Fill and Sign the Form 201p

Form 201PRev 2/17 The Family Court of the State of Delaware In and For New Castle County Kent County Sussex County PERMANENT GUARDIANSHIP AFFIDAVIT OF CONSENT OF CHILD 14 YEARS OF AGE OR OLDER 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 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 , (“Child”), 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 hereby agree that the above named Petitioner(s) shall be my guardian(s). 2) I understand that as my permanent guardian(s), the Petitioner(s) shall protect, manage and care for me as a parent would and that they shall make decisions regarding my care.SWORN TO AND SUBSCRIBEDbefore me this date, Affiant Notary Public/Clerk of Court