Form SG-3 - Waiver of citation renunciation and consent to appointment of standby guardian
SURROGATE'S COURT OF THE STATE OF NEW YORK
COUNTY OF ________
________x
Proceeding for the Appointment WAIVER OF CITATION
of a Standby Guardian for RENUNCIATION AND CONSENT
TO APPOINTMENT OF STANDBY GUARDIAN
________ (SCPA 1726(3))
An Infant. File No. ________
________x
I, ____________ whose domicile is:
____________
(Street Address) (City/Town/Village)
____________
(County) (State) (Zip)
am a competent person over the age of eighteen years. My interest in the above entitled proceeding is as follows: [Check appropriate interest]
[ ] Parent of the above named infant
[ ] Grandparent of the above named infant
[ ] Other (Specity) ____________
I hereby personally appear and waive the issuance and service of a citation in this matter and
(1) Consent that ____________
be appointed the standby guardian of the
a. [ ] Person only
b. [ ] Property only
c. [ ] Person and Property
(2) Renounce all right to letters of Guardianship which may hereafter be issued by the Court upon the qualification of the Standby Guardian.
Dated: ________
______________
(Signature)
______________
(Print Name)
STATE OF NEW YORK )
) ss.:
COUNTY OF ________ )
On ________, 19 ________, before me personally appeared ________ to me known and known to me to be the same person described in and who executed the foregoing instrument, and duly acknowledged that ________ he executed the same.
______________
Notary Public
______________
Name of Attorney
Commission Expires: ________
(Affix Notary Stamp or Seal) Address
________
Telephone Number