Page 1 of 1 - Consent to Guardianship by Mother - County ( 201) Form G IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF In the Matter of the Guardianship of: ) Case Number: ) ) CONSENT TO GUARDIANSHIP BY ) MOTHER Minor Child(ren) ) I, , the undersigned, being the natural mother of , a minor of the age of years, do hereby consent to and request the appointment of as guardian of my minor child. I hereby waive notice of hearing and waive any time to object to the petition of for the appointment of a guardian for my minor child. DATED this day of , 20 . Signature of Mother SUBSCRIBED and SWORN to before me this day of , 20. Notary Public for Oregon/Court Clerk My Commission Expires: American LegalNet, Inc. www.FormsWorkFlow.com