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Affidavit Of Consent To Termination Of Parental Rights And Adoption Form. This is a Delaware form and can be use in Family Court Statewide.
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Tags: Affidavit Of Consent To Termination Of Parental Rights And Adoption, 110, Delaware Statewide, Family Court
Form 110
(Rev. 12/07)
The Family Court of the State of Delaware
In and For
New Castle
Kent
Sussex County
AFFIDAVIT OF CONSENT TO TERMINATION OF
PARENTAL RIGHTS AND ADOPTION
I,
_________________________________________,
the
__________________
of
_______________________________________, who was born on ___________________ ,
agree and consent to the termination of my parental rights in said child and furthermore consent to
the adoption of said child by ___________________________________. Further, I understand the
importance of my decision and fully realize the effects of the termination of parental rights and the
adoption of said child. I have read and have had read to me the statements on the reverse side of
this form and fully understand and agree with each statement.
I have signed this consent voluntarily and of my own free will.
Consenting Party
Date
State of
County of
Sworn to subscribed before me:
Notary Public
Date
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Form 110
(Rev. 12/07)
TERMINATION OF PARENTAL RIGHTS AND
ADOPTION CONSENTING PARTY STATEMENT
I,
_________________________________,
THE
__________________________
of
________________________________________, who was born on _____________________:
1. Believe the adoption of my child by ________________________________ would be in the
child’s best interest.
2. Know that my decision to terminate my parental rights and to consent to the adoption of my
child is an important one.
3. Know and understand that upon the Court’s granting of the final decree of adoption that my
parental rights over said child shall be terminated and I will no longer be the legal parent of
my child.
4. Know and understand that when my child is adopted and my parental rights in said child are
terminated, I give up all rights, privileges, and responsibilities concerning the child.
5. Know and understand that when my child is adopted and my parental rights in said child are
terminated, the child becomes the child of _______________________________and
____________________________, and as a result the child’s name may be changed.
6. Know and understand that when my child is adopted and my parental rights in said child are
terminated, I will not have the right to visit with him/her or know his/her whereabouts.
7. Know and understand that when my child is adopted and my parental rights in said child are
terminated, my child loses the right to inherit from me and I lose the right to inherit from
him/her. This shall not in any way limit my right to provide for the disposition of my estate by
will.
8. Know and understand that I may, within sixty (60) days of the filing of the adoption petition
containing this consent, petition the Family Court to revoke this consent and dismiss the
adoption petition.
Consenting Party
Date
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