OFFICIAL FORM NO. 9 RENUNCIATION WAIVER OF PROCESS AND CONSENT SURROGATE'S COURT, COUNTY OF ______ ---------------------------Proceeding for the Appoint- ) ment of a Guardian ) WAIVER OF PROCESS, for ) RENUNCIATION AND ) CONSENT TO LETTERS ____________________________ ) OF GUARDIANSHIP An Infant ) ---------------------------The undersigned, whose domiciliary address is: ________________________________________________________________________ Street and Number ________________________________________________________________________ City, Village or Town State and whose interest in the above-entitled proceeding is as follows: (Check appropriate interest) ( ) Parent of the infant above-named. ( ) Grandparent of the infant above-named. ( ) Other: (Specify) ________________________________________________________ hereby personally appears in the Surrogate's Court of ______ County and (1) renounces all right to Letters of Guardianship of the person and property of said infant, (2) waives the issuance and service of process in this matter, and (3) consents that __________ be appointed the guardian of the person and property of said infant and that such letters may be granted to said person or to any other person entitled thereto without notice to the undersigned. Dated: __________ ___________________________ STATE OF _________ ) ) ss.: COUNTY OF ________ ) On ______, 19___, before me personally came __________ to me personally known to be the same person described in and who executed the foregoing instrument, and to me such person duly acknowledged that he or she executed the same. ___________________________________ American LegalNet, Inc. www.USCourtForms.com (Notary Public ) (NOTE: If acknowledgment taken outside New York State, Clerk's Certificate must be attached.) American LegalNet, Inc. www.USCourtForms.com