Written Consent Pursuant To M.g.l. C.210, Ch 2 - Voluntary And Unconditional Surrender

Download a blank fillable Written Consent Pursuant To M.g.l. C.210, Ch 2 - Voluntary And Unconditional Surrender in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Written Consent Pursuant To M.g.l. C.210, Ch 2 - Voluntary And Unconditional Surrender with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

WRITTEN CONSENT PURSUANT TO M. G. L. c. 210, § 2
[VOLUNTARY AND UNCONDITIONAL SURRENDER]
(type or print - complete in triplicate)
I, as the
of
, age
, of
(relationship to child: mother/father)
(name of child)
the
sex, born in
, on
,
(male/female)
(place of birth)
(date of birth)
do hereby voluntarily and unconditionally surrender
to the
(name of child)
care and custody of
for the purpose of adoption or
(agency or person receiving custody)
such other disposition as may be made by a court of competent jurisdiction. I waive notice of any
legal proceeding affecting the custody, guardianship, adoption or other disposition of
.
(name of child)
I UNDERSTAND THAT THIS SURRENDER IS FINAL AND CANNOT BE REVOKED.
Signature:
(person giving consent)
On this
day of
,
, before me personally came and
(day)
(month)
(year)
appeared
and in my presence duly executed the foregoing
instrument, and (he, she) acknowledged to me that (he, she) executed the same as (his, her) free
act and deed, fully cognizant of its irrevocability.
Date
State of
Notary Public
County of
Signed by
as (his, her) freely executed consent in the
(person giving consent)
presence of each of us, and of each other, who thereafter have hereunto signed our names as
witnesses.
1)
2)
(Witness No. 1 Signature)
(Witness No. 2 Signature)
(Address)
(Address)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go