Indiana Guardianship FormIndiana Guardianship FormIndiana Guardianship Form
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APPENDIX 5
(continued)
GUARDIANSHIP FORMS

STATE OF INDIANA
COUNTY OF (County)

)
) SS:
)

IN THE MATTER OF:
THE GUARDIANSHIP OF:
________________, A Minor.

IN THE (County) (Name of Court)
CAUSE NO.
)
)
)
)
)

CONSENT TO THE APPOINTMENT OF A GUARDIAN BY A RELATIVE
(Father, or Mother), being duly sworn upon his or her oath, says that he or she is an adult
and the natural father or mother of (child) and is familiar with the Petition of (Petitioners) for the
appointment of a guardian over the person of (child) and consents to the appointment of
(Petitioners) and hereby expressly waives service of summons and notice of hearing on said
guardianship petition.

__________________________________________
(name)

Sworn to me and subscribed in my presence, a Notary Public in and for the State of
Indiana, County of ________________this________day of_______________, 200_.

__________________________________________
Notary Public

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