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Affidavit of Voluntary Relinquishment of Parental Rights

STATE OF: ___________ COUNTY OF:____________ COUNTRY: USA

BEFORE ME, the undersigned authority, on this day personally appeared

________________________, a person known to me, who, upon his oath, deposed

and stated as follows:

1.“My name is _____________________________, I am over the age of 21. I have personal knowledge of the statements made herein and am otherwise competent to make this affidavit.”

2.I reside at

____________________________________________________________________

____________________________________________________________________

_____________________________________________________________________

I am _________ years of age and was born on ____________________.

3._______________________is the name of the child. Her/His present address is:

__________________________________________________________________.

________________________________was born on _______________________and is currently ___________________years old.

4._________________________________is the mother and legal guardian

of:_______________________________________ .

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5.Choose one (5A or 5B) by placing an X in the box in front of the statement and completing the statement.

5A.

[

] I am not presently under an obligation by court order to make payments for the

support of ______________________________________.

or

 

 

5B.

[

] I am presently under an obligation by court order to make payments for the

support of ______________________________________.

6.___________________________________ presently does not own any property of value, real or otherwise.

7.It is my belief that termination of my parent-child relationship with

__________________________________ is in her/his (circle one) best interest for the following reason (s):

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

_____________________________________________________________________

(If more space is needed, attach an additional sheet and number it 7.)

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8.____________________________________________ is biological mother and current legal guardian of___________________________________

and resides at

______________________________________________________________(full address: street, city, state, zip).

9.I have been informed of parental rights and duties and herein acknowledge both the nature and extent of these rights and duties and my relinquishment of said rights and duties.

10.I am aware that my relinquishment of parental rights with respect to

_____________________________________is irrevocable (beyond the period of 11 days set forth in paragraph #11).

11.I acknowledge my right, which is evidenced by my execution of this Affidavit, to revoke this relinquishment if done so before the 11th day after the date of this Affidavit.

12.Should I choose to revoke this relinquishment, I understand that my revocation is to be communicated to ____________________________________(mother) at

___________________________________________, with telephone number (____) _________________________________ .

I understand that, to revoke this relinquishment, I must sign a statement witnessed by two (2) credible persons and verified before a person authorized to take oaths. I understand that this statement must

be delivered to _________________________________(mother) at the above

address and that a copy shall also be filed with the Clerk of the Court in which the suit for termination of the parent-child relationship has been filed, if applicable.

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13.My signature below additionally evidences that a copy of this Affidavit has been provided to me at the time of my signature and execution.

FURTHER AFFIANT SAYETH NOT.

Affiant

SWORN TO and subscribed before me on this day of _______________ 20____.

Notary Public in and for the State of __________________________. My Commission

Expires:__________________________________

Signature of Notary_______________________________________

________________________________SIGNATURE OF WITNESS

________________________________ Witness Name Printed

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Documents used along the form

The Affidavit of Voluntary Relinquishment of Parental Rights form is often accompanied by several other documents that serve various purposes in the process of relinquishing parental rights. Below is a list of common forms and documents that may be used alongside this affidavit.

  • Consent to Adoption: This document indicates that a parent agrees to the adoption of their child by another individual or couple. It is typically signed after the relinquishment of parental rights and may be required by the court during the adoption process.
  • Termination of Parental Rights Petition: This is a formal request submitted to the court to terminate a parent's legal rights regarding their child. It outlines the reasons for the termination and is often filed alongside the affidavit.
  • Notice of Hearing: This document informs all relevant parties about the date and time of the court hearing regarding the termination of parental rights. It ensures that interested parties have an opportunity to attend and present their views.
  • Affidavit of Service: This form verifies that all necessary parties have been notified about the proceedings. It provides proof that the notice of hearing was delivered to the appropriate individuals.
  • Child’s Birth Certificate: A copy of the child's birth certificate may be required to establish the child's identity and confirm the relationship between the parent and child.
  • Financial Affidavit: This document outlines the financial situation of the parent relinquishing their rights. It may be used to assess the parent's ability to provide for the child and is often required in custody or support cases.
  • Doctors Excuse Note: This document is crucial for validating a patient's health condition and necessity for absence from work or school, ensuring that their rights are supported during the leave period. For more information, you can utilize the form available at https://doctorsnotetemplate.com/doctors-excuse-note-form/.
  • Parenting Plan: This document details the proposed arrangements for the child's care, including visitation rights and responsibilities. It is often created when parents are separating or when one parent is relinquishing their rights.
  • Background Check Authorization: This form grants permission for a background check to be conducted on the parent relinquishing their rights. It is often required by adoption agencies or courts to ensure the safety of the child.
  • Counseling Certificate: If counseling is recommended or required, this certificate confirms that the parent has completed the necessary counseling sessions related to the relinquishment process.

These documents collectively support the process of relinquishing parental rights and may be required by the court to ensure that all legal and procedural requirements are met. Each document serves a specific purpose and contributes to the overall clarity and legality of the proceedings.

Similar forms

  • Affidavit of Voluntary Relinquishment of Parental Rights: This document allows a parent to voluntarily give up their rights to a child. It outlines the parent’s personal information and the reasons for relinquishment, similar to the Affidavit Parental Rights form.
  • Parental Consent Form: This form is used to grant permission for a child to participate in activities or travel. Like the Affidavit Parental Rights, it requires the parent’s acknowledgment of their rights and responsibilities.
  • Trailer Bill of Sale: The https://nypdfforms.com/trailer-bill-of-sale-form/ is essential for documenting the sale and transfer of ownership of a trailer, ensuring clarity and compliance with New York state regulations.
  • Termination of Parental Rights Petition: This document is filed in court to formally end a parent’s legal rights to their child. It shares similarities with the Affidavit Parental Rights in that it addresses the parent-child relationship and the implications of termination.
  • Power of Attorney for Minor Child: This form allows a parent to designate another individual to make decisions on behalf of their child. Both documents require clear identification of the child and the parent’s intentions regarding parental authority.
  • Child Support Agreement: This agreement outlines the financial responsibilities of a parent towards their child. It is similar to the Affidavit Parental Rights in that it addresses the obligations of the parent, whether they are relinquishing rights or agreeing to support.
  • Guardianship Agreement: This document establishes a legal guardian for a child when the parent is unable to care for them. Like the Affidavit Parental Rights, it involves the transfer of certain parental rights and responsibilities to another party.

Misconceptions

Misconceptions about the Affidavit of Voluntary Relinquishment of Parental Rights can lead to confusion and misinformed decisions. Here are seven common misconceptions, along with clarifications for each.

  • It is easy to reverse the decision. Many believe that relinquishing parental rights is a simple process that can be undone at any time. In reality, this form makes it clear that the relinquishment is irrevocable after a specific period, except for a limited time frame of 11 days for revocation.
  • All parental rights can be relinquished without consequence. Some think that relinquishing parental rights means they will not have any responsibilities. However, the form requires the individual to acknowledge their parental duties and understand that relinquishment does not absolve them of all responsibilities until legally finalized.
  • The form is only for biological parents. It is a common belief that only biological parents can use this affidavit. In fact, legal guardians or individuals with parental responsibilities may also be involved in the process of relinquishing rights.
  • Once signed, the decision is permanent. While the relinquishment is generally irreversible after 11 days, individuals can revoke their decision within that time frame. It is important to follow the specific steps outlined in the affidavit to ensure the revocation is valid.
  • The affidavit guarantees the child's best interest. Some may assume that signing this affidavit automatically means the child's best interests are secured. However, the affidavit is only a statement of intent and does not guarantee that the child's welfare will be prioritized in future decisions.
  • Legal representation is not necessary. Many people think they can navigate this process without legal help. However, having a lawyer can provide essential guidance and ensure that all rights and responsibilities are understood and protected.
  • Filing the affidavit is the only step needed. Some believe that simply completing and filing the affidavit is enough. In reality, additional steps may be required, such as notifying the other parent and filing copies with the court, to ensure that the relinquishment is legally recognized.

Understanding these misconceptions can help individuals make informed decisions about their parental rights and responsibilities. It is crucial to approach this process with care and seek assistance when needed.

Understanding Affidavit Parental Rights

  1. What is the purpose of the Affidavit Parental Rights form?

    The Affidavit Parental Rights form is used when a parent voluntarily relinquishes their parental rights to a child. This document serves to formalize the decision and ensure that all parties understand the implications of such a relinquishment. It is essential for the legal process of terminating parental rights and can affect custody, support obligations, and the child's future welfare.

  2. Who should fill out the Affidavit Parental Rights form?

    The form should be filled out by the parent who wishes to relinquish their parental rights. They must be over the age of 21 and have personal knowledge of the statements made in the affidavit. It is crucial that the parent understands the nature and extent of their parental rights and the consequences of giving them up.

  3. Can a parent revoke their relinquishment of parental rights?

    Yes, a parent can revoke their relinquishment within 11 days of signing the affidavit. To do so, they must communicate their decision to the child's mother and provide a signed statement witnessed by two credible persons. This statement must also be verified before an authorized individual and delivered to the mother, with a copy filed with the court if applicable.

  4. What information is required on the Affidavit Parental Rights form?

    The form requires various pieces of information, including the names and addresses of the parent relinquishing rights, the child, and the child's current legal guardian. It also asks for the parent's age, the child's date of birth, and any existing court obligations regarding child support. Additionally, the parent must provide reasons for believing that relinquishing their parental rights is in the best interest of the child.

  5. What happens after the Affidavit Parental Rights form is signed?

    Once the affidavit is signed and notarized, it becomes a legal document. The relinquishment of parental rights is considered irrevocable after the 11-day revocation period unless the parent follows the proper procedure to revoke it. The form should be kept in a safe place, as a copy is typically provided to the parent at the time of signing.