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1. Title and Date: Formal title of the document and date of execution
2. Declarant Information: Full legal name, address, and identification details of the parent relinquishing rights
3. Child Information: Full name, date of birth, place of birth, and current residence of the child
4. Legal Capacity Declaration: Statement confirming the declarant's legal capacity to make this decision
5. Voluntary Relinquishment Statement: Clear and explicit statement of voluntary relinquishment of all parental rights and responsibilities
6. Understanding of Consequences: Detailed acknowledgment of understanding the permanent nature and consequences of the relinquishment
7. Counseling Confirmation: Statement confirming receipt of mandatory counseling regarding the relinquishment
8. No Duress Declaration: Statement confirming the decision is made freely without coercion or duress
9. Execution and Notarization: Space for signatures, witness information, and notary certification
1. Other Parent Information: Information about the other parent's status and rights, required when the other parent's rights are known and active
2. Adoption Consent: Additional section required if the relinquishment is connected to a planned adoption
3. Child Support Statement: Statement regarding outstanding child support obligations, required if there are existing support orders
4. Visitation Rights Waiver: Specific waiver of visitation rights, included when there's a need to explicitly address this aspect
5. Interpreter Certification: Required when the declarant needs language interpretation services
1. Child's Birth Certificate: Certified copy of the child's birth certificate as supporting documentation
2. Declarant's Identification Documents: Copies of parent's identification documents
3. Counseling Certificate: Documentation of completed mandatory counseling sessions
4. Court Orders: Copies of any relevant existing court orders regarding custody or support
5. Social Services Assessment: If applicable, report from Youth Welfare Office (Jugendamt) regarding the child's situation
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Social Worker
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Youth Welfare Officer
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Child Protection Specialist
Family Services Coordinator
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Family Rights Advocate
Adoption Specialist
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