Docket No.: _______________ State of New Jersey Camden County Surrogates Court In the matter of the Guardianship of: } GUARDIANSHIP CONSENT ___________________________________________, A Minor AKA: _____________________________________ To: _____________________________, Surrogate of the County of Camden Be it known that I _____________, ________________ of above namd me inor/incapacitated person of the age of _______________ years, do hereby consent to the appointment of _____________ as the guardian of said minor/incapacitated person and that I do hereby waive any right which I may have to be so appointed. Dated: ____/____/____ Signed in the presence of: STATE OF NEW JERSEY } SS. COUNTY OF CAMDEN Be it remembered, that on this, ______________, before me, undersigned authority, personally appeared _________________, who I am satisfied is the person named in the foregoing instrument, to whom I first made known the contents thereof, and thereupon they acknowledged that they signed, sealed and delivered the same as their act and deed, for the uses and purposes therein expressed. J2.DOC Page 1 of 1