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Consent To Termination Of Parental Rights Affidavit JC-1636 - Wisconsin
|Consent To Termination Of Parental Rights Affidavit Form. This is a Wisconsin form and can be used in Parental Rights Circuit Court Statewide .||
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FORM SUMMARY Name of Form: Form Number: Statutory Reference: Benchbook Reference: Purpose of Form: Consent to Termination of Parental Rights (Affidavit) JC-1636 §§48.41(2)(c) and 48.41(2)(d), Wisconsin Statutes JV 13 Affidavit by a parent consenting to the termination of their parental rights to a child. Party seeking the termination will usually make the arrangements to have this affidavit completed. Original filed with the court. May accompany the Petition for termination of parental rights (voluntary) or may be received subsequent to the filing of the petition. Modification, last update 07/05. Added Indian Child Welfare Act (ICWA) language and references. None This form is the product of the Wisconsin Records Management Committee, a committee of the Director of State Court's Office and a mandate of the Wisconsin Judicial Conference. If you have additional information that does not change the meaning of the form, attach it on a separate page. The form itself shall not be altered. Who Completes It: Distribution of Form: Accompanying Forms: New Form/Modification: Modifications: Comments: About this form: Date: 04/24/2008 Page 1 American LegalNet, Inc. www.FormsWorkflow.com STATE OF WISCONSIN, CIRCUIT COURT, COUNTY For Official Use IN THE INTEREST OF Consent to Termination of Parental Rights (Affidavit) Case No. a person under the age of 18. Date of Birth UNDER OATH, I STATE: 1. My name is My address is My date of birth is 2. My child is not a member of or eligible for membership in an Indian tribe. 3. For stepparent adoptions: father of this child mother · I am the was not born during a marriage with the other parent. was · The child For non-marital, non-adjudicated alleged fathers: , mother of this child. · I have never been married to · I have never been adjudicated (formally determined by a court) to be the father of this child. · I am aware that I am alleged to be the father of this child. · I am not admitting or denying that I am the father of this child. 4. I know that a petition to terminate my parental rights has been or will be filed. 5. I have been informed and understand that a court order terminating parental rights will permanently end ALL legal rights and duties that exist between myself and this child, such as: · Duty to support · Right to custody and visitation · Right to inherit 6. I wish to give up any parental rights that I may have to this child and consent to the court entering an order terminating my parental rights. 7. I give up the right to know of any future hearing or proceedings in this matter. 8. I am making this decision on my own free will. No promises or threats have been made to get me to sign this document. Subscribed and sworn to before me on Signature Notary Public, State of Wisconsin Name Printed or Typed My commission expires: Date FOR STEP PARENT ADOPTIONS, YOU MUST HAVE TWO WITNESSES SIGN BELOW IN ADDITION TO COMPLETING THE NOTARY SECTION ABOVE. Signature of Witness Signature of Witness JC-1636, 04/08 Consent to Termination of Parental Rights (Affidavit) §§48.41(2)(c) and 48.41(2)(d), Wisconsin Statutes American LegalNet, Inc. www.FormsWorkflow.com This form shall not be modified. It may be supplemented with additional material.