IN THE ____________ COURT OF ____________________ COUNTY, WEST VIRGINIA IN THE MATTER OF: ________________________________________ ________________________________________ ________________________________________ Minor(s) Under the Age of 18 Years WAIVER OF GUARDIAN APPOINTMENT I, _______________________________,
Name
Civil Action No. ______-______-______
Father / Mother the following minor(s):
Age Date of Birth
______________________________ ______________________________ ______________________________
______________ ______________ ______________
________________________ ________________________ ________________________
hereby waive my priority right to qualify for the appointment as guardian (check one or both)
of the person / of the estate of the above-named minor(s).
(Optional)
Additionally, I nominate, and respectfully request that the Court appoint,
___________________________________________, as such guardian. Dated this ________ day of _______________________, 20_______. ______________________________ Parent Taken, subscribed, and sworn or affirmed before me this ________ day of _______________________, 20_______. My commission expires: . ______________________________ Notary Public
Infant Guardianship Form 4 / 6-04