fills1>)PQTEXTttxt October 19960ptsddxts and fills1@)PQTEXTttxt` October 19970ptsddxts and fills1@)PQTEXTttxtݤ October 19980ptsddxts and fills1D)PQTEXTttxt October 19990ptsddxts and fills1D)PQTEXTttxt, October 20000ptsddxts and fills1F)PQTEXTttxtpSeptember 1996tsddxts and fills1H)PQTEXTttxt޴September 1997tsddxts and fills1J)PQTEXTttxtSeptember 1998tsddxts and fills1J)PQTEXTttxt<September 1999tsddxts and fills1N)PQTEXTttxtSeptember 2000tsddxts and fills1N)PQTEXTttxt Calendar.atg00tsddxts and fillsF~)OTEXTttxtCassette labels.atgts and fills=r)OTEXT????LCassette liner.atggts and fills=r)OTEXT???? CD liner.atger.atggts````d'@L^Pj$ odn9Helveticax @(@ @ "(ߨhpߨhpߨߨߨߨߨ  propalisZ propalis` propalisl propalisr porpsila porpsila<ETimes New RomanArialArial<\;,xd\+  N4Z3Submit :f 1302029182cfp1p\0fs|hxfpF@fpf f`l,, g(,,(d'h 6Tr6~this, Signature@ Version p  Data Vers$ Blue Keys *Graphics 0Header   6 FieldList< Form Info f LayoutProps x DesPathInfo ~&(bN!p I. BASIS   ' $ BI represent to the Court the following: 1.1 1.2 1.3  ttq>V t>qV  q>V,Arial (H(I represent to the Court the following: (H1.1 (H1.2 (HH1.3$" The petitioner seeking a guardianship for the child is: a. The petitioner's interest in the appointment is: Information about the child: Name: Date of birth: Address: The child:  TV* T*V q>V TV*,Arial (^9The petitioner seeking a guardianship for the child is: (^7a. The petitioner's interest in the appointment is: (^Information about the child: (^Name: (^Date of birth: (2^ Address: (H^ The child:,`, GUARDIANSHIP PETITIONJ,- p )DSHS 09-453 (REV. 08/1991) (AC 07/2002) r,@ ,p KDISTRIBUTION: Court file, Service file, Parent, Indian Tribe/Other party ,`P- "  Page 1 of 3   5 @ Sex:     p  Age:     ` DEPENDENCY OF:   W `"`  Xh!``! p    &SUPERIOR COURT OF WASHINGTON COUNTY OF  @  @   @ ,Arial (JSUPERIOR COURT OF WASHINGTON (J COUNTY OF0`! GUARDIANSHIP PETITION   z pp LEGAL NO:   4 H 0 dTitle  P@ 0 eTitle  H 0 fTitle  `p!@ 0 hTitle   @p JUVENILE DIVISION   Z 0!H 0 iTitle   H 0 jTitle  @!H 0 kTitle  !H  0 lTitle   pH  0 mTitle   0H  0 nTitle  P !H  0 oTitle  " #!H 0 pTitle  %&!@  q% &! is an Indian child as defined in the Indian Child Welfare Act, 25 U.S.C. 1903(4). 25 U.S.C. 1901 et seq., applies to this proceeding. See attached Addendum to Petition (DSHS 09-771).  XXHct$ XcH$t  Hct$,Arial (Znkis an Indian child as defined in the Indian Child Welfare Act, 25 U.S.C. 1903(4). 25 U.S.C. 1901 et seq., (enMapplies to this proceeding. See attached Addendum to Petition (DSHS 09-771).&(`!@  r&(`! May be an Indian child as defined in the Indian Child Welfare Act, 25 U.S.C. 1903 (4). The Indian Child Welfare Act may apply to this proceeding. See attached Addendum to Petition (DSHS 09-771).  ddec% dce% Hct$ ec%,Arial (wniMay be an Indian child as defined in the Indian Child Welfare Act, 25 U.S.C. 1903 (4). The Indian Child (n[Welfare Act may apply to this proceeding. See attached Addendum to Petition (DSHS 09-771).(*`!@  s(*`! Is or may be a Canadian Indian child or unenrolled Indian as defined in WAC 388-170-091. The Indian Child Welfare Act does not apply to this proceeding.  ::c% :c% ec% c%,Arial (neIs or may be a Canadian Indian child or unenrolled Indian as defined in WAC 388-170-091. The Indian (n4Child Welfare Act does not apply to this proceeding.`  D.O.B.    0` NAME   TITLE/AGENCY2 P  RELATIONSHIP3 !H 0 Title  ! " H  0 Title  *+!@  *+! OIs not Indian. The Indian Child Welfare Act does not apply to this proceeding.  *9  n37 Title  *+!H 0 uTitle  ,HT'&@(@%    ^^b*d ^*bd `pP 1.8 1.9 1.10  <=h =<h b*d <=h,Arial (MG1.8 (G1.9 (G1.10`*`! The approximate value and description of the child's property, including compensation, pension, insurance or allowance to which he/she may be entitled is: Information about the proposed guardian: Name: Address: A guardianship should be established. a. The child has been found to be a dependent child under RCW 13.34.030 (2). b. A dispositional plan has been entered pursuant to RCW 13.34.130. c. The child has been removed, or will, at the time of the hearing, have been removed from the custody of the parent for a period of at least six months pursuant to a finding of dependency under RCW 13-34.030 (2). d. The services ordered under RCW 13.34.130 have been offered or provided and all necessary services responsibly available, capable of correcting the parental deficiencies within the foreseeable future have been offered or provided. e. There is little likelihood that conditions will be remedied so the child can be returned to the parents in the near future. f. A guardianship rather than termination of the parent-child relationship or continuation of the child's current dependent status would be in the best interest of the family.  <U% U<% <=h <U%,Arial (M_jThe approximate value and description of the child's property, including compensation, pension, insurance (X_or (n_.allowance to which he/she may be entitled is: (_)Information about the proposed guardian: (_Name: (_ Address: (_&A guardianship should be established. (_Oa. The child has been found to be a dependent child under RCW 13.34.030 (2). (_Fb. A dispositional plan has been entered pursuant to RCW 13.34.130. (_lc. The child has been removed, or will, at the time of the hearing, have been removed from the custody of ()_the (4_o parent for a period of at least six months pursuant to a finding of dependency under RCW 13-34.030 (2). (J_gd. The services ordered under RCW 13.34.130 have been offered or provided and all necessary services (U_q responsibly available, capable of correcting the parental deficiencies within the foreseeable future have (`_ been offered or provided. (v_te. There is little likelihood that conditions will be remedied so the child can be returned to the parents in the (_ near future. (_tf. A guardianship rather than termination of the parent-child relationship or continuation of the child's current (_C dependent status would be in the best interest of the family.@ 0The nature of the child's incapacity is minority. Information about persons most closely related by blood or marriage to the child: a. Name: Relationship: Address: b. Name: Relationship: Address: c. Name: Relationship: Address: There  oU> Uo> <U% oU>,Arial (_2The nature of the child's incapacity is minority. (_RInformation about persons most closely related by blood or marriage to the child: (_{a. Name: Relationship: (_ Address: (_{b. Name: Relationship: (_ Address: (_{c. Name: Relationship: (_ Address: (0_There@ 1.5 1.6 1.7  00o>>d 0>od> oU> o>>d,Arial (H1.5 (H1.6 (0H1.7   H 0 vTitle   ` !H 0 wTitle   p 0 !H 0 xTitle     H 0 yTitle   ` !H 0 zTitle  0 0@!H 0 {Title   H 0 |Title  `!H 0 }Title   0!H 0 ~Title  p` P@  ` @ is   @ @  @,Arial (0i(;s p `@    ` Tis not in any state, a guardian or limited guardian for the person of the child.  *= @!H  0 Title  !H! 0 Title  !H" 0 Title  0!H# 0 Title  P The child is in the custody of    v p` 1.4     ` Pp!H 0 tTitle  !H 0 uTitle  ` &NAME OF INSTITUTION, AGENCY, OR PERSON ADDRESS",`, GUARDIANSHIP PETITIONJ,@ ,p KDISTRIBUTION: Court file, Service file, Parent, Indian Tribe/Other party ,`P- "  Page 2 of 3   5 ,- )DSHS 09-453 (REV. 08/1991) (AC 07/2002) r 0 Title  + ,@ KDISTRIBUTION: Court file, Service file, Parents, Indian Tribe/Other party `ApG // @@X   @@@@@@ @@@@@F1 * '*'*.F1 *D.F1 x hIDF1 TX.PF1 iI`/D`\I`/F1 F1 V5 0RxIiIZxIF1 wIFN- {IDdDV5 0ɫD֫D( 5IbDD.ORD_@@@  @@X  D. @@@  @@X  D. @@@   @@X  D. @@IRbD8.OR@@X D. LBH #m!  0 II. RELIEF REQUESTED   k  @  2.1 2.2 2.3  ?e ?e  ?e,Arial (I2.1 (I2.2 (I2.3 P! The Court Appoint a guardian for the child. The duration of the guardianship be until the child attains the age of 18 years or until further order of the Court. The proposed guardian be vested with the authority to provide day to day care and shelter for the child, to authorize the provision of necessary medical and dental care and treatment, and to otherwise assist the court in supervising the dependent child.  U/% U%/ ?e U/%,Arial (_,The Court Appoint a guardian for the child. (_nThe duration of the guardianship be until the child attains the age of 18 years or until further order of the (_Court. ( _lThe proposed guardian be vested with the authority to provide day to day care and shelter for the child, to (_hauthorize the provision of necessary medical and dental care and treatment, and to otherwise assist the (!_)court in supervising the dependent child. DATE  PETITIONER)@ TITLE/AGENCY/RELATIONSHIPhp   III. CERTIFICATION   Y p! I certify under penalty of perjury under the laws of the State of Washington that the foregoing representations are true and correct.  &&?% &?% U/% ?%,Arial (I`I certify under penalty of perjury under the laws of the State of Washington that the foregoing (I%representations are true and correct.  P The petitioner requests:   b  pH% 0 Title  !H& 0 Title  !H' 0 Title    Dated this   , p` `H( 0 Title    day of    p 0H) 0 Title  @ ,    p`H* 0 Title   at    pH+ 0 Title  "  , Washington.   = p` CITY  DAYp  MONTHpP YEAR!"!H, 0 Title  #0$@!H- 0 Title  $%!H. 0 Title  & '0`H/ 0 Title  & '0H0 0 Title  & '0!H1 0 Title  '(!H2 0 Title  "#0  SIGNATURE)$@$ TYPE OR PRINT NAMEL%&0  ADDRESS &()0 $TELEPHONE NUMBER (include area code)'@( xCITY STATE ZIP CODEj  j   j ,Arial (ypCITY STATE (ZIP CODE! The request for the establishment of a guardianship is based upon the following facts (including the reason(s) why appointment of a guardian is sought and why no alternative to guardianship is appropriate):  pp>Uh# pU>#h j  >Uh#,Arial (O_eThe request for the establishment of a guardianship is based upon the following facts (including the (Z_jreason(s) why appointment of a guardian is sought and why no alternative to guardianship is appropriate): !H$ 0 Title  @1.11    ,P, GUARDIANSHIP PETITIONJ,0 ,p KDISTRIBUTION: Court file, Service file, Parent, Indian Tribe/Other party ,PP-"  Page 3 of 3   5 ,- )DSHS 09-453 (REV. 08/1991) (AC 07/2002) rtZ0aq // @@X   @@@@@@ @@@@@F1 * '*'*.F1 *D.F1 x hIDF1 TX.PF1 iI`/D`\I`/F1 F1 V5 0RxIiIZxIF1 wIFN- {IDdDV5 0ɫD֫D( 5IbDD.ORD_@@@  @@X  D. @@@  @@X  D. @@@   @@X  D. @@IRbD8.OR@@X D. LBHNTchild. (_uThe duration of the guardianship be until the child attains the age of 18 years or until further order of the Court. (_lThe proposed guardian be vested with the authority to provide day to day care and shelter for the child, to ( _nauthorize the provision of nece