SUPERIOR COURT OF FULTON COUNTY STATE OF GEORGIA FAMILY DIVISION , Civil Action Plaintiff, v. , Defendant. Case Number CONSENT TO LEGITIMATION 1. I am the mother legal guardian legal custodian of following minor child(ren), who is/are the subject of this Legitimation action filed by the Petitioner: Current Name of Child Male / Female Year of Birth 2. I hereby give my consent to the following provisions, by writing my initials next to them. I do not agree to any of the provisions unless I have written my initials next to them. [Write your initials next to only the ones to which you agree. Draw a line through the ones to which you do not agree] _____ (a) I agree to the Petitioner legitimating our child(ren), whose names are listed in Paragraph 1 above. [Write your initials next to only the ones to which you agree. Draw a line through the ones to which you do not agree] Consent to Legitimation -- Rev. Sept. 2015 Provided by the Fulton Family Law Information Center Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com _____ (b) . (c) I agree to changing the child(ren's) last name to:____________________. _____ I agree to the following arrangement concerning custody and visitation: ___________________________________________________________________________. _____ (d) On the issue of child support: [Write your initials next to only one of the following, (1) to (4).] _____ (1) Child support has already been decided for the child(ren) by a court or agency in another case. I want the Court to decide child support and enter a child support _____ (2) order as part of this legitimation case. The Petitioner and I have reached an agreement on child support _____ (3) for the child(ren), and it is consistent with the Georgia child support guidelines. The completed Child Support Addendum and Worksheet is attached. I understand that it will be included in the final order in this case. _____ (4) The parties live together with the child(ren), so no child support order is necessary at this time. 3. I have read this consent document, and I understand it. I am giving my consent freely. I have written my initials next to all of the provisions in Paragraph 2 to which I am agreeing. I am not being forced to sign this consent, and I believe this legitimation is in the best interest of my child(ren). Respondent (Signature) Name: ___________________________________ Email: _________________________________ Subscribed & sworn to before me on , 20 . IF YOU DO NOT HAVE AN EMAIL ADDRESS, FILL OUT A CERTIFICATE OF NO EMAIL ADDRESS Phone (daytime): _______________ _______________________________ Notary Public Commission Expires: _____________ Consent to Legitimation -- Rev. Sept. 2015 Provided by the Fulton Family Law Information Center Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com