Petition for the Appointment of a Guardian of the Person of a Minor under the Age of 14 Years in Accordance with 20 Pa. C.S.A.§5111 (a)DECREE
Now,_______ , 20_______, upon consideration of the annexed Petition, it is hereby ORDERED and DECREED that Henry Doe is appointed Guardian of the Person of John Dunn, a Minor.
____________J.
PETITION
The Petition of Peter Dunn respectfully states that:
1. The Petitioner, Peter Dunn, is the uncle of John Dunn, being his late father's brother.2. John Dunn was born on January 1, 1993, and he resides at 275 Horse Hair Road, Philadelphia, PA 19199, with Petitioner.3. John Dunn is the child of Jane R. Dunn, who died on January 12, 2000, and Joseph B. Dunn, who died on July 7, 2001.4. John Dunn is in need of corrective surgery as described in the report of his physician annexed hereto as Exhibit "A," and ABC Hospital requires that a Guardian of his Person consent to such surgery.5. No other Guardian has been appointed for the Person of the Minor.6. The proposed Guardian, Henry Doe, is 40 years of age and resides at 10 Main Street, Philadelphia, PA 19199. The Consent of the proposed Guardian is attached hereto as Exhibit "A."7. The proposed Guardian is a cousin of John Dunn and has no interest adverse to him.8. The parents of John Dunn were, and the proposed Guardian is, Roman Catholic.9. No notice to the United States Veterans' Administration is required. Wherefore, Petitioner respectfully requests this Court to appoint Henry Doe as Guardian of the Person of John Dunn, a Minor.
Peter Dunn
The Consent of the Guardian to serve should be attached to the Petition, in the same form as it appears in 7.1 above. Philadelphia Rule 12.5.B.