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Blank Affidavit Parental Rights Form

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The Affidavit of Voluntary Relinquishment of Parental Rights form serves as a crucial legal document for individuals seeking to terminate their parental rights in a formalized manner. This form requires the affiant, the individual relinquishing their rights, to provide personal details, including their name, age, and residence, as well as information about the child involved. It outlines the relationship between the affiant and the child, establishing the legal context for the relinquishment. The form includes critical statements regarding any existing financial obligations to support the child, ensuring that all relevant responsibilities are addressed. Additionally, the affiant must articulate their belief that the termination of parental rights is in the best interest of the child, providing space for detailed reasoning. Understanding the implications of this decision is vital, as the form clarifies that the relinquishment is irrevocable after a specified period, although it allows for a revocation process within the initial eleven days. The document also emphasizes the need for proper notification and the witnessing of any revocation attempts, ensuring that the process is transparent and legally sound. Overall, this affidavit not only formalizes the relinquishment but also underscores the importance of informed consent in matters of parental rights.

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Dos and Don'ts

Do:

  • Provide accurate personal information, including your name and address.
  • Clearly state the reasons for relinquishing parental rights.
  • Sign the affidavit in front of a notary public.
  • Keep a copy of the completed affidavit for your records.

Don't:

  • Leave any sections blank; ensure all required fields are filled out.
  • Submit the affidavit without understanding the implications of relinquishing your rights.
  • Forget to communicate your intent to revoke within the specified timeframe.
  • Neglect to have the affidavit witnessed as required.

Affidavit Parental Rights Sample

Affidavit of Voluntary Relinquishment of Parental Rights

STATE OF: ___________ COUNTY OF:____________ COUNTRY: USA

BEFORE ME, the undersigned authority, on this day personally appeared

________________________, a person known to me, who, upon his oath, deposed

and stated as follows:

1.“My name is _____________________________, I am over the age of 21. I have personal knowledge of the statements made herein and am otherwise competent to make this affidavit.”

2.I reside at

____________________________________________________________________

____________________________________________________________________

_____________________________________________________________________

I am _________ years of age and was born on ____________________.

3._______________________is the name of the child. Her/His present address is:

__________________________________________________________________.

________________________________was born on _______________________and is currently ___________________years old.

4._________________________________is the mother and legal guardian

of:_______________________________________ .

PAGE 1

5.Choose one (5A or 5B) by placing an X in the box in front of the statement and completing the statement.

5A.

[

] I am not presently under an obligation by court order to make payments for the

support of ______________________________________.

or

 

 

5B.

[

] I am presently under an obligation by court order to make payments for the

support of ______________________________________.

6.___________________________________ presently does not own any property of value, real or otherwise.

7.It is my belief that termination of my parent-child relationship with

__________________________________ is in her/his (circle one) best interest for the following reason (s):

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

_____________________________________________________________________

(If more space is needed, attach an additional sheet and number it 7.)

PAGE 2

8.____________________________________________ is biological mother and current legal guardian of___________________________________

and resides at

______________________________________________________________(full address: street, city, state, zip).

9.I have been informed of parental rights and duties and herein acknowledge both the nature and extent of these rights and duties and my relinquishment of said rights and duties.

10.I am aware that my relinquishment of parental rights with respect to

_____________________________________is irrevocable (beyond the period of 11 days set forth in paragraph #11).

11.I acknowledge my right, which is evidenced by my execution of this Affidavit, to revoke this relinquishment if done so before the 11th day after the date of this Affidavit.

12.Should I choose to revoke this relinquishment, I understand that my revocation is to be communicated to ____________________________________(mother) at

___________________________________________, with telephone number (____) _________________________________ .

I understand that, to revoke this relinquishment, I must sign a statement witnessed by two (2) credible persons and verified before a person authorized to take oaths. I understand that this statement must

be delivered to _________________________________(mother) at the above

address and that a copy shall also be filed with the Clerk of the Court in which the suit for termination of the parent-child relationship has been filed, if applicable.

PAGE 3

13.My signature below additionally evidences that a copy of this Affidavit has been provided to me at the time of my signature and execution.

FURTHER AFFIANT SAYETH NOT.

Affiant

SWORN TO and subscribed before me on this day of _______________ 20____.

Notary Public in and for the State of __________________________. My Commission

Expires:__________________________________

Signature of Notary_______________________________________

________________________________SIGNATURE OF WITNESS

________________________________ Witness Name Printed

PAGE 4

Listed Questions and Answers

  1. What is the Affidavit of Voluntary Relinquishment of Parental Rights?

    The Affidavit of Voluntary Relinquishment of Parental Rights is a legal document that allows a parent to voluntarily give up their parental rights to their child. This document outlines the parent's personal information, the child's details, and the reasons for the relinquishment. It must be signed in the presence of a notary public to be valid.

  2. Who can complete this affidavit?

    Only a parent or legal guardian who is over the age of 21 can complete this affidavit. The individual must also have personal knowledge of the statements made in the document and be competent to make the affidavit.

  3. What information is required in the affidavit?

    The affidavit requires the following information:

    • The name and age of the parent relinquishing their rights.
    • The name and current address of the child.
    • The name of the child's mother and legal guardian.
    • Whether the parent is under a court order for child support.
    • A statement of the reasons for relinquishing parental rights.
  4. Can the relinquishment of parental rights be revoked?

    Yes, the relinquishment can be revoked within 11 days after signing the affidavit. To do so, the parent must communicate their intent to revoke to the child's mother and submit a signed statement witnessed by two credible persons, verified before a notary public.

  5. What happens if the relinquishment is not revoked?

    If the relinquishment is not revoked within the specified 11 days, it becomes irrevocable. This means that the parent permanently gives up their rights and responsibilities regarding the child.

  6. What are the consequences of signing this affidavit?

    By signing the affidavit, a parent acknowledges that they understand their parental rights and duties and are voluntarily relinquishing them. This decision can have significant emotional and legal implications, affecting custody, support, and visitation rights.

  7. Is legal counsel recommended before signing this affidavit?

    Yes, it is highly advisable to seek legal counsel before signing the affidavit. Understanding the full impact of relinquishing parental rights is crucial, and a lawyer can provide guidance on the process and potential consequences.

  8. What should be done after signing the affidavit?

    After signing the affidavit, the parent should ensure that a copy is provided to them. Additionally, if they choose to revoke the relinquishment within the 11-day period, they must follow the proper procedures outlined in the affidavit.

  9. Who needs to witness the revocation of relinquishment?

    The revocation statement must be witnessed by two credible persons. These witnesses should not have any interest in the outcome of the relinquishment or revocation process to ensure the validity of the statement.

Form Overview

Fact Name Description
Purpose The Affidavit of Voluntary Relinquishment of Parental Rights serves to formally terminate a parent's legal rights to their child.
Governing Law In many states, such as California, the process is governed by the California Family Code, specifically sections related to parental rights and responsibilities.
Irrevocability The relinquishment of parental rights is generally irrevocable after a specified period, often 11 days, unless a revocation statement is filed within that timeframe.
Notarization Requirement The affidavit must be notarized, confirming the identity of the affiant and the voluntary nature of the relinquishment.
Revocation Process If a parent wishes to revoke their relinquishment, they must do so in writing, witnessed by two credible persons, and delivered to the other parent.
Personal Knowledge The affiant must declare personal knowledge of the statements made in the affidavit, affirming their competence to execute the document.