Fill and Sign the Guardianship Consent of Person over 18 and Form

F.C.A. §§ 661; S.C.P.A. §§ 1706, 1726Form 6-3(Guardianship – Consent of Person Over 18 andPreference of Person Over 14 RegardingAppointment of Guardian)FAMILY COURT OF THE STATE OF NEW YORK4/2011COUNTY OF...............................................................................................Proceedings for the Appointment of a Docket No.” Guardian of the Person Family File No.” Standby Guardian” CONSENT OF PERSON” Permanent Guardian OVER 18 YEARS OF AGE” Kinship Guardian” PREFERENCE OF MINOR (subsidized kinship guardian program)OVER 14 YEARS OF AGE REGARDINGAPPOINTMENT OF GUARDIANofA Person Under the Age of 21...........................................................................................State of New York:: ss.:County of:I am the person under the age of 21 who is the subject of this proceeding. I was born on[specify date and year of birth]:[Check applicable box(es)]:” I am over the age of 18, I have read the petition and believe it to be true and I consent tothe appointment of [specify name of proposed guardian]: as the: ” Guardian of my Person ” Standby Guardian ” Permanent Guardian” Kinship Guardian (subsidized kinship guardian program) until I reach the age of 21. 1 ” I am over the age of 14 and under the age of 18, I have read the petition and believe it to betrue, and I [check applicable box]: ” join in ” oppose ” do not have a preference regarding therequest for the appointment [specify name of proposed guardian]: as the: ” Guardian of my Person ” Standby Guardian ” Permanent Guardian ” Kinship Guardian (subsidized kinship guardian program)._____________________________________________________________ Sworn to this __ daySignature of Subject of Proceeding of , Print or type name___________________________ (Deputy Clerk of the Court)Signature of Attorney, if any(Notary Public) Attorney’s Name (Print or Type) Attorney’s Address and Telephone Number While the appointment of the guardian continues until I reach the age of 21, I understand that payments 1under the subsidized kinship guardian program will only continue if the application for payments was made after my16 birthday AND the social services district determines that: (i) I am completing secondary education or a program thleading to an equivalent credential; (ii) I am enrolled in an institution providing post-secondary or vocationaleducation; (iii) I am employed for at least eighty hours per month; (iv) I am participating in a program or activitydesigned to promote, or remove barriers to, employment; or (v) I am incapable of any of the above activities due to amedical condition regularly documented in my case plan.