OCFS-4316A. Attachment A-Extra Judicial Surrender

Form OCFS-4316A, the Extra Judicial Surrender, is a form used to document the voluntary surrender of a child to a responsible adult. It is typically used when a parent or legal guardian is unable to care for their child and is unable to find a relative or friend to take the child into their home. This form is used to ensure that the child's health and safety is maintained and that the child is placed into a safe and secure environment.

The form is completed by the parent or legal guardian and the adult accepting the surrender. Both parties must sign the form in order to complete the process. The form includes the following sections:

Section 1 is the identification of the child being surrendered. This includes the child's name, date of birth, and address. Section 2 is the identification of the parent or guardian surrendering the child. This includes the name, address, and contact information of the parent or guardian. Section 3 is the identification of the adult accepting the surrender. This includes the name, address, and contact information of the adult. Section 4 is the terms of the surrender, which includes the date, place, and other terms and conditions as agreed upon by the parties.

The form also includes other sections, such as Section 5, which is a statement of agreement between the parent or guardian and the adult accepting the surrender. This section includes a statement that the adult is able to provide a safe and secure environment for the child. Section 6 is a statement of understanding that outlines the rights and responsibilities of the parties. This section also includes a statement that the parent or guardian understands that the child will be placed in the care of the adult for an indefinite period of time and that the parent or guardian will not be able to reclaim the child without the consent of the adult.

The Extra Judicial Surrender form is used in a variety of situations, including when a parent or guardian is unable to care for their child due to illness, financial hardship, or other extenuating circumstances. It is important to complete the form accurately and thoroughly, as inaccurate or incomplete information may result in the child being denied entry into the care of the adult. Additionally, the form must be signed by both parties in order for it to be legally binding. Additional documents may be required in order to complete the form, such as a birth certificate, proof of identity, and proof of address.

There are other forms that may be used in similar transactions or purposes, such as an adoption or guardianship agreement. However, the Extra Judicial Surrender form is the only form that is used for voluntary surrender of a child. The form is an important tool for ensuring that the child's health and safety is maintained and that the child is placed into a safe and secure environment.