IN THE ____________ COURT OF ____________________ COUNTY, WEST VIRGINIA IN THE MATTER OF: ________________________________________ Civil Action No. ________________________________________ ______-______-______ ________________________________________ Minor(s) Under the Age of 18 Years WAIVER OF GUARDIAN APPOINTMENT I, _______________________________,
Father /
Mother the following minor(s): Name A ge D ate of Birth ______________________________ ______________ ________________________ ______________________________ ______________ ________________________ ______________________________ ______________ ________________________ hereby waive my priority right to qualify for the appointment as guardian (check one or both)
of the person /
of the estate of the above-named minor(s). (Optional)
Additionally, I nominate, and respectfully request that the Court appoint, ___________________________________________, as such guardian. Dated this ________ day of _______________________, 20_______. ______________________________ P aren t Taken, subscribed, and sworn or affirmed before me this ________ day of _______________________, 20_______. My commission expires: . ______________________________ Notary Public Infant Guardianship Form 4 / 6-04