ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): Telephone No.: Fax No. (Optional): E-Mail Address (Optional): ATTORNEY FOR (Name): Bar No: FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE Costa Mesa Justice Complex Harbor Blvd. Costa Mesa, CA 92626-1554 GUARDIANSHIP OF , MINOR DECLARATION OF NON-COMPLIANCE (Guardianship) CASE NUMBER: did not comply with the terms of the Guardianship Settlement Agreement filed on (date) as follows: Therefore, I ________________________________ request that the guardianship matter be set for hearing.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: ___________________ _______________________________ _______________________________ (TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT) Approved for Optional Use L-2664 (Rev. May 2023) DECLARATION OF NON-COMPLIANCE (Guardianship)