Irrevocable Mother'S Affidavit Of Relinquishment Of Parental Rights To A Licensed Child-Placing Agency - Texas District Court Page 6

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VERIFICATION
VERIFICATION
VERIFICATION
VERIFICATION
STATE OF TEXAS
§
BEFORE ME, the undersigned notary public, on this day personally appeared
_______________________, who, being by me duly sworn on her oath, deposed and said that she is the
affiant and that she has read the foregoing Irrevocable Affidavit of Relinquishment of Parental Rights to
Licensed Child-Placing Agency and that the statements contained therein are within her personal knowledge
and are true and correct.
This Irrevocable Affidavit of Relinquishment of Parental Rights to Licensed Child-Placing
Agency was subscribed and sworn before me on this _______ day of _____________________,
__________, by the affiant.
______________________________________
Notary Public, State of Texas
Relinquishment of Parental Rights
Page 6
Affiant’s Initials _________

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