Fla. R. Juv. P. Form 8.984

ORDER TERMINATING PARENTAL RIGHTS (VOLUNTARY)

THIS CAUSE came before this court on.....(all dates of the

adjudicatory hearing)..... for an adjudicatory hearing on the petition

for termination of parental rights filed by.....(name)...... Present

before the court were:

..... .....(Name)....., Petitioner

..... .....(Name)....., Attorney for the petitioner

..... .....(Name)....., Attorney for the department

..... .....(Name)....., Department/agency caseworker

..... .....(Name)....., Child

..... .....(Name)....., Attorney/Attorney ad litem for Child

..... .....(Name)....., Mother

..... .....(Name)....., Attorney for mother

..... .....(Name)....., Father of.....(child).....

..... .....(Name)....., Attorney for father

..... .....(Name)....., Guardian ad litem

..... .....(Name)....., Attorney for guardian ad litem

..... .....(Name)....., Legal custodian

..... .....(Name)....., Attorney for legal custodian

..... .....(Name)....., Other: ..........

COMMENT: The name of the guardian ad litem and the attorney ad

litem, if appointed, must be listed on the order, even if he or she

was not present at the hearing.

..... The mother, .....(name)....., executed a voluntary

surrender of her parental rights for the minor child(ren),

.....(name(s))....., which is accepted by the court without objection.

COMMENT: Repeat the following as necessary.

..... The father, .....(name)....., executed a voluntary surrender

of his parental rights for the minor child(ren), .....(name(s)).....,

which is accepted by the court without objection.

The court has carefully considered the testimony of witnesses,

reviewed the exhibits, reviewed the file, heard argument of counsel,

and considered recommendations and arguments of all parties. The

court finds by clear and convincing evidence that the parents,

.....(names)....., have surrendered their parental rights to the minor

child(ren) under section 39.806(1)(a), Florida Statutes, and that

termination of parental rights is in the manifest best interests of the

child(ren). The specific facts and findings supporting this decision

are as follows:

1. That the mother, .....(name)....., ..... was..... was not

personally served with the summons and the petition.

COMMENT: Service is not required if surrender was signed

before filing of petition.

2. That the father, .....(name)....., ..... was..... was not

personally served with the summons and the petition.

COMMENT: Service is not required if surrender was signed

before filing of petition.

3. That the parents were advised of their right to counsel in

all prior dependency court proceedings which they attended. The

mother has been represented by legal counsel, .....(name).....,

starting on or about.....(date)..... The father has been represented

by legal counsel, .....(name)....., starting on or about.....(date)......

4. The mother, .....(name)....., freely, knowingly, voluntarily,

and..... with..... without advice of legal counsel executed an

affidavit and acknowledgment of surrender, consent, and waiver of

notice on.....(date)....., for termination of her parental rights to the

minor child(ren), under section 39.806(1)(a), Florida Statutes.

5. The father, .....(name)....., freely, knowingly, voluntarily,

and.....with..... without advice of legal counsel executed an

affidavit and acknowledgment of surrender, consent, and waiver of

notice on.....(date)....., for termination of his parental rights to the

minor child(ren), under section 39.806(1)(a), Florida Statutes.

6. That at all times relevant to this action the interests of

this/these child(ren) has/have been represented by a guardian ad

litem. The guardian ad litem, .....(name)....., ..... agrees..... does not

agree that it is in the best interests of the child(ren) for parental

rights to be terminated in this cause.

COMMENT: Guardian ad litem not required in voluntary

surrender.

7. Under the provisions of sections 39.810(1)–(11), Florida

Statutes, it is in the manifest best interests of the child(ren) for

parental rights to be terminated for the following reasons:

(a) Regarding any suitable permanency custody

arrangement with a relative of the child(ren), the court finds...........

(b) Regarding the ability and disposition of the parent

or parents to provide the child(ren) with food, clothing, medical care

or other remedial care recognized and permitted under state law

instead of medical care, and other materials needs of the child(ren),

the court finds...........

(c) Regarding the capacity of the parent or parents to

care for the child(ren) to the extent that the child(ren)’s safety, well-being, and physical, mental, and emotional health will not be

endangered upon the child(ren)’s return home, the court finds

(d) Regarding the present mental and physical health

needs of the child(ren) and such future needs of the child(ren) to the

extent that such future needs can be ascertained based on the

present condition of the child(ren), the court finds...........

(e) Regarding the love, affection, and other emotional

ties existing between the child(ren) and the child(ren)’s parent or

parents, siblings, and other relatives, and the degree of harm to the

child(ren) that would arise from the termination of parental rights

and duties, the court finds...........

(f) Regarding the likelihood of an older child remaining

in long-term foster care upon termination of parental rights, due to

emotional or behavioral problems or any special needs of the

child(ren), the court finds...........

(g) Regarding the child(ren)’s ability to form a

significant relationship with a parental substitute and the likelihood

that the child(ren) will enter into a more stable and permanent

family relationship as a result of permanent termination of parental

rights and duties, the court finds...........

(h) Regarding the length of time that the child(ren) has

lived in a stable, satisfactory environment and the desirability of

maintaining continuity, the court finds...........

(i) Regarding the depth of the relationship existing

between the child(ren) and present custodian, the court finds

(j) Regarding the reasonable preferences and wishes of

the child(ren), if the court deems the child(ren) to be of sufficient

intelligence, understanding, and experience to express a preference,

the court finds...........

(k) Regarding the recommendations for the child(ren)

provided by the child(ren)’s guardian ad litem or the legal

representative, the court finds...........

(l) Regarding other relevant factors including.........., the

court finds...........

THEREFORE, it is ORDERED AND ADJUDGED that:

1. The petition for termination of parental rights is

GRANTED.

2. The parental rights of the father, .....(name)....., and of

the mother, .....(name)....., to the child(ren), .....(name(s))....., are

hereby terminated under section 39.806(..........), Florida Statutes.

COMMENT: Repeat the above for each child and parent on

petition.

3. The child(ren), .....(name(s))....., is/are hereby placed in

the permanent care and custody of.....(agency name)..... for

subsequent adoption.

4. A hearing for the department to provide a plan for

permanency for the child(ren) shall be held on.....(date)....., within

30 days of rendering of order, at.....(time)......

DONE AND ORDERED on.....(date)....., in.......... County,

Florida.

Circuit Judge

Copies to:

NOTICE

Under section 39.815, Florida Statutes, any child, any parent,

guardian ad litem, or legal custodian of any child, any other

party to the proceeding who is affected by an order of the

court, or the department may appeal to the appropriate District

Court of Appeal within the time and in the manner prescribed

by the Florida Rules of Appellate Procedure, which is 30 days

from the date this order is rendered (signed and filed). A parent

may have the right to a court-appointed attorney as provided

by law.

Under Florida Rule of Juvenile Procedure 8.530, a parent, who

had an attorney in the termination of parental rights

proceeding, shall have 20 days after this order terminating

parental rights is entered to file a motion in the trial court

claiming ineffective assistance of counsel. A parent does not

have the right to a court-appointed attorney to assist the

parent with a motion claiming ineffective assistance of

counsel, but the parent may independently obtain an attorney

to represent the parent in the motion. The motion must

contain the case name, case number, and identify the date the

written order terminating parental rights was entered. The

motion must also contain the current mailing address and e-

mail address, if any, and the phone number(s) of the parent

filing the motion for the purpose of receiving notices and

orders. In the motion, the parent must identify specific acts or

omissions in the attorney’s representation of the parent during

the termination proceedings that the parent claims constituted

a failure to provide reasonable, professional assistance, and the

parent must explain how the errors or omissions prejudiced the

parent’s case to such an extent that but for counsel’s deficient

performance the rights of the parent would not have been

terminated.