Although chapter 34 of the Texas Family Code permits a parent to enter an authorization agreement with a person with whom the child is placed under a parental child safety placement agreement approved by the Texas Department of Family and Protective Services, this form does not address such a situation, which would undoubtedly involve the department.
NOTICE: THIS DOCUMENT
CONTAINS SENSITIVE DATA
Include § 6 of the Introduction in volume 1 of this manual concerning protection of sensitive data in filed documents. |
[Caption. See § 3 of the Introduction in volume 1 of this manual.]
[Petition/Motion] for Order Approving Execution of Authorization Agreement[s] for Adult Caregiver
[Name[s] of petitioner[s] or movant[s]], [Petitioner[s]/Movant[s]], request[s] the Court to issue an order granting [Petitioner[s]/Movant[s]] approval and permission to execute [an] Authorization Agreement[s] for Adult Caregiver. In support, [Petitioner[s]/Movant[s]] show[s]:
1.Discovery in this case is intended to be conducted under [level 2/level 3] of rule 190 of the Texas Rules of Civil Procedure. [If level 3, see form 5-1.]
2.Petitioner[s] object[s] to the assignment of this matter to an associate judge for a trial on the merits or presiding at a jury trial.
3.This Petition for Order Approving Execution of Authorization Agreement[s] for Adult Caregiver is brought by [name[s]], Petitioner[s]. [The last three numbers of [Petitioner/[name]]’s driver’s license number are [numbers]./[Petitioner/[name]] has not been issued a driver’s license.] [The last three numbers of [Petitioner/[name]]’s Social Security number are [numbers]./[Petitioner/[name]] has not been issued a Social Security number.] [If applicable, repeat statements for other petitioner.] Petitioner[s] [is/are] the parent[s] of the child[ren].
Include the following if applicable. |
Respondent is [name of respondent]. [Respondent should be served with process [include if applicable: at [address, city, state, zip code]]/No service on Respondent is necessary at this time].
Continue with the following for a petition. |
4.This Court has continuing, exclusive jurisdiction of this suit.
5.The following child[ren] [is/are] the subject of this suit:
Name:
Sex:
Birth date:
County of residence:
Repeat above information for each additional child. |
6.The following parties may be affected by this suit:
Name:
Relationship: [e.g., managing conservator, possessory conservator, parent, guardian of person, guardian of estate]
Select one of the following. |
Process should be served [include if applicable: at [address, city, state, zip code]].
Or |
No service is necessary at this time.
Or |
Citation by publication or other substituted service is necessary for the reasons stated in the affidavit attached as Exhibit [exhibit number/letter].
Repeat for each additional party. |
Include the following if any party resides outside Texas. |
Information required by section 152.209 of the Texas Family Code is provided in the affidavit attached as Exhibit [exhibit number/letter].
Include appropriate long-arm jurisdiction facts if applicable. |
Include the following in a motion. |
7.Movant[s] [is/are] the [petitioner[s]/respondent[s]] in this case. [Name of respondent] is the [respondent/petitioner].
Continue with the following for a motion or petition. |
8.[Petitioner[s]/Movant[s]] request[s] that the Court grant [Petitioner[s]/Movant[s]] approval and permission to execute [an] Authorization Agreement[s] for Adult Caregiver authorizing certain acts permitted by section 34.002 of the Texas Family Code with regard to the child[ren] in the form attached to this [petition/motion] as Exhibit[s] [exhibit number[s]/letter[s]].
9.The adult caregiver is [name of adult caregiver].
10.Approval of execution of the authorization agreement[s] is in the best interest of the child[ren] because [specify].
11. [Petitioner[s]/Movant[s]] pray[s] that the Court grant approval and permission to [Petitioner[s]/Movant[s]] to execute the Authorization Agreement[s] for Adult Caregiver as requested above. [Include if applicable: Petitioner[s] pray[s] that citation and notice issue as required by law.] [Petitioner[s]/Movant[s]] pray[s] for general relief.
[Name]
Attorney for [Petitioner[s]/Movant[s]]
State Bar No.:
[E-mail address]
[Address]
[Telephone]
[Fax]
Include the following notice of hearing if the case is already pending. Also include certificate of conference and certificate of service if applicable. |
Notice of Hearing
The above motion is set for hearing on __________________ at ____________ __.m. in [designation and location of court].
SIGNED on ________________________________.
Judge or Clerk
Certificate of Conference
A telephone conference was attempted on [date] with [name], the attorney for the opposing party, on the merits of this motion. Agreement could not be reached; therefore, the motion is presented to the Court for a determination.
[Name]
Attorney for [name[s] of movant[s]]
Certificate of Service
I certify that a true copy of this [document/[title of document]] was served in accordance with rule 21a of the Texas Rules of Civil Procedure on the following on [date]:
[Name of attorney of record or party to be served] by [electronic filing manager/e-mail at [e-mail address]/fax at [fax number]/personal delivery at [address]/commercial delivery service at [address]/certified mail at [address]/first-class mail at [address]]. [Repeat for each attorney of record or party to be served.]
[Name]
Attorney for [name[s] of movant[s]]
Attach copy of each proposed agreement as exhibit(s). |