Parental Responsibility Agreement. Section 4ZA Children Act 1989 (Acquisition of parental responsibility by second female parent)
| Published date | 21 March 2018 |
| Subject Matter | Children Act forms |
Parental Responsibility Agreement
Section 4ZA Children Act 1989 (Acquisition of parental
responsibility by second female parent)
Read the notes on the other side before
you make this agreement.
Keep this form in a safe place
Date recorded at The Central Family
Court:
This is a Parental Responsibility Agreement regarding
the Child Full Name
Gender Date of birth Date of 18th birthday
Between
the Mother Name
Address
and other parent Name
(Second female
parent) Address
We declare that that we are the parents of the above child and we agree that the above mentioned parent shall
have parental responsibility for the child (in addition to the mother having parental responsibility
for the child).
Signed (Mother) Signed (Other parent)
Date Date
The following evidence of identity The following evidence of identity
was produced by the person signing above: was produced by the person signing above:
Signed in the presence of: Signed in the presence of:
Name of Witness Name of Witness
Address Address
Signature of Witness Signature of Witness
Certicate
of witness
C(PRA3) (08.14) © Crown copyright 2014
[A Justice of the Peace] [Justices’ Clerk]
[An assistant to a justices' clerk] [An Ofcer
of the Court authorised by the judge to
administer oaths]
[A Justice of the Peace] [Justices’ Clerk]
[An assistant to a justices' clerk] [An ofcer
of the court authorised by the judge to
administer oaths]
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