Notarized And Verified Consent Or Nomination By Minor
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Notarized And Verified Consent Or Nomination By Minor Form. This is a Massachusetts form and can be use in Probate And Family Court Statewide.
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Tags: Notarized And Verified Consent Or Nomination By Minor, MPC 441, Massachusetts Statewide, Probate And Family Court
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
NOTARIZED AND VERIFIED CONSENT
OR NOMINATION BY MINOR
Division
In the Interests of:
Middle Name
First Name
Last Name
Minor
I,
(full name of minor) am 14
First Name
Middle Name
Last Name
years of age or older and I:
Consent to the appointment of
First Name
Last Name
M.I.
(full name) as my guardian(s) pursuant to G.L. c. 190B, § 5-203.
Do not consent to the appointment of
First Name
Last Name
M.I.
(full name) as my guardian(s) pursuant to G.L. c. 190B, 5-203.
§
Nominate
(full name), as my
M.I.
First Name
Last Name
guardian(s) pursuant to G.L. c. 190B, §5-207.
VERIFICATION AND ACKNOWLEDGMENT
I swear/affirm under oath that I have read the foregoing Consent or Nomination by Minor and that the statements set forth
therein are true and correct to the best of my knowledge.
Date
Signature of Minor
(Address)
(City/Town)
(Apt, Unit, No. etc.)
(State)
(Zip)
Primary Phone #
NOTARIZATION
, ss
On this
day of
Date
, 20
personally appeared
,
before me, the undersigned notary public, and proved to me through satisfactory evidence of identification, which was
, to be the person whose name is signed on the preceding or attached document
in my presence.
Signature of Notary Public
(Print name)
My Commission Expires
MPC 441 (5/30/11)
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