IN THE SUPERIOR COURT OF FULTON COUNTY STATE OF GEORGIA FAMILY DIVISION Petitioner. ________________________________ Civil Action File No. and Judge ___________________________________ Respondent. ______________________________ MOTHER’S CONSENT TO LEGITIMATION (Mother to complete this document) 1. I, _____________________________________________, am the mother of the following child(ren): Name Male/Female Birth Date 2. I hereby consent in writing to the following: (check any to which you consent) □ The legitimation of the child(ren) listed above by the Petitioner/ biological father, _______________________________________________. □ The change of the child(ren)’ s last name to ______________________________________. □ I otherwise consent as follows:__________________________________________________ __________________________________________________________________________ 3. I make this consent freely and knowingly. I have not been forced to sign this consent, and I am not under any duress at the time that I am signing this Consent to Legitimation. This the _____ day of ___________________, 20_____. ________________________________________ MOTHER/RESPONDENT Mother’s name (print): _____________________ Mother’s address:_________________________ ________________________________________ Mother’s phone number: ____________________ Sworn to and subscribed before me this _____ day of ____________________, 20____. ______________________________________ Notary public My Commission expires: (NOTE: An Acknowledgment of Service will also be required.) Mother’s Consent to Legitimation Form © 2006 Fulton County Superior Court Family Division American LegalNet, Inc. www.FormsWorkflow.com