Form Jv-140 - Application To The Juvenile Court Department For Appointment As Guardian Ad Item

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FOR COURT USE ONLY
APPLICATION
_________________________
Mail Application to:
Initial Review
to the
Administrative Office
_________________________
of the Juvenile Court
Juvenile Court Department
Approved
3 Center Plaza, 7th Floor
for Appointment as Guardian Ad Litem
_________________________
Boston, MA 02108
Entered
Name:
Business Address:
Residential Address:
Telephone (Bus):
Telephone (Res):
FAX:
BBO No.:
Email:
All notices and announcements regarding the guardian ad litem fee-generating appointment list are sent by email.
1) I have been appointed as an attorney (Atty), court investigator (CI), and/or a guardian ad litem (GAL) in
the following county division(s) of the Juvenile Court: (check all that apply)
Barnstable
Berkshire
Bristol
Essex
Franklin/Hamp
Hampden
Atty
Atty
Atty
Atty
Atty
Atty
CI
CI
CI
CI
CI
CI
GAL
GAL
GAL
GAL
GAL
GAL
Middlesex
Norfolk
Plymouth
Suffolk
Worcester
Atty
Atty
Atty
Atty
Atty
CI
CI
CI
CI
CI
GAL
GAL
GAL
GAL
GAL
2) Have you ever been removed from a fee-generating appointment list as an attorney, court investigator,
or guardian ad litem?
No
Yes If yes, please describe the circumstances for removal, indicate the
court(s) of removal and type of appointment(s) removed from.
JV-140 (01/20/2015)
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