I, _________________________________, the natural mother/father of the minor child, ______________________________, who was born on ________________, hereby make the following nomination of a legal guardian of the person and property of my minor child, in the event I am unable, physically or mentally, to care for my child.
I
In the event I become unable to care for my minor child, it is my desire, and I hereby nominate, my friend, companion, and life partner, _________________________, currently residing in _________________, _______________, to be the legal guardian of the person and property of my minor child, _______________________. He/She is to serve without having to post a bond.
This nomination is based on the fact that a loving and parental relationship exists between ____________________ and _____________________. Furthermore, my minor child, ___________________________, has lived with this adult and looks to him/her for guidance, support, and affection. It would be detrimental to my child, _________________________, to deprive him/her of this established relationship at a time when I am unable to provide the security and care necessary to my child’s health development. It is in the child’s best interest that ____________________ be named the guardian of my minor child.
It is my strong belief that it would be in ______________________’s best interests to be placed in the care and custody of _________________________ notwithstanding the interest or availability of each and every one of my family members so to act as guardian.
I have chosen _______________________ as __________________’s guardian because he/she is the person most suitable and capable of helping and guiding ________________________. I believe that _______________________ can and will provide a warm, stable, and loving home for my child, and care for him/her and teach him/her with understanding and love.
I have given this matter long and careful contemplation before choosing any guardian for my child. I have considered each of my family members as well as close friends as possible guardians. After long and thoughtful reflection, for all of the above reasons, I firmly believe that it will be in ____________________’s best interests that __________________________ be named guardian of the person and estate (property) of my minor child in the event of my disability.
II
In the event that ______________________________ is unable to serve as guardian or is disqualified by a Court of law from serving, I nominate ___________________ to serve as the guardian of the person and property of my child, ________________.
III
[Both the identity and whereabouts of the minor child’s natural father are unknown to me.]
or
[The minor child was conceived through alternative insemination by an anonymous donor and has no natural father.]
or
[The minor child was conceived through alternative insemination by donor. Said donor waived, in writing, any and all rights he may have to object to my nomination of a guardian.]
I have purposefully not nominated my parents or siblings to be the guardians of my child in the event of my disability. It is my belief that they lack an established, close, and warm relationship with my child. I believe it would be detrimental to _____________________ to remove him/her from _________________________ and place him/her with adults who are, for all practical purposes, strangers.
IN WITNESS WHEREOF, I have hereunto signed my name this _______ day of ______________, 20___.
__________________________________________
Client’s Name
Witnesses
_______________________ executed this document, consisting of _____ pages in our presence. At his/her request, and in his/her presence, we have hereunto subscribed our names as attesting witness thereto. Each of us declares that __________________ appears to be of sound mind and free from duress or undue influence at the time he/she signed this document. He/She affirmed that he/she is aware of the nature of the document and signed it freely and voluntarily. _______________________________ Residing at ______________________________
_______________________________ Residing at ______________________________ State of _______________
County of _____________ At ___________________________, __________________ on the ____ day of 20__, ___________________________ personally appeared before me. He/She acknowledged this instrument, by him/her sealed and subscribed, to be his/her free act and deed. __________________________________________
Notary Public |
