Missouri > Local Circuit Courts > 7th Circuit (Clay County) > Probate > Minors And Adults
Consent To Serve 428 - Missouri
| Consent To Serve Form. This is a Missouri form and can be used in Minors And Adults Probate 7th Circuit (Clay County) Local Circuit Courts . |
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CIRCUIT COURT OF CLAY COUNTY, MISSOURI PROBATE DIVISION No. Matter of , *Respondent / *Minor. CONSENT TO SERVE The undersigned hereby consents to serve as Guardian and/or Conservator of the above-named Respondent/Minor, if appointed by the Court and in support thereof states: 1. The undersigned has never pled guilty to nor been convicted of a misdemeanor (except traffic convictions ) or a felony. 2. The undersigned spouse is: 3. The undersigned resides at: 4. The undersigned is presently employed by: , located at: 5. The following listed persons will know the whereabouts of the undersigned: ____________________________________________________________________________ Name _______ _____________________________________________________________________ Address ____________________________________________________________________________ Name ____________________________________________________________________________ Address ________ ____________________________________________________________________ Name ____________________________________________________________________________ Address 6. The undersigneds Social Security Number____________________________________ THE STATEMENTS AND REPRESENTATIONS IN THIS DOCUMENT ARE MADE UNDER OATH AND ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THEY ARE MADE SUBJECT TO THE PENALTIES OF MAKING A FALSE AFFIDAVIT OR DECLARATION. Dated:______________ Signature____________________________________________ Address________________________________________ ________________________________________ Telephone:________________________________________ Form 428 Page 1 of 1 Revised 3/14/2003
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