Fill and Sign the Affiant on This Date Form

Form 202Rev 2/17 The Family Court of the State of Delaware In and For New Castle County Kent County Sussex County GUARDIANSHIP AFFIDAVIT OF CONSENT OF A CHILD’S PARENT Petitioner Respondent Name Name File Number Street Address (including Apt) Street Address (including Apt) P.O. Box Number P.O. Box Number Petition Number City/State/Zip Code City/State/Zip Code Date of Birth Date of Birth 2nd Petitioner (if any) 2nd Respondent (if any) Name Name Street Address (including Apt) Street Address (including Apt) P.O. Box Number P.O. Box Number City/State/Zip Code City/State/Zip Code Date of Birth Date of Birth BE IT REMEMBERED, that , (“Affiant”), on this date ,being duly sworn by me according to the law, personally appeared before me, a Notary Public for the State and County declared above, did depose and say:1) I am the Respondent in the above captioned matter involving my child:Child’s Name: Child’s Date of Birth: 2) I hereby agree that the above referenced Petitioner(s) shall become the guardian(s) of this child. As guardian, the Petitioner(s) shall protect, manage and care for this child.3)I understand that I shall have the primary responsibility to support this child financially and that this child will have the right to inherit from me and I will have the right to inherit from the child.4) I understand that my visitation and contact with the child shall be that which is set forth in a Court Order or a Consent Order entered into by all parties to this matter.5)I understand that the Court may appoint counsel to indigent respondents in guardianship cases. I freely and voluntarily waive my right to counsel.6) I understand that by signing this document and authorizing its filing, I am entering an appearance and agreeing to waive service of process of the petition for guardianship.SWORN TO AND SUBSCRIBEDbefore me this date, Affiant Notary Public/Clerk of Court