New York Codes, Rules and Regulations
Title 22 - JUDICIARY
Subtitle D - Forms
Chapter VII - Surrogate's Court Forms
Subchapter A - Forms Authorized By Section 207.52
Surrogate's Forms
Form SG-6 - Consent of petition for standby guardian
SURROGATE'S COURT OF THE STATE OF NEW YORK
COUNTY OF ________
________x CONSENT OF PETITIONER
Proceeding for the Appointment FOR STANDBY GUARDIAN
of a Standby Guardian for (Pursuant to SCPA 1726 (3) (e) (iii))
________
An Infant.
________x File No. ________
I ________, state that:
1. I am the petitioner in the proceeding for the appointment of a Standby Guardian of my minor child.
2. A decree was signed on ________ appointing ________ standby guardian effective upon the execution of this consent.
3. Notwithstanding the request in the petition that the Standby Guardian's authority be effective upon my (incapacity) (death) (incapacity or death), [Delete inapplicable provision] I hereby consent to commencement of the Standby Guardian's authority upon (his) (her) receipt of this written consent executed in accordance with the provisions of Section 1726 (3) (e) (iii) of the Surrogate's Court Procedure Act.
4. I am physically unable to sign this written consent and have directed
______________
Name of person other than Standby Guardian to sign on my behalf in my presence and in the presence of two witnesses whose signatures are set forth below [Delete if inapplicable]
Dated: ________
______________
Petitioner's Signature
______________
Signature of Person other than Petitioner
I declared that the person whose name appears above (signed this consent in my presence) (was physically unable to sign and asked another to sign this document, who did so in my presence). I further declare that I am at least eighteen years old and am not the person designated as standby guardian.
Dated: ________ Witness:
______________
Signature
______________
Print Name
______________
Address
________
Dated: ________ Witness:
______________
Signature
______________
Print Name
______________
Address
________
I
(Name of Standby Guardian) appointed or designated as such by ________
hereby acknowledge that I have received the foregoing consent on the following date ________.
______________
Signature
______________
Print Name
[Note: The Standby Guardian must file this written consent with the Court within 90 days of receipt of the written consent. Failure to file may result in the guardian's authority being rescinded by the Court.]
Name of Attorney: ____________ Tel. No. ________
Address of Attorney: ____________
____________
