Application to Dispense with the Appointment of a Guardian for a Minor - Fairfield County Probate

In the matter of Case number Name of minor Date of birth Address of minor Value of minor's estate Nature of property in the minor's estate line 1 Nature of property in the minor's estate line 2 Nature of property in the minor's estate line 3 Name of parent/legal custodian 1 Address for parent/legal custodian 1 Telephone number for parent/legal custodian 1 Consent attached for parent/legal custodian 1 Name of parent/legal custodian 2 Address for parent/legal custodian 2 Telephone number for parent/legal custodian 2 Consent attached for parent/legal custodian 2 Deposited in a financial institution in the name of the minor Amount deposited in financial institution Delivered to the minor's parent/legal custodian Amount delivered to parent/legal custodian Delivered to the person by whom the minor is maintained Amount delivered to person by whom minor is maintained Name of person by whom minor is maintained Address of person by whom minor is maintained Telephone number of person by whom minor is maintained

Delivered to the minor Amount delivered to the minor Other distribution described Other distribution amount Other distribution description line 1 Other distribution description line 2 Other distribution description line 3 Statement in support of the proposed distribution line 1 Statement in support of the proposed distribution line 2 Statement in support of the proposed distribution ,one 3 Statement in support of the proposed distribution line 4 Statement in support of the proposed distribution line 5 Statement in support of the proposed distribution line 6 Statement in support of the proposed distribution line 7 Statement in support of the proposed distribution line 8 Statement in support of the proposed distribution line 9 Statement in support of the proposed distribution line 10 Statement in support of the proposed distribution line 11 Statement in support of the proposed distribution line 12 Statement in support of the proposed distribution line 13 Statement in support of the proposed distribution line 14 Statement in support of the proposed distribution line 15 Attorney typed or printed name Attorney address Attorney city, state and zip Attorney telephone number Attorney email address Attorney registration number Applicant typed or printed name Applicant address Applicant city, state and zip Applicant telephone number Applicant email address