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r1r STANDING COMMITTEE ON RULES OF PRACTICE - Maryland ...

r1r STANDING COMMITTEE ON RULES OF PRACTICE - Maryland ...

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3. Right to Attorney.<br />

I understand that:<br />

(city, state, and county of birth)<br />

(a) The court will appoint an attorney for me if (i) because<br />

of a disability, I am incapable of consenting to the adoption or<br />

of effectively participating in the adoption proceeding or (ii)<br />

my adoption or guardianship would involuntarily terminate the<br />

parental rights of at least one of my parents.<br />

(b) Even if the court is not required to appoint an<br />

attorney for me, if I am under 18 years of age the court may<br />

nevertheless appoint an attorney for me.<br />

(c) If I choose to seek the appointment or advice of an<br />

attorney, I cannot now consent to the adoption and this Consent<br />

Form will be ineffective as a consent.<br />

Check one of the following statements:<br />

[ ] I do not want an attorney.<br />

[ ] I already have an attorney whose name, address, and<br />

telephone number are __________________________________<br />

________________________________________________________________.<br />

(Name) (Address) (Telephone Number)<br />

[ ] I want an attorney.<br />

[IF A REQUEST IS MADE FOR AN ATTORNEY, SIGN HERE AND DO NOT<br />

COMPLETE THE REST <strong>OF</strong> THIS FORM]<br />

____________________________ _______________________________<br />

(Date) (Signature)<br />

-85-<br />

_______________________________<br />

(Address)

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