Approved, SCAO
JIS CODE: AOT
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
CASE NO. ACCEPTANCE OF APPOINTMENT (JUVENILE GUARDIAN)
Court telephone no.
COUNTY
Court address
1. In the matter of
name, alias(es), DOB
2. I have been appointed juvenile guardian of the child named above. 3. I accept the appointment, submit to personal jurisdiction of the court, will not delegate my authority, and agree to file reports and to perform required duties.
Date
Signature of juvenile guardian Name (type or print) Address City, state, zip Date of birth Telephone no.
Do not write below this line - For court use only
JC 92 (6/09)
ACCEPTANCE OF APPOINTMENT (JUVENILE GUARDIAN)
MCL 700.5215, MCR 3.979(B), (E)