Dom. Rel. Forms. 4A-501

As amended through August 23, 2024
Rule 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(s).

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)).

[] Petitioner(s) have a Guardianship Assistance Agreement with the Children, Youth and Family Department ("CYFD"). Attach a copy of the agreement (check if applicable).

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 he/she wants the named Petitioner(s) as the guardian(s)? __
f. Is the child a Native American child?6 _____ Yes _____ No If yes, what tribe is the child enrolled with or eligible to be enrolled with?

____________________________________________________________

Have you contacted/informed the tribe of this Petition? _____ Yes _____ No If yes, who did you contact and how did you make contact? _________________________________________________________________________

Tribal contact information (address and phone number):

_________________________________________________________________________

_________________________________________________________________________

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 he/she wants the named Petitioner(s) as the guardian(s)? __

f. Is the child a Native American child?6 _____ Yes _____ No

If yes, what tribe is the child enrolled with or eligible to be enrolled with?

_________________________________________________________________________

Have you contacted/informed the tribe of this Petition? _____ Yes _____ No

If yes, who did you contact and how did you make contact?

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Tribal contact information (address and phone number):

_________________________________________________________________________

_________________________________________________________________________

C.INFORMATION ABOUT CHILD'S PARENTS (RESPONDENTS)7
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):

_________________________________________________________________________

_________________________________________________________________________.

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).8

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 including whether parent(s) have signed a Voluntary Placement Agreement with CYFD):

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

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):

_________________________________________________________________________

_________________________________________________________________________

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).8

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 including whether parent(s) have signed a Voluntary Placement Agreement with CYFD):

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

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.

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

[] Parent(s) signed a Voluntary Placement Agreement with CYFD, placing the children in CYFD's legal custody, and to the best of Petitioner's knowledge, the Voluntary Placement Agreement has not been revoked.

[] Petitioner(s) signed a Guardianship Assistance Agreement with CYFD and to the best of petitioner(s) knowledge, it has not been revoked.

3. If a Respondent-parent is willing and able to parent the child(ren), are there extraordinary circumstances that justify granting the guardianship?9

_____ Yes (please explain) _____ No

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

E.OTHER INFORMATION
1. Are there any other court cases involving these children? _____ Yes ____ No If yes, please provide:

Case Number _____________________________________________________

Type of case __________________________________________________

2. Is there CYFD involvement? _____ 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 18 child? _____ Yes _____ No
4. Do any other person(s) have or claim to have court ordered custody of the child(ren)?10 _____

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)?10 _____ 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

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

________________________

________________________

USE NOTES

1. Enter the initials of each child. Each child should be listed in the petition under Section A.

2. Forms 4A-501 to 513 NMRA are required to be used by persons representing themselves in kinship guardianship proceedings. Parties represented by an attorney may use other forms that serve the same purpose.

3. A petitioner must be an adult with whom the child has a significant bond. See NMSA 1978, Section 40-10B-5 (2022) for persons who may file as a petitioner under the Kinship Guardianship Act.

4. Fill out Section B for each child you are seeking guardianship over. If you are applying for guardianship of more than two children, repeat the sections as necessary for each child.

5. Any minor child fourteen (14) years of age or older must be served with a copy of this petition. If a child is fourteen (14) years of age or older and does not want the petitioner(s) to be the child's guardian, the court will not appoint the petitioner(s). See NMSA 1978, § 40-10B-11(B) (2001). If the child is fourteen (14) years of age or older and consents to the petitioner(s) as guardian(s), please use the Nomination of Kinship Guardian Form, Form 4A-506 NMRA.

6. The Indian Child Welfare Act defines "Indian child" as "any unmarried person who is under age eighteen and is either (a) a member of an Indian tribe, or (b) is eligible for membership in an Indian tribe and is the biological child of a member of an Indian tribe." See 25 U.S.C. § 1903(4) (1978).

7. If there are more than two parents for the children involved, repeat the information for each additional parent. Unless the child's parent is deceased or the parent's parental rights have been terminated, use Form 4-206 NMRA for service of process on each parent named in the petition unless (a) the parent has waived service in writing; (b) the parent is deceased; or (c) the parent's rights as a parent have been terminated by a court order.

8. Form 4A-505 NMRA must be signed, notarized, and filed with the court for each respondent-parent who consents to the guardianship.

9. For example: Has the child lived with the petitioner(s) for so long that removing the child would cause anguish or harm to the child? Are there other reasons why the child should not be with the parent?

10. If there are other people claiming to have court-ordered custody or court-ordered visitation of the child(ren), they must also be served with a copy of the petition and notice of the hearing.

11. If CYFD has legal custody of any child named in this petition, CYFD must be served with a copy of this petition. CYFD has designated addresses and individuals to accept service of the petition. Court clerks and the local CYFD office will supply the address and contact information for the address and person that will accept service on behalf of CYFD.

12. Both parents may be ordered to pay child support. The petitioners' income should not be used for calculation of child support.

Dom. Rel. Forms. 4A-501

Provisionally approved, effective 8/15/2003 until8/31/2004; approved, effective 1/20/2005; 4-981 recompiled and amended as 4A-501 by Supreme Court Order No. 16-8300-020, effective for all pleadings and papers filed on or after12/31/2016; as amended by Supreme Court Order No. 22-8300-020, effective for all pleadings and papers filed on or after 12/31/2022.

ANNOTATIONS The 2016 amendment, approved by Supreme Court Order No. 16-8300-020, effective December 31, 2016, rewrote the form and Use Note. Recompilations. - Pursuant to Supreme Court Order No. 16-8300-020, former 4-981 NMRA was recompiled and amended as 4A-501 NMRA, effective for all pleadings and papers filed on or after December 31, 2016.