§ Petition, Consent and Order for MotherAppointment as s Next Friend

Petition, Consent and Order for Mother’s Appointment as Next Friend

                                [Publisher's note: Referenced interactive forms can be accessed at www.selfrepresent.mo.gov]

   In what Missouri county will this case be               In the Circuit Court of                      MISSOURI
   filed?

    If this case has already been filed, what is the    Case Number                                     Division Number
    case number of the pending case?

    The Parties       1. I am the mother of the child(ren) listed below and consent to my appointment as next friend of the
                                      child(ren). I request that I be appointed as next friend for the child(ren). My name and address is:

                                     ____________________    ____________       ________________
                                     (Mother's First Name)              (Middle Name)    (Mother's Last Name)

                                     ______________________________________________________________
                                           (Street)

                                     __________________________________    _________________   ________
                                                          (City)                                                         (State)                             (Zip)

                                    _________________________________    ____________________________
                                        (Telephone Number)                                             (E-Mail Address)

                            2.   The following child(ren) is/are PLAINTIFF(S) in this case and each child who is age 14 years or
                                   older requests that I be appointed as next friend for him or her in this case

                                  a.    _____________________________________                       Birth Date: __________
                                         (Child's full name as it appears on the birth certificate)                      (mm/dd/ yyyy)

                                        _______________ CHILD SIGN HERE (if age 14 or older)

                                b. _____________________________________                           Birth Date: __________
                                    (Child's full name as it appears on the birth certificate)                                (mm/dd/ yyyy)

                                   _______________ CHILD SIGN HERE (if age 14 or older)

                                c. _____________________________________                           Birth Date: __________
                                   (Child's full name as it appears on the birth certificate)                                      (mm/dd/ yyyy)

                                  _______________ CHILD SIGN HERE (if age 14 or older)

                               d. _____________________________________                               Birth Date: __________
                                   (Child's full name as it appears on the birth certificate)                                    (mm/dd/ yyyy)
                                  _______________ CHILD SIGN HERE (if age 14 or older)

                              e. _____________________________________                                  Birth Date: __________
                               (Child's full name as it appears on the birth certificate) (mm/dd/ yyyy)

                             _______________ CHILD SIGN HERE (if age 14 or older)

                             f. _____________________________________                               Birth Date: __________
                                (Child's full name as it appears on the birth certificate)                             (mm/dd/ yyyy)
                              _______________ CHILD SIGN HERE (if age 14 or older)

                                  Petition, Consent and Order for Mother's Appointment as Next Friend--Page 1 of 2

Form CAFC751-01/01/               This form is available for free at www.selfrepresent.mo.gov
2011
                      3.     [ ] The child(ren) reside(s) with me.

                               [ ]The child(ren) reside(s) with the following person(s) at the following address:

                              ____________________   ____________    _________________   _________
                                          (First Name)               (Middle Name)              (Last Name)          (Jr./Sr./III)

                            ______________________________________________________________
                                        (Street)

                            __________________________________   _________________    ________
                                              (City)                                                                 (State)                           (Zip)

                            _________________________________    ____________________________
                                     (Telephone Number)                                                (E-Mail Address)

                          ____________________________________ ____________________________________
                                                        MOTHER SIGN HERE                          PRINT YOUR NAME HERE

     ATTORNEY INFORMATION (To be completed by your attorney)                       Do not enter any
                                                                                                                                            information here if
     ____________________________     ____________________                  you are filing this
    Attorney--SIGN HERE                                Missouri Bar Number                        case without the assistance of a lawyer.
    __________________________________________________                 This information should be
     Attorney for Movant--PRINT YOUR NAME HERE                                                 completed by your attorney.
    __________________________________________________
         (Street)
    _______________________________    ___________    _____                   [ ] I have assisted
                              (City)                                                (State)            (Zip)                      Plaintiff(s) in the preparation of these
    ________________        ____________     ___________________                pleadings, but I am
        (Telephone Number)      (Fax Number)              (Email Address)                  not entering my appearance on behalf
                                                                                                                                           of Plaintiff(s).

    Mother is appointed as next friend for the minor child(ren) listed
    above.

    So Ordered:

    ___________________________     ___________
               Judge/Commissioner                      Date

                                      Petition, Consent and Order for Mother's Appointment as Next Friend--Page 2 of 2

Form CAFC751-01/01/         This form is available for free at www.selfrepresent.mo.gov
2011

                           [Publisher's note: Referenced interactive forms can be accessed at www.selfrepresent.mo.gov]