Declaration of Appointment of Guardian for
My Children in the Event of My Death or Incapacity
I, _William Sample____, make this Declaration to appoint the guardian for my children, (names
of children), in the event of my death or incapacity.
I designate the following individuals to serve as guardians of the person of my children as listed
in preferred order and not serving jointly unless so specifically noted:
First: Phillip Sample, serving alone____________________;
Second: Bob and Mary Jones, serving jointly or the survivor__; and
Third: Junior Sample, serving alone____________________.
I designate the following individuals to serve as guardian of the estate of my children as listed
in preferred order and not serving jointly unless so specifically noted:
First: Phillip Sample, serving alone____________________;
Second: Bob and Mary Jones, serving jointly or the survivor__; and
Third: Junior Sample, serving alone____________________.
If any guardian or alternate guardian dies, does not qualify, or resigns, the next named
alternate guardian becomes guardian of my children.
Dated: ______________________, 20___.
I, _____________________________, sign my names to this instrument consisting of 1 pages
on ______________________, 20___ and do declare that I sign and execute this instrument as
my Declaration of Appointment of Guardian for My Children in the Event of My Death or
Incapacity, that I sign it willingly, that I execute it as my free and voluntary acts for the purposes
therein expressed, and that I are eighteen years of age or older, of sound mind, and under no
constraint or undue influence.
***
www.cunninghamlegal.com | 916-235-8700
This form is a free service as part of CunninghamLegal’s “Child Guardianship Kit” and does not constitute nor
replace legal advice. No printed information here constitutes an agreement of any kind.
Declaration of Appointment of Guardian for
My Children in the Event of My Death or Incapacity
I, ______________________________, make this Declaration to appoint the guardian for my
children, _______________________________________, in the event of my death or
incapacity.
I designate the following individuals to serve as guardians of the person of my children as listed
in preferred order and not serving jointly unless so specifically noted:
First: ______________________________________________;
Second: ____________________________________________; and
Third: _______________________________________________.
I designate the following individuals to serve as guardian of the estate of my children as listed
in preferred order and not serving jointly unless so specifically noted:
First: ______________________________________________;
Second: ____________________________________________; and
Third: _______________________________________________.
If any guardian or alternate guardian dies, does not qualify, or resigns, the next named
alternate guardian becomes guardian of my children.
Dated: ______________________, 20___.
I, _____________________________, sign my names to this instrument consisting of 1 pages
on ______________________, 20___ and do declare that I sign and execute this instrument as
my Declaration of Appointment of Guardian for My Children in the Event of My Death or
Incapacity, that I sign it willingly, that I execute it as my free and voluntary acts for the purposes
therein expressed, and that I are eighteen years of age or older, of sound mind, and under no
constraint or undue influence.
***
www.cunninghamlegal.com | 916-235-8700
This form is a free service as part of CunninghamLegal’s “Child Guardianship Kit” and does not constitute nor
replace legal advice. No printed information here constitutes an agreement of any kind.
ACKNOWLEDGMENT OF WITNESSES
I declare under penalty of perjury under the laws of the State of California that on the day and
year written above, _____________________________, published and declared this
instrument to be his/her Declaration of Appointment of Guardian for Children in the Event of
Death or Incapacity, that s/he signed this instrument in my presence, and at his/her request,
and in the presence of each other, have signed my name as attesting witness. I also declare
that each of us is now more than eighteen years of age and a competent witness.
I also declare that at the time of my attestation of this instrument,
__________________________ was, to my best knowledge and belief, of sound mind and
memory, eighteen years of age or older and under no duress, menace, fraud,
misrepresentation, constraint or undue influence.
Executed on ______________________, 20___ in the County of _________________,
California.
***, Witness
Address
***, Witness
Address
www.cunninghamlegal.com | 916-235-8700
This form is a free service as part of CunninghamLegal’s “Child Guardianship Kit” and does not constitute nor
replace legal advice. No printed information here constitutes an agreement of any kind.