Form GDN M103 "Declaration Explaining Reasons for Minor Guardianship" - Washington

What Is Form GDN M103?

This is a legal form that was released by the Washington Superior Court - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2021;
  • The latest edition provided by the Washington Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form GDN M103 by clicking the link below or browse more documents and templates provided by the Washington Superior Court.

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Download Form GDN M103 "Declaration Explaining Reasons for Minor Guardianship" - Washington

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Superior Court of Washington, County of
In the Guardianship of:
No.
Declaration Explaining the Reasons for
Respondent/s (minors/children)
Minor Guardianship Petition
(DCLR)
Declaration Explaining the Reasons for
Minor Guardianship
Use this form to explain the reasons why you asked for Minor Guardianship, why the court should appoint
the person you propose as guardian, and (if applicable) why the parents’ contact should be limited. Use
this form together with:
 Minor Guardianship Petition (form GDN M 102)
 Minor Standby Guardianship Petition
Important! If the children are age 12 or older, this form must be served on them unless you get a court
order to withhold. If you believe it might be harmful for the children to read about the reasons, use these
forms to ask the court for permission not to serve the children.
 Motion to Withhold Certain Documents from the Minor (form GDN M 106)
 Order on Motion to Withhold Certain Documents from the Minor (form GDN M 107)
1. Why do the children need a guardian?
Parent 1 (Name):
:
[ ]
consented, after being fully informed of the nature and consequences of
guardianship.
[ ]
had their parental rights terminated.
[ ]
is not willing or able to provide for the support, care, education, health, safety,
and welfare of a child under age 18 (exercise the parenting functions in RCW
26.09.004). This is true because (explain and give examples):
RCW 11.130.190, .220
Declaration Explaining Reasons for
(01/2021)
Minor Guardianship
GDN M 103
p. 1 of 5
Superior Court of Washington, County of
In the Guardianship of:
No.
Declaration Explaining the Reasons for
Respondent/s (minors/children)
Minor Guardianship Petition
(DCLR)
Declaration Explaining the Reasons for
Minor Guardianship
Use this form to explain the reasons why you asked for Minor Guardianship, why the court should appoint
the person you propose as guardian, and (if applicable) why the parents’ contact should be limited. Use
this form together with:
 Minor Guardianship Petition (form GDN M 102)
 Minor Standby Guardianship Petition
Important! If the children are age 12 or older, this form must be served on them unless you get a court
order to withhold. If you believe it might be harmful for the children to read about the reasons, use these
forms to ask the court for permission not to serve the children.
 Motion to Withhold Certain Documents from the Minor (form GDN M 106)
 Order on Motion to Withhold Certain Documents from the Minor (form GDN M 107)
1. Why do the children need a guardian?
Parent 1 (Name):
:
[ ]
consented, after being fully informed of the nature and consequences of
guardianship.
[ ]
had their parental rights terminated.
[ ]
is not willing or able to provide for the support, care, education, health, safety,
and welfare of a child under age 18 (exercise the parenting functions in RCW
26.09.004). This is true because (explain and give examples):
RCW 11.130.190, .220
Declaration Explaining Reasons for
(01/2021)
Minor Guardianship
GDN M 103
p. 1 of 5
Parent 2 (Name):
:
[ ]
consented, after being fully informed of the nature and consequences of
guardianship.
[ ]
had their parental rights terminated.
[ ]
is not willing or able to provide for the support, care, education, health, safety,
and welfare of a child under age 18 (exercise the parenting functions in RCW
26.09.004). This is true because (explain and give examples):
2.
Children’s best interests
It is in the best interests of the children to appoint a guardian because (explain how having a
guardian would be good for the children):
RCW 11.130.190, .220
Declaration Explaining Reasons for
(01/2021)
Minor Guardianship
GDN M 103
p. 2 of 5
3.
Why the person I propose should be guardian
(Name/s of proposed guardian/s):
should be appointed guardian because (explain why this person is the best choice):
4.
Should parent/s contact be limited?
[ ] No.
[ ] Yes. I ask the court to give limited or no visitation because the following reasons for
limiting visitation apply:
[ ] Mandatory limiting factors from RCW 26.09.191(2). A parent has one or more of
these problems as follows (check all that apply):
[ ] Abandonment – (Parent’s name):
intentionally abandoned a child listed in 2 for an extended time.
[ ] Neglect – (Parent’s name):
substantially refused to perform his/her parenting duties for a child listed in 2.
[ ] Child Abuse – (Parent’s name):
(or someone living in that parent’s home) abused or threatened to abuse a
child. The abuse was (check all that apply):
physical
sexual
repeated emotional abuse.
[ ]
[ ]
[ ]
[ ] Domestic Violence – (Parent’s name):
(or someone living in that parent’s home) has a history of domestic violence as
defined in RCW 26.50.010.
[ ] Assault – (Parent’s name):
(or someone living in that parent’s home) has assaulted or sexually assaulted
someone causing grievous physical harm, causing fear of such harm, or
resulting in a pregnancy.
RCW 11.130.190, .220
Declaration Explaining Reasons for
(01/2021)
Minor Guardianship
GDN M 103
p. 3 of 5
[ ] Sex Offense –
[ ] (Parent’s name):
has been convicted of a sex offense as an adult.
[ ] Someone living in (parent’s name):
’s home has
been convicted as an adult or adjudicated as a juvenile of a sex offense.
[ ] Other limiting factors from RCW 26.09.191(3) – A parent has one or more of these
problems as follows (check all that apply):
[ ] Neglect – (Parent’s name):
neglected his/her parental duties towards a child listed in 2.
[ ] Emotional or physical problem – (Parent’s name):
has a long-term emotional or physical problem that gets in the way of his/her
ability to parent.
[ ] Substance Abuse – (Parent’s name):
has a long-term problem with drugs, alcohol, or other substances that gets in
the way of his/her ability to parent.
[ ] Lack of emotional ties – (Parent’s name):
has few or no emotional ties with a child listed in 2.
[ ] Abusive use of conflict – (Parent’s name):
uses conflict in a way that endangers or damages the psychological
development of a child listed in 2.
[ ] Withholding the child – (Parent’s name):
has kept the other parent away from a child listed in 2 for a long time, without a
good reason.
[ ] Other (specify):
Explain and give examples for each limiting factor if not already covered above:
Petitioner fills out below:
I declare under penalty of perjury under the laws of the state of Washington that the facts I have
provided on this form (and any attachments) are true. [ ] I have attached (number):
pages.
Signed at (city and state):
Date:
Petitioner signs here
Print name
Co-Petitioner (if any) fills out below:
RCW 11.130.190, .220
Declaration Explaining Reasons for
(01/2021)
Minor Guardianship
GDN M 103
p. 4 of 5
I declare under penalty of perjury under the laws of the State of Washington that the facts I have
provided on this form are true.
Signed at (city and state):
Date:
Co-Petitioner signs here
Print name
RCW 11.130.190, .220
Declaration Explaining Reasons for
(01/2021)
Minor Guardianship
GDN M 103
p. 5 of 5
Page of 5