Form 202 Rev 2/17 The Family Court of the State of Delaware In and For New Castle County Kent County Sussex County GUARDIANSHIP AFFIDAVIT OF CONSENT OF A CHILD'S PARENT Petitioner Name Street Address (including Apt) Respondent Name Street Address (including Apt) File Number P.O. Box Number City/State/Zip Code P.O. Box Number City/State/Zip Code Petition Number Date of Birth Date of Birth 2nd Petitioner (if any) Name Street Address (including Apt) P.O. Box Number City/State/Zip Code Date of Birth 2nd Respondent (if any) Name Street Address (including Apt) P.O. Box Number City/State/Zip Code Date of Birth BE IT REMEMBERED, that , ("Affiant"), 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 am the Respondent in the above captioned matter involving my child: Child's Name: Child's Date of Birth: , 2) I hereby agree that the above referenced Petitioner(s) shall become the guardian(s) of this child. As guardian, the Petitioner(s) shall protect, manage and care for this child. 3) I understand that I shall have the primary responsibility to support this child financially and that this child will have the right to inherit from me and I will have the right to inherit from the child. 4) I understand that my visitation and contact with the child shall be that which is set forth in a Court Order or a Consent Order entered into by all parties to this matter. 5) I understand that the Court may appoint counsel to indigent respondents in guardianship cases. I freely and voluntarily waive my right to counsel. 6) I understand that by signing this document and authorizing its filing, I am entering an appearance and agreeing to waive service of process of the petition for guardianship. SWORN TO AND SUBSCRIBED before me this date, Affiant Notary Public/Clerk of Court American LegalNet, Inc. www.FormsWorkFlow.com