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Get KS Form 183 2013-2024

RELINQUISHMENT OF MINOR CHILD TO AGENCY Pursuant to K.S.A. 38-2268 NOTICE TO PARENT: This is an important legal document and by signing it you are permanently giving up all custody and other parental rights to the child named herein. You are to receive a copy of this document. I, (Child s name) , mother father of , a minor child, state: (Name) 1. The child was born on (Date of birth) at a..m. p.m. 2. I reside at and State of (Place of birth) at : , County of . 3.

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