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Appearance Waiver And Consent To Adopt 292 - Kentucky
| Appearance Waiver And Consent To Adopt Form. This is a Kentucky form and can be used in Civil Statewide . |
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AOC-292 Doc. Code: AWCA Case No. Rev. 3-01 Page 1 of 1 Court [ ] Circuit [ ] Family Commonwealth of Kentucky Court of Justice County APPEARANCE -WAIVER AND KRS 625.041(3) CONSENT -TO-ADOPT IN THE INTEREST OF: _____________________________________________________________________, a child Address: _____________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ I, (print/type mothers name) ______________________________________________, voluntarily and knowingly waive my right to appear in the above-styled Voluntary Te rmination of Parental Rights proceeding. I consent to adoption of the above-named child. This waiver and agreement is entered freely and with full knowledge of the consequences of said waiver. Mothers Signature: _______________________________________ Mothers address to which final judgment is to be sent: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Subscribed and sworn to before me this ______ day of ________________, 2______. My commission expires: ____________________, 2_____. ______________________ ________________________________ County Notary Public I, (print/type fathers name) ______________________________________________, voluntarily and knowingly waive my right to appear in the above-styled Voluntary Te rmination of Parental Rights proceeding. I consent to adoption of the above-named child. This waiver and agreement is entered freely and with full knowledge of the consequences of said waiver. Fathers Signature: ______________________________________ Fathers address to which final judgment is to be sent: _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Subscribed and sworn to before me this _______ day of ________________, 2______. My commission expires: ____________________, 2_____. ______________________ _______________________________ County Notary Public____________________________________________ ____________________________________________ Guardian for Minor Mother Guardian for Minor FatherCounsel for [ ] Mother / [ ] Father: _______________________________________________________________(If a joint petition is filed, counsel shall be designated as attorney for both parties.) Signature of Cabinet Designee: _______________________________________________________________Distribution: Copy to Cabinet for Families & Children Page 1 of 1
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