RELATIVE/KINSHIP STATEMENT
I, , parent of the above named child(ren), state the
following persons are my relatives, relatives of the other parent or persons who have
a substantial relationship with the child. I understand that I must list ALL relatives
and possible kinship placements regardless of whether I believe the child should be
placed with such person(s), and I specifically retain the right to support or oppose
such placement. I further understand that I must list all such information available to
me and must update this information in the future as it becomes known or available
to me.
Name Relationship Address/Tele#
Signature of Parent Date:
(TO BE FILED IN THE COURT'S LEGAL FILE PRIOR TO DISPOSITION OF
THE CAUSE)