Fill and Sign the Be it Remembered that on This Date Form

Form 265(Rev02/11) The Family Court of the State of Delaware In and For New Castle Kent Sussex County STANDBY GUARDIANSHIP AFFIDAVIT OF CONSENT OF A CHILD’S PARENT Petitioner v. Respondent2nd Petitioner (if any) v. 2nd Respondent (if any)BE IT REMEMBERED, that on this date, , (“Affiant”), who, being duly sworn to me according o the law personally appeared before me, a Notary Publicfor 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 that above referenced Standby Guardian(s) shall become the guardian(s) of this child upon the occurrence of a triggering event and that the Alternate Standby Guardian shall serve in that role if the Standby Guardian is unable to do so. 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 in this manner. Affiant Sworn to subscribed before me this ______ day of ______________________, _________ Mediator/Notary Public Date NameName File Number Street AddressStreet Address P.O. Box NumberP.O. Box Number Petition Number City/State/Zip CodeCity/State/Zip Code Attorney NameAttorney Name NameName Street AddressStreet Address P.O. Box NumberP.O. Box Number City/State/Zip CodeCity/State/Zip Code Attorney NameAttorney Name