Form 6-4 - Guardianship Waiver Of Process, Renunciation, And Consent
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F.C.A. § 661,
Form 6-4
S.C.P.A. § 1703
Guardianship- Waiver of
Process, Renunciation,
and Consent
9/2012
NCFC 7/2013
FAMILY COURT OF THE STATE OF NEW YORK
COUNTY OF NASSAU
..............................................................................
Proceeding for the Appointment of a Guardian of
Waiver of Process,
Renunciation, and
Consent
,
First
M.I.
Last
FILE #
DOCKET #
A Person Under the Age of 21
..............................................................................
(Court use only)
STATE OF
)
:ss.:
COUNTY OF
)
The undersigned, whose name and permanent address is:
and whose interest in the above-entitled guardianship proceeding for the above person under the age
of 21, who is hereafter referred to as the subject, is as follows: [check
appropriate box]
G
Birth mother of the subject of this proceeding,
G
Birth father of the subject of this proceeding,
G
Person with whom the subject resides, if other than the parents or petitioner,
G
Adult next of kin of the subject, if birth parents are deceased,
G
Person who has adopted the subject or who has received legal guardianship or custody
of the subject,
hereby personally appears in the Family Court of Nassau County and
1. waives the issuance and service of process in this matter,
2. renounces all rights to letters of guardianship of the person of the subject,
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