Fill and Sign the Consent Order Permanent Guardian of the Person Delaware Form

Form 124P Rev 2/18 The Family Court of the State of Delaware In and For New Castle County Kent County Sussex County CONSENT ORDER – PERMANENT GUARDIANSHIP Petitioner Respondent Petitioner (if any) Respondent (if any) Guardian Ad Litem (if any) IN THE INTEREST OF the following child:       ,       1 of 3Name D.O.B. Name D.O.B. File Number                         Street Address Street Address                   P.O. Box Number P.O. Box Number Petition Number             City/State/Zip Code City/State/Zip Code                   Phone Number Phone Number             Relation to Child(ren) Relation to Child(ren)             Attorney Name Attorney Name             Interpreter needed? Yes No Interpreter needed? Yes No Language       Language       Name D.O.B. Name D.O.B.                         Street Address Street Address             P.O. Box Number P.O. Box Number             City/State/Zip Code City/State/Zip Code             Phone Number Phone Number             Relation to Child(ren) Relation to Child(ren)             Attorney Name Attorney Name             Interpreter needed? Yes No Interpreter needed? Yes No Language       Language       Name       Law Firm       Office Address       City/State/Zip Code       Phone Number       Form 124P Rev 2/18 Name Date of Birth The parties in the above entitled cause agree upon the following arrangement and do consent to the entry of an Order providing for same: PERMANENT GUARDIANSHIP AWARDED TO:       Relat Street Address Relationship to Child:             P.O. Box Number       City/State/Zip Code       For Respondent: I understand the importance of my decision and fully realize the effects of granting permanent guardianship of my child to the above-named individuals; I understand that I retain the following rights: a. The right to visitation, contact and information as ordered by the court; b. The right to inheritance by and from the child; c. The right to consent to termination of parental rights and/or adoption of the child; AND d. The right to seek modification of the visitation, contact and information portions of the permanent guardianship order. I understand that after this consent is signed by me and confirmed, I may not petition the Court to modify or terminate the Permanent Guardianship. I understand that I may still have the primary responsibility to support my child financially; I know and understand that I have the right to be served with a copy of the petition for permanent guardianship, and have a hearing on that petition. I understand that the Family Court may conduct a hearing on this matter. I hereby waive my right to service and any notice of such hearing by checking the following box ; I know that I will receive notice of the final order of the Court only if I check the following box ; I have received a copy of my signed consent; and I have signed this consent voluntarily and of my own free will. I have neither been promised nor received any money or anything else of value in exchange for this consent. Respondent(s) shall have visitation as follows:       BE IT REMEMBERED , that on this date,       ,       ,       2 of 3 Form 124P Rev 2/18 who, 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: We, the undersigned, hereby agree upon the following permanent guardianship agreement for the above-named child. We signed this consent agreement voluntarily and of our own free will. THE RESPONDENTS ACKNOWLEDGE THAT EACH WAS ADVISED THAT IF HE/SHE IS INDIGENT AND WISHES TO HAVE COURT APPOINTED COUNSEL REPRESENT HIM/HER IN THIS ACTION, COUNSEL MAY BE APPOINTED FOR HIM/HER IN THIS ACTION. HE/SHE FREELY AND VOLUNTARILY WAIVES HIS/HER RIGHT TO COUNSEL. THE RESPONDENTS EACH ACKNOWLEDGE THAT BY SIGNING THIS DOCUMENT AND AUTHORIZING ITS FILING, HE/SHE IS ENTERING AN APPEARANCE AND AGREEING TO WAIVE SERVICE OF PROCESS OF THE PETITION FOR GUARDIANSHIP. This agreement of the parties is subject to review of the parties’ criminal histories by a hearing officer before entry as an order of the court. If signed by a Commissioner, the parties hereby waive their right to a Review of a Commissioner’s Order as this Order is entered pursuant to their voluntary agreement. Child (if over 14 years of age) Petitioner 2 nd Petitioner (if any) Respondent 2 nd Respondent (if any) SWORN TO AND SUBSCRIBED before me this date,       Notary Public/Clerk of Court SO ORDERED this       Day of ,       .       Judge/Commissioner 3 of 3