CONSENT TO ADOPTION BY MINOR WHO IS FOURTEEN (14) YEARS OF AGE OR OLDER
STATE OF TENNESSEE
COUNTY OF
This the _____day of ____________________, 20__.
FURTHER AFFIANT SAITH NOT
Please Print: _______________________________________________
Signature: _____________________________________________
Sworn to and subscribed before me this ____day of _________________, 20___.
Please Print: ______________________________
Judge of the ____________Court for
______________County, Tennessee
Signature: ___________________________________________
T.C.A. § 36-1-117