Del. Code tit. 24 § 1785

Current through 2024 Legislative Session Act Chapter 494

Section 1785 - Short form of affidavit and application for waiver of parental notice requirement

The following shall be sufficient form of affidavit and application for waiver of parental notice requirement under this subchapter:

IN THE FAMILY COURT OF THE STATE OF DELAWARE

IN AND FOR (NAME OF COUNTY) COUNTY

IN THE MATTER OF: ) AFFIDAVIT AND

) APPLICATION FOR

(NAME OF MINOR APPLICANT), ) WAIVER OF NOTICE

) OF

) ABORTION

STATE OF DELAWARE )

)

________ COUNTY, SS: )

BE IT REMEMBERED that on this __________ day of ____________ , A.D. ________

before me, (name of person authorized to perform notarial acts), personally appeared

(name of minor applicant/affiant) who, being by me duly sworn or affirmed,

depose and say:

(1) That the minor applicant resides at (minor's address);

(2) That the Court may send its order to (mailing address designated by

applicant minor) and leave telephone messages for the applicant minor at

(phone number designated by applicant minor);

(3) That the minor applicant is pregnant;

(4) That the minor applicant desires to obtain an abortion;

(5) That the minor applicant desires that the Court waive the notice

requirement of § 1783 of Title 24;

(6) That the minor applicant believes that she is mature and well-informed

enough to make the abortion decision on her own and/or it would be in her best

interest that a waiver of notice be granted because (state reasons why mature

and well-informed enough and/or waiver of notice is in best interest based

upon the applicant's age and family circumstances and the long-term and

short-term consequences to the applicant of termination or continuation of the

pregnancy.

WHEREFORE, this minor applicant intends to submit this affidavit and

application for waiver of notice of abortion to the Family Court, and pray

that an order be issued waiving the notification requirement of § 1783 of

Title 24 as to the following persons: (identify each such person).

............................

Minor applicant/affiant

SWORN TO or affirmed and subscribed before me by the minor applicant/affiant

this ________ day of ________ , A.D. ________ .

............................

(Notary)

24 Del. C. § 1785

70 Del. Laws, c. 238, § 1; 70 Del. Laws, c. 186, § 1.;