IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION AT IN THE ESTATE OF ESTATE NUMBER , Minor(s) CONSENT TO APPOINTMENT OF FIDUCIARY I request the appointment of as guardian of the person and/orconservator of the estate of: who (is) (are) My natural children for the following reasons: I hereby freely and voluntarily consent to the appointment of the above named person. I understand that suchappointment shall be subject to laws of the State of Missouri and the supervision of the probate division. I understand that I shall not have any right or claim to control or custody of such child(ren) or property. I understandthat the appointment is permanent and will not be set aside merely at my request. I understand that the appointmentwill only be set aside upon resignation of the fiduciary or upon proof that the fiduciary should be removed upongrounds as provided by law after notice and hearing to all persons interested in the welfare of the child(ren). Ihereby state that this consent is freely given without condition and without representation by any person, includingthe proposed fiduciary, to the effect that this proceeding is a temporary undertaking which may be terminated at myrequest. Natural Parent Page 1 of 2 >>>> 2STATE OF ) COUNTY OF ) On before me a Notary Public in and for said State and County, personallyappeared to me known to be the person described in and who executedthe Consent to Appointment of Fiduciary as natural parent and acknowledged the same as her/his free act and deed for the uses and purposes therein stated. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal at my office in said State and County, the day and year first above written. Notary Public My commission expires: Form 10323 Page 2 of 2 7/26/96