Adoption Consent Form - Texas

TEXAS ADOPTION CONSENT: PARENT'S AFFIDAVIT OF VOLUNTARY RELINQUISHMENT

Before signing: Complete every field and have two credible witnesses and a person authorized to take oaths present. The parent must sign at least 48 hours after the child's birth. Give the parent a copy when signed. A biological parent must also prepare the medical history report required by Tex. Fam. Code § 161.1031. This affidavit designates a prospective adoptive parent as managing conservator; it does not itself terminate parental rights.

1. Parent and Child

I, [parent's full legal name], am the parent of the child identified below. I reside in [county] County, Texas, and am [age] years old.

• Child's full name: [name]
• Child's age: [age]
• Child's date and time of birth: [date and time]
• Place of birth: [city, state]
• Date and time this affidavit is signed: [date and time]

2. Required Family and Property Information

Guardians of the child's person and estate: [Names and addresses of each guardian, or “None.”]

Court-ordered child support: I [am / am not] presently obligated by court order to pay support for this child. If yes, identify the court, cause number, and obligation: [details].

Property owned or possessed by the child: [Full description and value of each item, or “None.”]

Other parent — complete one:

• ☐ Other parent's name and county of residence: [name and county].
• ☐ The other parent's rights were terminated by [death / court order]. Details: [details].
• ☐ The child has no presumed father.

3. Relinquishment and Designation

I have been informed of my parental rights and duties. I voluntarily relinquish my parental rights to this child and believe termination of the parent-child relationship is in the child's best interest for these reasons: [specific reasons].

I designate [full name of prospective adoptive parent], residing in [county] County at [full address], to serve as managing conservator of the child as permitted by Tex. Fam. Code § 161.103(b)(12).

This affidavit is revocable only if revocation is made before the 11th day after the date I sign it. It is irrevocable on or after the 11th day under Tex. Fam. Code § 161.1035.

NOTICE OF RIGHT TO REVOKE: IF YOU REVOKE THIS RELINQUISHMENT, YOU MUST DO SO BEFORE THE 11TH DAY AFTER THE DATE YOU SIGN THIS AFFIDAVIT.

The person designated to receive a revocation is [recipient's name], at [full delivery address]. To revoke, I must sign a statement witnessed by two credible persons and verified before a person authorized to take oaths, and deliver a copy to that designated person. If I know a termination suit based on this affidavit has been filed, I must also file a copy with the court clerk. See Tex. Fam. Code § 161.103(g).

I understand that a court order, rather than this affidavit alone, determines termination of parental rights. Written consent of a managing conservator may also be required for the adoption under Tex. Fam. Code § 162.010.

4. Parent's Signature and Witnesses

I swear that the statements above are true and that I sign voluntarily after reading this affidavit or having it read to me. I received a copy when I signed.

Parent's signature: ______________________________ Date and time: __________________

Printed name: ____________________________________

Credible witness 1: Signature ______________________________

Printed name and address: _______________________________________________

Credible witness 2: Signature ______________________________

Printed name and address: _______________________________________________

5. Verification Before Person Authorized to Take Oaths

STATE OF TEXAS § COUNTY OF __________________ §

Subscribed and sworn to before me by [parent's name] on [date] at [time]. The two witnesses identified above witnessed the parent's signature.

Signature of person authorized to take oaths: ______________________________

Printed name and capacity: _______________________________________________

Commission expiration, if applicable: ______________________________

Court note: Adoption itself is excluded from jury trial under Tex. Fam. Code § 105.002(b)(1). This affidavit does not waive any separate right that may apply in a termination proceeding.