Form 202P (Rev. 11/15) The Family Court of the State of Delaware In and For New Castle Kent Sussex County PERMANENT GUARDIANSHIP AFFIDAVIT OF CONSENT OF A CHILD'S PARENT Petitioner Name Street Address Respondent Name File Number Street Address P.O. Box Number City/State/Zip Code P.O. Box Number Petition Number City/State/Zip Code Date of Birth Date of Birth 2nd Petitioner (if any) Name Street Address P.O. Box Number City/State/Zip Code Date of Birth 2nd Respondent (if any) Name Street Address P.O. Box Number City/State/Zip Code Date of Birth BE IT REMEMBERED, that on this date, , ("Affiant"), who, being duly sworn to 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. 3. 4. 5. I hereby agree that the above referenced Petitioner(s) shall become the permanent guardian(s) of this child. As guardian, the Petitioner(s) shall protect, manage and care for this child. 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. 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. I know and understand that I have the right to be served with a copy of the petition for permanent guardianship and to attend a hearing on the permanent guardianship of my child(ren). I understand that the Family Court may conduct a hearing on this matter, which I have a right to attend. I waive the rights following any box that I have checked: My right to service of process; My right to notice of such a hearing; And my right to attend the hearing. Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Form 202P (Rev. 11/15) 6. 7. I understand that after the Permanent Guardianship is granted, I may not petition the Court to modify or terminate the Permanent Guardianship. I would like to receive a copy of the final order of the Court: Yes No SWORN TO AND SUBSCRIBED before me this date, Notary Public/Clerk of Court Affiant Print Name of Affiant Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com