Authorization Agreement For Nonparent Relative Or Voluntary Caregiver

AUTHORIZATION AGREEMENT

August 2011

Page 3 of 4

FOR NONPARENT RELATIVE OR

VOLUNTARY CAREGIVER

WARNINGS AND DISCLOSURES

cument. The parent and the relative or voluntary

This authorization agreement is an important legal do

caregiver must read all of the warnings and disclosures before signing this authorization agreement.

The parent and relative are not required to consult an attorney but are advised to do so.

A parent's rights as a parent may be adversely affected by placing or leaving the parent's child with

another person.

This authorization agreement does not confer on the relative or voluntary caregiver the rights of a

managing or possessory conservator or legal guardian.

eement may terminate the authorization agreement and

A parent who is a party to this authorization agr

resume custody, possession, care, and control of the child on demand and at any time the parent may

request the return of the child.

Failure by the relative or voluntary caregiver to return the child to the parent immediately on request may

have criminal and civil consequences.

Under other applicable law, the relative or voluntar

y caregiver may be liable for certain expenses relating

to the child in the relative's or voluntary caregiver's care, but the parent still retains the parental obligation

to support the child.

In certain circumstances, this authorization agreement may not be entered into without written permission

of the court. Examples of when court permission must be granted include when a court has entered a

previous order granting custody or establishing a child support obligation.

This authorization agreement may be terminated by certain court orders affecting the child.

This authorization agreement does not supersede, in

validate, or terminate any prior authorization

agreement regarding the child.

This authorization agreement is void if a prior authorization agreement regarding the child is in effect and

has not expired or been terminated.

MAILING

REQUIREMENTS:

When both parents do not sign the parent authorization agreement, a copy of the agreement MUST be

deceased or has had his or her parental rights

mailed to the non-signing parent, unless that parent is

terminated. This authorization agreement is void unless:

1. The parties mail a copy of this agreement to a non-signing parent not later than the 10th day

after the date the authorization agreement is signed, by certified or international registered

mail, as applicable, return receipt requested.

2. If the parties do not receive a response from the non-signing parent before the 20th day after the

date the copy of the agreement is mailed, the parties must mail a second copy of the agreement

by first class mail or international first class mail

not later than

, as applicable, to the parent

the 45th day after the date the authorization agreement is signed.

EXCEPTION

MAILING

REQUIREMENTS:

If a parent who did not sign the authorization agreement does not have court-ordered possession of

or access to the child who is the subject of the agreement, the parent who is a party to the

agreement does not have to mail a copy of the agreement to the non-signing parent if either of the

following circumstances applies:

1. A protective order has been issued against the non-signing parent as provided under Chapter

85 of the Texas Family Code or under a similar law of another state for committing an act of

the Texas Family Code) against the parent

family violence (as defined by Section 71.004 of

Authorization Agreement For Nonparent Relative Or Voluntary Caregiver - Texas Page 3

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