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Irrevocable Mother'S Affidavit Of Relinquishment Of Parental Rights To A Licensed Child-Placing Agency - Texas District Court Page 4

may be placed for adoption and adopted is in the best interest of the child(ren). I understand that I make this

termination possible by executing this affidavit. With that in mind, I hereby declare that this Affidavit of

Relinquishment of Parental Rights is and shall be final, permanent and irrevocable.

“I FULLY UNDERSTAND THAT, IF I CHANGE MY MIND AT ANY TIME, I CAN

NEVER FORCE THE AGENCY TO DESTROY, REVOKE OR RETURN THIS AFFIDAVIT AND

THAT I CANNOT TAKE BACK OR UNDO THIS AFFIDAVIT IN ANY WAY.

"I have carefully considered alternative plans for my child(ren)'s future and have obtained the advice of

whatever family members, friends, or other persons and professionals I felt were necessary to help me make this

decision. This decision is very difficult for me to make, and under other circumstances I might have made a

different decision. Nevertheless, under the circumstances I find myself in, I have decided that I cannot provide

properly for the child(ren)'s physical and emotional needs, and I want ABRAZO ADOPTION

ASSOCIATES, to select a permanent home for the child(ren) and to place the child(ren) in that home to be

adopted. As I sign this Affidavit of Relinquishment of Parental Rights, I know that ABRAZO ADOPTION

ASSOCIATES, in accepting my child(ren) for adoptive placement and assuming responsibility for my

child(ren), is relying on my promise that I will not attempt to reclaim my child(ren). With this in mind, I

declare that I fully understand the meaning of this affidavit of relinquishment and the finality of my action in

signing it and, understanding all this, I am signing it freely, voluntarily, and with the firm conviction that this

decision is the best available alternative for my child(ren).

"I am signing this affidavit today because I want to sign it and not because ABRAZO ADOPTION

ASSOCIATES, or any other person or persons want me to sign it. I am ready emotionally and in every other

way to make the decision I am making today.

“I am signing this affidavit in the presence of the two undersigned witnesses, each of whom is known

by me to be a credible person and each of whom is present and acting as a witness. I want them to be here and

to witness my signature. I am also signing this affidavit before a notary public who has asked me under oath

whether or not each and every statement in this affidavit is true and correct and advised me not to sign it

unless it is.

Relinquishment of Parental Rights

Page 4

Affiant’s Initials _________

Irrevocable Mother'S Affidavit Of Relinquishment Of Parental Rights To A Licensed Child-Placing Agency - Texas District Court Page 4