Free Agreement Nonparent Relative Caregiver PDF Form Prepare Document Here

Free Agreement Nonparent Relative Caregiver PDF Form

The Authorization Agreement for Nonparent Relative or Voluntary Caregiver form is a critical legal document crafted to comply with Chapter 34 of the Texas Family Code. It authorizes specified relatives or voluntary caregivers to make certain decisions for a child, encompassing medical treatments, schooling, and more, without conferring the full legal rights of a guardian or conservator. To safeguard the welfare of the child involved and ensure legal compliance, clicking the button below to fill out this form accurately is imperative.

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Content Overview

When families face challenges that require a child to be cared for by someone other than their parents, the Authorization Agreement for Nonparent Relative or Voluntary Caregiver form becomes an important tool to facilitate this arrangement legally and safely. Originating from Chapter 34 of the Texas Family Code, this form is designed to authorize a nonparent relative or a voluntary caregiver to make specific decisions on behalf of a child. These decisions range from authorizing medical treatments and applying for public benefits to enrolling the child in school and more, highlighting the form’s comprehensive scope that aims to ensure the child's well-being in the absence of parental care. Not only does it specify the powers granted to the caregiver, but it also delineates the legal obligations of both the parent and the caregiver, including the requirement to keep each other informed about any changes in contact information. Furthermore, it outlines various conditions under which the agreement can be executed, such as the lack of court involvement or specific court permissions if necessary. Warnings and disclosures are also provided to ensure both parties understand the legal significance of the agreement, emphasizing the temporary nature of the arrangement and the parent's ability to resume care of the child at any time. This paper carries significant legal weight, also mandating the mailing requirements to the non-signing parent unless specific exceptions apply, ensuring all parties are duly informed. Such an agreement stands as a testament to the law’s flexibility and consideration for the welfare of children, ensuring they receive care and support in a structured and legally recognized manner.

Example - Agreement Nonparent Relative Caregiver Form

AUTHORIZATION AGREEMENT FOR NONPARENT RELATIVE OR VOLUNTARY CAREGIVER

August 2011 Page 1 of 4

This authorization agreement is made in conformance with Chapter 34 of the Texas Family Code concerning the following Child:

Child's Full Name:

Date of Birth:

Parent completing this form:

Full Name:

Physical Address:

Telephone Number:

Other contact information:

Child's other parent:

Full Name:

Physical Address:

Telephone Number:

Other contact information:

Parent voluntarily authorizes the following relative or Parental Child Safety Placement voluntary caregiver to make certain decisions regarding the child, as listed on the next page of this authorization agreement.

Name:

Relationship to Child (check one):

Child's Grandparent Child's Adult Sibling Child's Aunt or Uncle

Parental Child Safety Placement Voluntary Caregiver in accordance with Child Protective Services

Physical Address:

Telephone Number:

Other contact information:

PARENT AND RELATIVE OR VOLUNTARY CAREGIVER UNDERSTAND THAT THEY ARE REQUIRED BY LAW TO IMMEDIATELY PROVIDE EACH OTHER WITH INFORMATION REGARDING ANY CHANGE IN THE OTHER PARTY'S ADDRESS OR CONTACT INFORMATION.

AUTHORIZATION AGREEMENT FOR NONPARENT RELATIVE OR VOLUNTARY CAREGIVER

August 2011 Page 2 of 4

Parent authorizes the above named relative or voluntary caregiver to perform the following acts in regard to the child and the relative or voluntary caregiver assumes the responsibility of performing these functions:

(1)To authorize medical, dental, psychological, surgical treatment, and immunization of the child, including executing any consents or authorizations for the release of information as required by law relating to the treatment or immunization;

(2)To obtain and maintain health insurance coverage for the child and automobile insurance coverage for the child, if appropriate;

(3)To enroll the child in a day-care program or public or private preschool, primary or secondary school;

(4)To authorize the child to participate in age-appropriate extracurricular, civic, social, or recreational activities, including athletic activities;

(5)To authorize the child to obtain a learner's permit, driver's license, or state-issued identification card;

(6)To authorize employment of the child; and

(7)To apply for and receive public benefits on behalf of the child.

(8)This authorization agreement does not confer on the relative or voluntary caregiver of the child the right to authorize the performance of an abortion on the child or the administration of emergency contraception to the child

To the best of the parent's and the relative's or voluntary caregiver's knowledge (check if applicable):

This child is not the subject of a current (pre-existing) valid authorization agreement, and no parent, guardian, custodian, licensed child-placing agency or other agency makes any claim to actual physical possession or care, custody or control of the child that is inconsistent with this authorization agreement.

To the best of the parent's and the relative's or voluntary caregiver's knowledge (choose one from below):

THERE IS NO COURT INVOLVEMENT WITH THIS CHILD

All of the following statements must apply:

There is no court order or pending suit affecting the parent-child relationship concerning the child.

There is no pending litigation in any court concerning custody, possession, or placement of the child or access to or visitation with the child.

The court does not have continuing jurisdiction concerning the child.

THIS CHILD HAS BEEN THE SUBJECT OF A COURT ACTION

The court with continuing jurisdiction concerning the child has given written approval for the execution of the authorization agreement accompanied by the following information:

The county in which the court is located;

The number of the court; and

The cause number in which the order was issued or the litigation is pending. Please staple a copy of the court's order to this agreement.

AUTHORIZATION AGREEMENT FOR NONPARENT RELATIVE OR VOLUNTARY CAREGIVER

August 2011 Page 3 of 4

WARNINGS AND DISCLOSURES

This authorization agreement is an important legal document. The parent and the relative or voluntary caregiver must read all of the warnings and disclosures before signing this authorization agreement.

The parent and relative are not required to consult an attorney but are advised to do so.

A parent's rights as a parent may be adversely affected by placing or leaving the parent's child with another person.

This authorization agreement does not confer on the relative or voluntary caregiver the rights of a managing or possessory conservator or legal guardian.

A parent who is a party to this authorization agreement may terminate the authorization agreement and resume custody, possession, care, and control of the child on demand and at any time the parent may request the return of the child.

Failure by the relative or voluntary caregiver to return the child to the parent immediately on request may have criminal and civil consequences.

Under other applicable law, the relative or voluntary caregiver may be liable for certain expenses relating to the child in the relative's or voluntary caregiver's care, but the parent still retains the parental obligation to support the child.

In certain circumstances, this authorization agreement may not be entered into without written permission of the court. Examples of when court permission must be granted include when a court has entered a previous order granting custody or establishing a child support obligation.

This authorization agreement may be terminated by certain court orders affecting the child.

This authorization agreement does not supersede, invalidate, or terminate any prior authorization agreement regarding the child.

This authorization agreement is void if a prior authorization agreement regarding the child is in effect and has not expired or been terminated.

MAILING REQUIREMENTS:

When both parents do not sign the parent authorization agreement, a copy of the agreement MUST be mailed to the non-signing parent, unless that parent is deceased or has had his or her parental rights terminated. This authorization agreement is void unless:

1.The parties mail a copy of this agreement to a non-signing parent not later than the 10th day after the date the authorization agreement is signed, by certified or international registered mail, as applicable, return receipt requested.

2.If the parties do not receive a response from the non-signing parent before the 20th day after the date the copy of the agreement is mailed, the parties must mail a second copy of the agreement by first class mail or international first class mail, as applicable, to the parent not later than the 45th day after the date the authorization agreement is signed.

EXCEPTION TO MAILING REQUIREMENTS:

If a parent who did not sign the authorization agreement does not have court-ordered possession of or access to the child who is the subject of the agreement, the parent who is a party to the agreement does not have to mail a copy of the agreement to the non-signing parent if either of the following circumstances applies:

1.A protective order has been issued against the non-signing parent as provided under Chapter 85 of the Texas Family Code or under a similar law of another state for committing an act of family violence (as defined by Section 71.004 of the Texas Family Code) against the parent

AUTHORIZATION AGREEMENT FOR NONPARENT RELATIVE OR VOLUNTARY CAREGIVER

August 2011 Page 4 of 4

who signed the agreement or any child of the parent who signed the agreement; or

2.The non-signing parent has been convicted of any of the following criminal offenses against the parent who signed the agreement or any child of the parent who signed the agreement: O any offense under Title 5 of the Texas Penal Code (including murder, homicide,

kidnapping, assault and sexual assault); or

O any other criminal offense in Texas or any other state if the offense involves a violent act or prohibited sexual conduct.

This authorization agreement (select one of the following two):

Expires on this date:

OR

Is valid until revoked in writing by either party

In addition, check here if you want the agreement to continue in effect after your death or during any period of incapacity.

Execution of a subsequent authorization agreement does not by itself supersede, invalidate, or terminate a prior authorization agreement.

By signing below, parent and the relative or voluntary caregiver acknowledge that they have each read this authorization agreement carefully, are entering into the authorization agreement voluntarily, and have read and understand all of the Warnings and Disclosures included in this authorization agreement.

_____________________________________

PARENT

Printed name:

SUBSCRIBED AND ACKNOWLEDGED BEFORE ME on this ____ day of _________________, 20____.

_____________________________________

Notary Public in and for the State of TEXAS

_____________________________________

PARENT**

Printed name:

SUBSCRIBED AND ACKNOWLEDGED BEFORE ME on this ____ day of _________________, 20____.

_____________________________________

Notary Public in and for the State of TEXAS

_____________________________________

RELATIVE OR VOLUNTARY CAREGIVER

Printed name:

SUBSCRIBED AND ACKNOWLEDGED BEFORE ME on this ____ day of _________________, 20____.

_____________________________________

Notary Public in and for the State of TEXAS

Form Data

Fact Name Description
Governing Law This agreement is in accordance with Chapter 34 of the Texas Family Code.
Purpose of the Form Allows a nonparent relative or voluntary caregiver to make certain decisions for a child.
Scope of Authorization Includes medical, dental, educational decisions, and the ability to apply for public benefits on behalf of the child.
Limits Does not allow the relative or caregiver to consent to an abortion or the administration of emergency contraception for the child.
Termination Can be terminated by the parent at any time or by certain court orders.

How to Fill Out Agreement Nonparent Relative Caregiver

Filling out the Authorization Agreement for Nonparent Relative or Voluntary Caregiver form is a critical process that allows a nonparent relative or voluntary caregiver to make specific decisions for a child in the absence of the child's parents. It's important to approach this task with accuracy and care to ensure the well-being of the child is maintained and that all legal requirements are met. Here are the steps you need to take to correctly fill out the form:

  1. Start by entering the Child's Full Name and Date of Birth at the top of the form to identify whom the agreement concerns.
  2. Fill in the Parent completing this form section with the Full Name, Physical Address, Telephone Number, and Other contact information of the parent initiating the agreement.
  3. Complete the section titled Child's other parent with similar details: Full Name, Physical Address, Telephone Number, and Other contact information.
  4. In the Parent voluntarily authorizes the following relative or Parental Child Safety Placement voluntary caregiver section, fill in the Name, check the appropriate Relationship to Child box, and provide Physical Address, Telephone Number, and Other contact information of the designated caregiver.
  5. Proceed to the second page, which details the specific acts the relative or caregiver is authorized to perform. Review these carefully to understand the scope of authority being granted.
  6. Address the section regarding the child's current legal situation by checking the applicable box to indicate if the child is or is not the subject of a current valid authorization agreement or court involvement.
  7. If there is court involvement, staple a copy of the relevant court order to this agreement as instructed on the form.
  8. Thoroughly read the Warnings and Disclosures section on page 3 to understand the legal implications and responsibilities involved in completing this agreement.
  9. Review and complete the Mailing Requirements section to ensure compliance with the process if both parents do not sign the authorization agreement.
  10. On the final page, decide on the expiration of the agreement—enter a specific date or indicate if it is valid until revoked in writing. Also, consider if you want the agreement to continue in effect after the parent's death or during any period of incapacity by checking the appropriate box.
  11. Ensure the parent, and the relative or voluntary caregiver signs and prints their names in the designated spaces provided at the end of the form. The signing must be Subscribed and Acknowledged Before a Notary Public with the date of acknowledgment clearly indicated.

Once all steps are completed, the form is legally binding, granting the named relative or voluntary caregiver the authority to make decisions on behalf of the child within the specified scope. Remember, the form can be revoked or modified at any time by the parent in writing, reflecting any changes in the caregiving arrangement or legal circumstances concerning the child.

FAQ

What is an Authorization Agreement for Nonparent Relative or Voluntary Caregiver?

An Authorization Agreement for Nonparent Relative or Voluntary Caregiver is a legal form that allows a parent to give certain caretaking authorities to a relative or a voluntary caregiver. This form, in line with the Texas Family Code Chapter 34, enables the designated caregiver to make decisions about the child’s medical treatment, education, insurance coverage, and more, while not granting them full legal custody or guardianship of the child.

Who can be authorized as a Nonparent Relative or Voluntary Caregiver?

The form allows parents to authorize a relative such as the child’s grandparent, adult sibling, aunt, or uncle, or a voluntary caregiver selected through a Parental Child Safety Placement with Child Protective Services. This person must be willing and able to take on the responsibility of caring for the child, including making decisions about their health, education, and welfare.

Can the authorization be terminated, and if so, how?

Yes, either party, the parent or the relative/voluntary caregiver, can terminate the authorization at any time. The parent can resume custody and control of the child on demand. If the caregiver refuses to return the child upon the parent’s request, they may face criminal and civil consequences. For the agreement to be officially terminated, it must be done in writing by either party.

What are the mailing requirements if both parents do not sign the agreement?

If only one parent signs the authorization agreement, a copy must be mailed to the non-signing parent unless their parental rights have been terminated or the parent is deceased. This mailing must be done no later than the 10th day after the agreement is signed, using certified or international registered mail. If no response is received within 20 days, a second copy must be mailed by first-class post. Certain exceptions apply, such as in the case of a protective order against the non-signing parent or a criminal conviction against them for violent or sexual offenses.

Common mistakes

  1. Not providing complete information about the child and the parents: One common mistake is not filling out every section of the form that asks for details about the child (such as the child's full name and date of birth) and the parents (including full names, physical addresses, and contact information). This oversight can cause delays and confusion.

  2. Incorrectly identifying the relationship of the caregiver to the child: The form requires the person filling it out to check the correct box indicating the caregiver's relationship to the child (e.g., grandparent, adult sibling, aunt, or uncle). Misidentifying this relationship can lead to questions about the caregiver's eligibility and authority.

  3. Failing to notify the other parent in cases where both do not sign: If both parents do not sign the authorization agreement, a copy must be mailed to the non-signing parent unless specific exceptions apply. Overlooking or ignoring this requirement can invalidate the agreement.

  4. Overlooking the legal declaration section about previous agreements or court involvement: The form contains important checkboxes concerning the child's current legal status, including whether there is a pre-existing authorization agreement or court involvement. Failure to accurately acknowledge these conditions can invalidate the new agreement or conflict with existing legal orders.

  5. Omitting the signature and notarization process: Every signature box at the end of the form must be duly signed and acknowledged before a notary public. Missing out on this crucial step fails to legally bind the agreement, rendering it ineffective.

When filling out the Authorization Agreement for Nonparent Relative or Voluntary Caregiver, it's essential to pay close attention to every detail and follow all the instructions to ensure the agreement is valid and effective. Missteps can delay the process and possibly affect the well-being of the child involved.

Documents used along the form

In legal matters involving the care of a child by a nonparent relative or voluntary caregiver, utilizing the Authorization Agreement for Nonparent Relative or Voluntary Caregiver form is a significant step. However, to ensure the arrangement is both comprehensive and legally sound, several other forms and documents are often used in conjunction. These documents not only support the initial agreement but also serve to solidify the caregiver's authority in various aspects of the child's welfare and education.

  • Medical Consent Form for a Minor: This document grants the caregiver the authority to make medical decisions on behalf of the child. It covers consent for medical, dental, and surgical care, ensuring the child receives appropriate medical attention when needed without delay.
  • Temporary Guardianship Agreement: While the Authorization Agreement provides substantial authority, a Temporary Guardianship Agreement can offer a higher level of legal assurance. This document typically grants the caregiver rights akin to those of a guardian, allowing for more significant decisions regarding the child's welfare, education, and property.
  • Child's Medical History Form: Essential for nonparent caregivers, this document provides a comprehensive history of the child's medical issues, allergies, medications, and past treatments. The form is invaluable for medical appointments, especially in emergencies or when visiting a new healthcare provider.
  • School Enrollment Authorization: A document specifically authorizing the nonparent relative or voluntary caregiver to enroll the child in school, sign school-related forms, and make decisions regarding the child's education. It may also serve to inform the school of the child’s living situation and the caregiver's authority.
  • Benefit Claim Forms: If the caregiver is authorized to apply for and receive public benefits on behalf of the child, as indicated in the Authorization Agreement, appropriate government benefit forms must also be completed. These might include applications for Medicaid, food assistance, or educational grants, tailored to the child's needs.

Together, these documents form a sturdy legal framework that supports the nonparent relative or voluntary caregiver arrangement, ensuring the child’s needs are met in the absence of the parent. They provide clarity and legal backing for the caregiver, aid in the administration of health and educational services, and ensure that the child's welfare is consistently prioritized. It is highly recommended that caregivers and parents understand and prepare these additional forms alongside the Authorization Agreement to ensure a seamless and supported caregiving arrangement.

Similar forms

  • A Power of Attorney for Child Care shares similarities in assigning authority over certain decisions regarding a minor. Like the Authorization Agreement for Nonparent Relative or Voluntary Caregiver, it enables an adult other than the parent to make decisions related to the child’s education, medical care, and other significant areas.

  • The Temporary Guardianship Agreement is akin to this form as it grants temporary custody and decision-making powers over a child to another relative or adult. This typically covers the same areas such as education, healthcare, and daily living but is usually for a specified period.

  • A Medical Consent Form for Minors focuses specifically on granting authority to a nonparent to make medical decisions. This form parallels the medical decision-making provision in the Authorization Agreement, enabling the caregiver to authorize treatments and procedures.

  • The Child Travel Consent Form allows a child to travel with an adult who is not their legal guardian, similar to part of what can be covered under this Agreement when it involves authorizing day-to-day and extracurricular activities which may include travel.

  • Educational Consent Forms permit a nonparent to make educational decisions, including school enrollment and participation in school activities, echoing the educational provisions allowed under the Authorization Agreement.

  • A Child Care Authorization Letter is designed for a short-term arrangement to grant a caregiver permission to take care of a child, including making emergency decisions. While more informal, its intent aligns closely with the Authorization Agreement’s purpose of assigning caregiving responsibilities.

  • Benefit Claims Authorization for Minors allows a designated adult to apply for and manage benefits on behalf of a child, such as social security or government aid, which is also a function of the Authorization Agreement in ensuring the child’s needs are met financially and for healthcare.

  • Lastly, a Driver’s License or ID Card Authorization form, which might not be a standalone document but a part of broader consent forms, allows a minor to obtain a driver’s license or state ID. This specific responsibility can be part of the broader powers granted to a caregiver under the Authorization Agreement, reflecting its comprehensive nature in caring for the child’s varied needs.

Dos and Don'ts

When filling out the Agreement Nonparent Relative Caregiver form, there are specific do's and don'ts that should be followed to ensure the process is completed accurately and effectively. Below are five key considerations for each category.

Things You Should Do:

  1. Read through the entire form carefully before beginning to fill it out to understand all the requirements and implications.
  2. Ensure all information about the child, the parent completing the form, and the designated nonparent relative caregiver or voluntary caregiver is accurate and current, including full names, physical addresses, and contact information.
  3. Check the appropriate relationship of the caregiver to the child, whether it's a grandparent, adult sibling, aunt, uncle, or a voluntary caregiver, to make sure it accurately reflects the situation.
  4. Be clear and specific about the types of decisions the nonparent relative caregiver or voluntary caregiver is authorized to make on behalf of the child, such as medical treatments, enrollment in educational institutions, and employment authorization.
  5. Follow mailing requirements strictly if both parents do not sign the authorization agreement, including sending a copy of the agreement to the non-signing parent by certified or international registered mail, return receipt requested, within the specified time frames.

Things You Shouldn't Do:

  1. Do not leave any sections incomplete or fail to provide specific required details, such as the child’s full name, date of birth, and other parent's information if known.
  2. Do not ignore the need to attach a copy of any related court order if the child has been the subject of a court action that affects this agreement. Staple the court's order to the agreement as required.
  3. Do not overlook the legal implications and requirements disclosed in the form, including understanding that this form does not grant custodial or legal guardian status to the caregiver.
  4. Do not enter into this agreement without considering seeking legal advice, especially in complex situations or when court orders concerning the child are involved.
  5. Do not fail to mail a second copy of the agreement by first class mail or international first class mail to the non-signing parent if no response is received from them before the 20th day after the date the original copy of the agreement is mailed, as stipulated in the form's requirements.

Misconceptions

When discussing the Authorization Agreement for Nonparent Relative or Voluntary Caregiver, several misconceptions commonly arise. Understanding these misconceptions is crucial for families considering this legal arrangement. The following explanations aim to clarify these misunderstandings:

  • Misconception 1: The agreement grants the caregiver full legal custody of the child. In reality, this agreement does not provide the caregiver with the rights of a managing or possessory conservator or legal guardian. It simply authorizes them to make certain decisions on behalf of the child, without altering the legal custody that remains with the parent.
  • Misconception 2: The agreement is permanent and cannot be revoked. Contrary to this belief, a parent who has signed the authorization agreement can terminate it at any time, resuming full custody, care, and control of the child. The agreement is designed to be flexible to accommodate changing family circumstances.
  • Misconception 3: Signing the agreement absolves the parent of all financial responsibilities towards the child. While the agreement may authorize the caregiver to apply for and receive public benefits for the child, the parent's financial obligation to support their child remains intact. Parents are still responsible for the child's financial well-being.
  • Misconception 4: The agreement can be entered into without notifying the other parent. This is incorrect; if both parents do not sign the agreement, a copy must be mailed to the non-signing parent, unless that parent is deceased, has had their parental rights terminated, or specific exceptions apply related to the protection of the parent or child.
  • Misconception 5: Any relative or caregiver can be authorized under this agreement without restrictions. The agreement specifically requires that the caregiver be a relative or a voluntary caregiver meeting certain conditions, such as being part of a Parental Child Safety Placement in accordance with Child Protective Services. This limitation helps ensure the child's safety and well-being.
  • Misconception 6: The agreement allows the caregiver to make decisions regarding the termination of pregnancy for the child. This is explicitly prohibited under the agreement. The caregiver cannot authorize the performance of an abortion on the child or the administration of emergency contraception without further legal authorization.

It's important for parents and caregivers to fully understand the terms and implications of the Authorization Agreement for Nonparent Relative or Voluntary Caregiver. Being informed helps ensure the best interests of the child are always prioritized.

Key takeaways

Understanding the Agreement Nonparent Relative Caregiver form is essential for anyone considering this arrangement in Texas. Below are eight key takeaways for completing and using this form:

  • Legal Foundation: The agreement is established under Chapter 34 of the Texas Family Code and is designed to authorize nonparent relatives or voluntary caregivers to make certain decisions for a child.
  • Decision-Making Authority: The form grants designated relatives or caregivers the authority to make important decisions regarding the child’s medical treatments, education, extracurricular activities, employment, and the application for public benefits.
  • Information Sharing: Both the parent and the relative or voluntary caregiver are legally mandated to keep each other informed about any changes in contact or address information immediately.
  • Court Involvement: The form requires disclosure of any court involvement with the child, such as court orders, pending suits, or litigation related to custody, possession, or placement of the child. In some cases, court approval may be necessary to execute the agreement.
  • Legal Limitations: This authorization does not confer the rights of a managing or possessory conservator or legal guardian to the caregiver. Moreover, it does not allow the caregiver to authorize the performance of an abortion or the administration of emergency contraception to the child.
  • Termination and Resumption of Parental Rights: A parent can terminate the agreement at any time, resuming custody and control of the child. The caregiver must return the child immediately upon such a request to avoid potential criminal and civil consequences.
  • Mailing Requirements: If both parents do not sign the authorization agreement, a copy must be mailed to the non-signing parent, following specific guidelines, unless exempt under certain circumstances such as protective orders or criminal convictions against the non-signing parent.
  • Duration and Revocation: The agreement specifies its validity period and can be revoked in writing by either party at any time. Provisions can be made for the agreement to remain in effect after the death or during the incapacity of the parent.

Completing the Agreement Nonparent Relative Caregiver form requires careful consideration and understanding of its terms. Both parties should read all warnings and disclosures before signing to ensure the welfare of the child is prioritized and protected within the scope of this legal arrangement.

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