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Include the following notice if the revocation is filed with the court. See § 6 of the Introduction in volume 1 of this manual concerning protection of sensitive data in filed documents. |
NOTICE: THIS DOCUMENT
CONTAINS SENSITIVE DATA
Revocation of Authorization Agreement for Adult Caregiver
I, [name], a party to the Authorization Agreement for Adult Caregiver signed on [date] regarding the child [name], hereby revoke the authorization agreement.
Written notice of this revocation is being given to each party to the agreement by [U.S. mail/[specify other writing]]. This written revocation is being filed with the appropriate county clerks and court clerks as required by section 34.008 of the Texas Family Code.
SIGNED on ________________________________.
[Name of parent or adult caregiver]