F.C.A. § 661 Form 6-3
S.C.P.A. § 1706 Guardianship- Consent of
Person Over 18 or
Preference of Person Over
14
4/2011
NCFC 6/2013
FAMILY COURT OF THE STATE OF NEW YORK
COUNTY OF NASSAU
..............................................................................
Proceeding for the Appointment of a Guardian of G Consent of Person Over Age 18
and Under Age 21 Regarding
Appointment of a Guardian
, G Preference of Minor Over Age 14
First M.I. Last and Under Age 18 Regarding
Appointment of a Guardian
A Person Under the Age of 21
.......................................................................................
STATE OF )
:ss.:
COUNTY OF )
I am the person under the age of 21 who is the subject of this proceeding. I was born on
[specify date of birth]: .
[check U applicable box]:
G I am over the age of 18. I have read the petition and believe it to be true, and I consent to the
appointment of [specify name of proposed guardian]: as the
guardian of my person until I reach the age of 21.
G I am over the age of 14 and under the age of 18. I have read the petition and believe it to be
true, and join in the request for the appointment of [specify name of proposed guardian]:
as the guardian of my person.
Subject [sign name before a notary]
Sworn to before me this
day of , 20
Notary Public
FILE #
DOCKET #
(Court use only)
