Guardianship of Minors Renunciation
Docket No.: ______________
State of New Jersey
Essex County Surrogate’s Court
Hall of Records, Room 206
ALTURRICK KENNEY
SURROGATE
Newark, New Jersey 07102
DEVERO D. MCDOUGAL
DEPUTY SURROGATE
Phone: 973-621-4900
Fax: 973-621-2654
In the matter of the Guardianship of:
_____________________________________________, a Minor
AKA: ________________________________________
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GUARDIANSHIP
RENUNCIATION
To: Theodore N. Stephens II, Surrogate of the County of Essex;
Be it known that the following individuals with the indicated relationships to the above-referenced of above
named minor person of the age of _____years, do hereby consent to the appointment of
___________________________ as the guardian of said minor/incapacitated person and that I do hereby waive
any right which I may have to be so appointed.
Renouncing Name (s) Relationship Signature
Dated: ______/______/______ Signed in the presence of:
Witness Signature
STATE OF NEW JERSEY
COUNTY OF ESSEX
}SS.
BE IT REMEMBERED, that on this, ____/____/____, before me undersigned authority personally appeared;
Renouncing Name (#1) Renouncing Name (#2)
who I am satisfied is/are the person(s) named in the foregoing instrument, to whom I first made known the
contents thereof, and thereupon they acknowledged that they signed, sealed and delivered the same as their act
and deed, for the uses and purposes therein expressed.
__________________________________________________
Notary Public/Attorney at Law of the State of New Jersey
My Commissi
on Expires: ____________________________
Affix Seal