New Mexico District Court Self-Help Guide

PARENTAL CONSENT TO APPOINTMENT OF GUARDIAN AND WAIVER OF SERVICE OF PROCESS

4-985

[Kinship Guardianship Act, Sections
40-10B-1 to 40-10B-14 NMSA 1978]

STATE OF NEW MEXICO

COUNTY OF

JUDICIAL DISTRICT No.

V.

Petitioner

Respondent

IN THE MATTER OF THE GUARDIANSHIP

OF

PARENTAL CONSENT TO APPOINTMENT OF GUARDIAN
AND WAIVER OF SERVICE OF PROCESS
(Paternity admitted)

I, upon my oath or affirmation state:

1. PARENTS OF THE CHILD

I, , am the [ ]¹ of (circle one) of:

Name: ,

Date of birth:

Present address:

2. MY AGREEMENT TO GIVE THE KINSHIP GUARDIANS MY LEGAL
RIGHTS AND DUTIES AS A PARENT

I understand that by signing this paper:

A. I am giving

(1) my legal rights and duties as a parent, except for the right to
consent to adoption and the duty to pay child support; and

(2) unless we have agreed upon visitation, the authority to make
all decisions when and if I may visit with my [ ].

B. If I want to terminate the kinship guardianship of the above child, I
will have to prove that the circumstances surrounding the signing of
this paper have changed and that it is in the best interest of my [ ]
[ ] that the guardianship be terminated.

C. I agree that it is in the best interest of the above child that the above
named petitioners be named as kinship guardians for the above child.

3. CHILD SUPPORT OBLIGATION

I understand that the petitioners are not requesting child support in
this proceeding.

I agree to pay child support as follows:

I understand that the court may require me to pay child support and
understand that the amount ordered can be changed by the court at any time
in the future.

4. CONSENT TO APPOINTMENT OF GUARDIAN

I consent to the appointment of as [ ] of the above [ ].

5. WAIVER OF RIGHT TO SERVICE OF SUMMONS AND PETITION

I have copies of the Petition for Order Appointing Kinship Guardian filed in
this case and waive service of the summons and additional pleadings.

I have not been given anything in exchange for signing this consent form.

6. RIGHT NOT TO SIGN

I UNDERSTAND THAT I DO NOT HAVE TO SIGN THIS CONSENT
FORM AND THAT I HAVE THE RIGHT TO CONTEST THIS ACTION.
I AM KNOWINGLY AND VOLUNTARILY SIGNING THIS FORM.

When I sign below, I am telling the judge that I have read this document and
agree with everything in it. I state upon my oath or affirmation that this
document and the statements in it are true and correct to the best of my
information and belief.

7. RIGHT TO WITHDRAW CONSENT

I understand that I may withdraw this consent at any time before the court
enters an order granting the petition for kinship guardianship by filing with
the court a motion notifying the court of my withdrawal of consent.²

Printed name

Address:

Telephone:

)

Acknowledged, subscribed and sworn to before me this day of

, , by , the petitioner.

My commission expires:

Notary Public

USE NOTES

1. This form should be used only if both respondents admit that that they are
the parents of the child. If paternity has not been established, Civil Forms
4A-331 and 4A-332 NMRA may be used to establish paternity. It is not
necessary to establish paternity for the court to enter a kinship guardianship
order, however, child support may not be ordered to be paid by a respondent
who has been named as the father of the child unless paternity has been
established.

2. If a respondent wishes to withdraw consent prior to the final court order
appointing the petitioner as kinship guardian, Form 4-991 NMRA may be
used.

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[Provisionally approved, effective August 15, 2003 until August 31, 2004; approved,
October 14, 2004.]

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