ORDER
❒ Application Granted
❒ Application Denied
DATE: _________________________ ______________________________________________
CIRCUIT COURT JUDGE
Certificate of Document Preparation. You are required to truthfully complete this certificate
regarding the document you are filing with the court. Check all boxes and complete all blanks
that apply:
❒ I selected this document for myself and I completed it without assistance.
❒ I paid or will pay money to __________________ for assistance in preparing this
form.
______________________________________________________________________________
Signature of Petitioner
Print Name
______________________________________________________________________________
Address or Contact Address
City, State, Zip
Telephone or Contact Telephone
I certify that this is a true copy:
_________________________________
Petitioner’s Signature
PAGE 1 of 2 APPLICATION FOR GUARDIAN AD LITEM
Stalking: AppGuardianAdLitem- Ver02 (5/09)