SURROGATE'S COURT OF THE STATE OF NEW YORK
COUNTY OF ________
________x
Proceeding for the Appointment of a Standby Guardian for CONSENT OF INFANT OVER 14
________
File No. ________
An Infant.
________x
I, the infant herein, being over 14 years of age, join in the foregoing petition and consent that ________ be appointed standby guardian of my
[ ] person only
[ ] property only
[ ] person and property
______________
(Signature)
______________
(Print Name)
STATE OF NEW YORK )
) ss.:
COUNTY OF ________ )
On ________ 19 ________, before me personally came ________ to me known and known to me to be the person described in and who executed the foregoing instrument, and duly acknowledged to me that ________he executed the same.
______________
Notary Public
Commission Expires:
(Affix Notary Stamp or Seal)
Name of Attorney: ____________ Tel. No. ________
Address of Attorney: ____________
____________