Unless Ordered Confidential Pursuant To Family Court Act 154-b
Unless Ordered Confidential Pursuant To Family Court Act 154-b
Form 6-4
(Guardianship of a Minor – Waiver of
Process, Renunciation or Consent)
9/2012
FAMILY COURT OF THE STATE OF NEW YORK
COUNTY OF
........................................................................................
Proceedings for the Appointment of a
G Guardian G Standby Guardian of the Person Docket No.
of WAIVER OF PROCESS,
RENUNCIATION OR
a Minor CONSENT TO
G GUARDIANSHIP
G STANDBY GUARDIANSHIP
........................................................................................
The undersigned , who resides at [specify
1
address]:
and whose interest in the above-entitled proceeding is as follows [check applicable box]:
G Parent of the above-named Minor.
G Grandparent of the above-named Minor.
G Other [specify]:
personally appears in the Court of County and [check
applicable box(es)]:
G renounces all rights to Letters of Guardianship of the person of the Minor; and
G waives the issuance and service of process in this matter; and
G consents that [specify proposed guardian or standby guardian]: be
appointed the G Guardian G Standby Guardian of the person of the Minor; and that Letters of Guardianship
may be granted to the above-named person or to any other person entitled to such appointment without
notice to the undersigned.
______________________________________
Signature)
______________________________________
Print or Type Name
____________________________________
Signature of Attorney, if any
______________________________________
Attorney's Name (Print or Type)
______________________________________
_____________________________________
Attorney's Address and Telephone Number
Sworn to before me this __________
day of ______________, _________.
______________________________
(Deputy)Clerk of the Court
Notary Public
1
Unless ordered confidential pursuant to Family Court Act §154-b.