GEORGIA DIVISION OF FAMILY AND CHILDREN SERVICES

CHILD WELFARE POLICY MANUAL

Chapter:

(3) Legal

Policy
Title:

Voluntary Surrender of Parental

Rights

Policy
Number:

3.12

Effective
Date:

December 2014

Previous
Policy #:

103.2-103.5
103.8 103.9
103.13

CODES/REFERENCES
O.C.G.A. 15-11-2; 11-3-23; 19-7-22; 19-8-4; 19-8-5; 19-8-9; 19-8-11; 19-8-27
REQUIREMENTS
The Division of Family and Children Services (DFCS) shall:
1. Consent to the voluntary surrender of parental rights only when adoption is a viable plan
for the child. (See policy 10.22 Foster Care: Permanency Planning for guidance on
adoption as a permanency plan.)
2. Involve the mother, father and child (where appropriate) in the planning for voluntary
surrender.
3. Execute the voluntary surrender of parental rights:
a. Twenty-four (24) hours after the birth of the child; or
b. Prior to the birth of the child, for putative father(s) only, but any time after the
biological mother has executed a sworn statement identifying such person as the
putative father of the unborn child; or
c. By any [biological or legal] parent regardless of age.
NOTE: The voluntary surrender given by the minor shall be binding as if they
were of legal age;
NOTE: DFCS shall not execute a voluntary surrender of parental rights until twenty-four
(24) hours after the actual birth of the child for the mother, legal father or any man who
has executed either a voluntary acknowledgment of legitimating or a voluntary
acknowledgement of paternity. In exceptional or extraordinary circumstances a waiver of
this policy can be obtained from the State Foster Care Services Unit Director. The waiver
may be obtained by telephone but will be confirmed in writing from the State Foster Care
Unit.
4. Use the designated DFCS forms to execute a valid voluntary surrender of parental rights
that clearly specifies the parents right to withdraw the surrender and the timeframe for
withdrawal.
5. Execute all voluntary surrender documents in the presence of a DFCS representative
and a notary.
6. At the time of surrender, provide a copy of all completed documents to the parent(s) or
guardian signing the surrender.
7. Petition Superior Court or Juvenile Court when:
a. DFCS is considering placement of the child for the purpose of adoption; and
b. One or more of the parents voluntarily surrendered his/her parental rights to a
child to DFCS for adoption; and
c. There is another parent who has not voluntarily surrendered his/her rights; and
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d. Grounds for termination of parental rights against the remaining parent exist.
NOTE: Where grounds for terminating the remaining parent(s)' right exist, it must
be terminated by court order for the child to be placed for adoption (See policy
3.11 Legal: Termination of Parental Rights).
The putative father of a child may:
1. Execute a surrender of his paternal rights to the child prior to birth of the child for the
purpose of an adoption any time after the biological mother has executed a sworn
statement identifying such person as the putative father of the unborn child. A pre-birth
surrender, when signed under oath by the putative father, shall:
a. Serve to relinquish the putative fathers rights to the child;
b. Waive the putative fathers right to notice of any proceeding with respect to the
childs adoption, custody, or guardianship;
c. Give the court jurisdiction to enter a final order of adoption of the child; and
d. Give the court jurisdiction to enter an order for the purpose of the childs legal
custody or guardianship.
2. Surrender his rights to the child for the purpose of adoption.
3. Withdraw the voluntary surrender within ten (10) days from the date of execution,
regardless of the date of birth of the child.
4. Be held responsible for the child up until the final order of adoption. If a final order of
adoption is not entered after the execution of a pre-birth surrender and paternity is
established by acknowledgement, by administrative order, or by judicial order then the
putative father shall be responsible for child support or other financial obligations to the
child.
NOTE: If a child is placed in another state that does not accept voluntary surrenders, it will be
necessary to confirm the voluntary surrender by court order. (See policy 11.25 Adoption:
Placement of a Georgia Child Into Another State for Adoption Purposes)
Volunteer Surrender to a Third Party Child in Temporary Custody of DFCS
When a parent of a child in the temporary custody of DFCS surrenders their rights to a third
party for the purpose of adoption and DFCS is in agreement that adoption by the third party is in
the childs best interest, DFCS shall petition the Juvenile Court and request to be relieved of
custody of the child and physical custody be placed with the prospective adoptive parent
pending finalization of the adoption in Superior Court following:
1. The completion of an adoptive family evaluation by an evaluator that recommends
placement of the child in the prospective adoptive home. (See Policy 11.32 Adoption:
Independent Adoption Family Evaluation For the Purpose of Adoption By a Third Party
for the guidelines for completing a family evaluation for an independent adoption); or
2. An order being issued by the Superior Court authorizing placement of the child with the
third party prior to completion of the home study.
If DFCS does not agree that adoption by the third party would be in the childs best interest,
DFCS shall:
1. Make a referral to the Special Assistant to the Attorney General (SAAG) for
representation and consultation; and
2. File a motion to intervene in Superior Court where the adoption petition was filed.
NOTE: When a parent of a child in temporary custody of DFCS surrenders their rights to the
child to a third party for the purpose of adoption, DFCS is not required to transfer physical
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custody of the child until such time that the custody order expires, is vacated, or the adoption is
finalized.
Volunteer Surrender to a Private Agency Child in Temporary Custody of DFCS
When a parent of a child in temporary custody of DFCS voluntarily surrenders their rights to a
child to a licensed child placing agency (CPA) for the purpose of adoption and there is no basis
for objection, DFCS shall:
1. Negotiate a plan for transitioning the child from DFCS to the private agency; and
2. Petition Juvenile Court to be relieved of custody.
If DFCS determines relinquishment to the CPA is not in the childs best interest, DFCS shall
make a referral to the SAAG for consultation regarding the appropriate action to protect the best
interest of the child.
NOTE: DFCS is not required to transfer physical custody of the child until such time that the
custody order expires, is vacated, or the adoption is finalized.
Withdrawal of Voluntary Surrender
The parent(s) shall have the right to withdraw the surrender:
1. Within ten (10) days after signing. The ten (10) days shall be counted consecutively
beginning with the day immediately following the date the surrender was executed;
however, if the tenth (10th) day falls on a Saturday, Sunday or legal holiday then the last
day on which the surrender may be withdrawn shall be the next business day; and
2. By written notice delivered in person or mailed by registered or statutory overnight
delivery to the address designated in the surrender document.
NOTE: After ten (10) days the surrender cannot be withdrawn. If the surrendering parent(s)
fails to withdraw the voluntary surrender within the ten (10) days, the voluntary surrender shall
stand on its own and no further court action is necessary to validate the surrender.
Reinstatement of Parental Rights Following a Voluntary Surrender
The child shall have the right to petition the court to reinstate parental rights, following a
voluntary surrender, if the following circumstances exist:
1. The child has not been adopted, after three (3) years from the date parent(s) voluntarily
surrendered; and
2. The court has determined the permanency plan is no longer adoption; and
3. The child fourteen (14) years of age or older signed the petition (unless there is good
cause why they should not).
NOTE: The childs petition to reinstate parental rights may be filed prior to the three (3) year
timeframe if the child and DFCS or licensed child-placing agencies (with custody of the child)
stipulate that the child is no longer likely to be adopted. (See policy 3.11 Legal: Termination of
Parental Rights for the complete guidelines on the reinstatement of parental rights)
PROCEDURES
The Social Services Case Manager (SSCM) will:
1. Consult with the Social Services Supervisor (SSS) and the County Director prior to
accepting a voluntary surrender on a child;
2. Assess the birth familys situation thoroughly;
3. Explore all possible alternate plans including, but not limited to:
a. Financial assistance;

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b. Relative assistance and placement;

c. Counseling-parenting training;
d. Family support services (such as daycare or homemakers); and
e. Temporary foster care placement.
4. Make the parent(s) aware:
a. Of their obligation to continue child support until finalization of the adoption;
b. If only one (1) parent surrenders his/her parental rights, DFCS may move forward
with terminating the remaining parents parental rights through Juvenile or
Superior Court; and
c. Of their right to withdraw the surrender within ten (10) days.
5. Initiate the voluntary surrender after the twenty-four (24) hours waiting period.
EXCEPTION: A voluntary surrender of parental rights can be initiated prior to the birth of
the child, for putative father(s) only, but any time after the biological mother has
executed a sworn statement identifying such person as the putative father of the unborn
child
NOTE: The voluntary surrender will not be signed until twenty-four (24) hours after the
actual birth of the child for the mother, legal father or any man who has executed either a
voluntary acknowledgment of legitimation or a voluntary acknowledgement of paternity.
In extraordinary circumstances a waiver of this policy can be obtained from the State
Foster Care Services Unit Director. The waiver may be obtained by telephone but will be
confirmed in writing from the State Foster Care Unit.
6. Execute the voluntary surrender using the following DFCS forms, based on each [legal
or biological] parents relationship to the child:
NOTE: Careful attention must be given to obtaining the correct form from each parent or
legal guardian surrendering. Using the incorrect form may invalidate the surrender.
When a biological mother has determined she wants to voluntarily surrender her parental
rights to a child, the following information and forms will be completed for the surrender
to be valid:
a. Surrender of Rights Final Release for Adoption (Legal Parent);
b. Affidavit of Department Representative;
NOTE: This is signed by the DFCS Representative who explained the surrender
to the mother.
c. Acknowledgment of Surrender of Rights;
d. Mothers Affidavit; and
e. Verification of divorce (if applicable) by means of divorce decree.
When a legal and biological father has determined he wants to voluntarily surrender his
parental rights to a child, the following forms will be completed for the surrender to be
valid:
a. Surrender of Rights Final Release for Adoption (Legal Parent);
b. Affidavit of Department Representative; and
NOTE: This is signed by the DFCS representative who explained the surrender to
the father.
c. Acknowledgment of Surrender of Rights.

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When a legal father but not the biological father has determined he wants to voluntarily
surrender his parental rights to a child, the following forms will be completed for the
surrender to be valid:
a. Surrender of Rights Final Release for Adoption (Legal Parent); or if he prefers
b. Disclaimer, Denial and Surrender of Rights, Final Release for Adoption; and
c. Affidavit of Department Representative; and
NOTE: This is signed by the DFCS Representative who explained the surrender
to the legal father.
d. Acknowledgment of Surrender of Rights.
NOTE: The Surrender of Rights Final Release for Adoption(Legal Parent) or Disclaimer,
Denial and Surrender of Rights, Final Release for Adoption must be completed, but not
both. Completing both forms will invalidate the voluntary surrender.
When a biological father but not the legal father has determined he wants to voluntarily
surrender his parental rights to a child, the following forms will be completed for the
surrender to be valid:
a. Surrender of Rights Final Release for Adoption (Biological Not Legal Father); or if
he denies paternity
b. Disclaimer, Denial and Surrender of Rights, Final Release for Adoption; and
c. Affidavit of Department representative; and
NOTE: This is signed by the DFCS Representative who explained the surrender
to the father.
d. Acknowledgment of Surrender of Rights.
NOTE: The Surrender of Rights Final Release for Adoption (Biological Not Legal Father)
or Disclaimer, Denial and Surrender of Rights, Final Release for Adoption must be
completed, but not both. Completing both forms will invalidate the voluntary surrender.
When an adoptive parent(s) has determined he/she wants to voluntarily surrender
his/her parental rights to a child, the following forms will be completed by each adoptive
parent who wishes to surrender:
a. Surrender of Rights, Final Release for Adoption (Legal Parent);
b. Affidavit of Department Representative;
NOTE: This is signed by the DFCS representative who explained the surrender to
the adoptive parent(s).
c. Acknowledgment of Surrender of Rights; and
d. Adoptive Mothers Affidavit;
NOTE: To be completed by the adoptive mother only, if applicable.
When a grandparent(s) or guardian(s) of a minor child wishes to acknowledge support of
the surrender decision, the grandparent(s) or guardian will complete the
Acknowledgment by Grandparent(s) or Guardian(s) form.
NOTE: This form is not required for a voluntary surrender to be valid, only the parent of
a child may surrender parental rights of the child no matter the parents age. The
Acknowledgment by Grandparent(s) or Guardian(s) form carries no legal weight, but can
be a useful casework tool when working with the family where the surrendering parent is
a minor.
7. Carefully review the voluntary surrender documents and conform to the following:

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a. The childs name and birth date is exactly the same as the legal name and birth
date on the birth certificate;
b. Original signatures on all documents;
c. Each document is notarized;
d. The notary will not be the SSCM who has worked with the family;
e. The unofficial witness on the voluntary surrender and acknowledgment of
surrender forms will not be the person who signs the Affidavit of Department
Representative; and
f. Original signatures and notary stamp is obtained on three (3) copies of each form
signed.
8. Provide a copy of each signed document to each parent who surrendered their parental
rights at the time the voluntary surrender is executed.
9. Provide a Withdrawal of Surrender form to each parent who surrendered their parental
rights.
10. Follow the steps outlined in policy 11.1 Adoption: Adoption Preparation to provide and
secure necessary information to/from each parent who surrendered their parental rights
in preparation for adoption.
10. If the child surrendered fits the description of Wait List Child, contact the Adoption
Exchange, State Permanency Unit for the identification of a Wait List Adoptive Home,
within six (6) hours of executing the voluntary surrender. (See policy 11.7 Adoption: Wait
List Child). A Wait List Child is a child:
a. Five (5) years of age or younger;
b. Of any race or ethnicity; and
c. Who has no physical, mental or emotional disability.
11. Exercise a diligent search to identify a parent, relative or other persons who have
demonstrated an ongoing commitment to the child who may be considered as a possible
placement for the child. See policy 5.13 Investigation: Diligent Search
12. Document the voluntary surrender in Georgia SHINES immediately following the ten (10)
day revocation period.
NOTE: A voluntary surrender of parental rights is only binding and valid after the ten (10)
day revocation period has expired and should only be entered into Georgia SHINES
upon its validity. The voluntary surrender should be documented in the Legal Action and
Outcome page as such:
a. The Court/Action Date - the date the voluntary surrender documents are signed;
b. The Action Type - Voluntary Surrender Biological Mother, Biological and Legal
Father, Legal Father, Biological Father, Putative Father, Adoptive Mother or
Adoptive Father;
NOTE: Ensure that action type matches the parent relationship of that parent to
the child who was surrendered to DFCS.
c. Hearing/Court Order Type - not applicable;
d. The Outcome - not applicable;
e. Attendees/Involved Parties - select all appropriate parties involved;
f. Complete narrative detailing the events of the surrender; and
g. Check complete.
NOTE: Entering the legal action in Georgia SHINES will notify the Adoption Exchange,
State Permanency Unit by a system generated alert. The date the Adoption Exchange,
State Permanency Unit is notified is the actual date the legal action is completed in
Georgia SHINES.
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13. Within three (3) business days upload all the information and forms related to the
voluntary surrender to Georgia SHINES External Documentation, including a copy of the
waiver allowing the voluntary surrender to be executed prior to the twenty-four (24) hour
waiting period (if applicable).
14. Attach to the original copy of the Child Life History an original copy of the voluntary
surrender documents with original signature and raised seal. If the voluntary surrender is
taken less than twenty-four (24) hours after birth, the waiver must also be attached to the
Child Life History.
Voluntary Surrender to a Third Party or Child Placing Agency (CPA) Child in Temporary
Custody of DFCS
The name and address of each person to whom the child is surrendered may be omitted to
protect confidentiality, provided the surrender sets forth the name and address of his agent for
purposes of notice of withdrawal.
Withdrawal of Voluntary Surrender
If a legal and/or biological parent wishes to withdraw their voluntary surrender, within the ten
day period, provide the Withdrawal of Surrender form to the parent(s).
NOTE: It is not legally necessary that a withdrawal of surrender be on this form. The
withdrawal may take any format as long as it is delivered in writing to the address listed in the
acknowledgment within the required time frame.
PRACTICE GUIDANCE
The mother, father and child(ren) (where appropriate) should all be involved in the planning for
a voluntary surrender. A voluntary surrender should not be taken to Juvenile Court to confirm
that parental rights are terminated. A properly executed voluntary surrender after the ten (10)
day revocation period has expired is as legally valid as a termination court order.
NOTE: There may be exceptions in some Juvenile Court circuits or jurisdictions.
If there is any doubt as to the competence of the signer, a voluntary surrender will not be taken.
In this case it will be necessary to go to court to terminate parental rights. If the parent wishes
to express to the judge that he/she wants to voluntarily surrender parental rights, the judge
could then incorporate this into a court order as the grounds for termination.
A voluntary surrender that is not properly executed cannot be corrected by confirming it in
Juvenile Court. The court cannot determine rights where terminated based on the voluntary
surrender, if the documents were incorrectly executed.
It is not necessary to confirm a voluntary surrender by court order for the purpose of Title IV-E
adoption assistance for an Applicable Child.
Adoption (Private Agency)
Adoption of a child through a child placing agency (CPA) licensed by the State of Georgia to
place children for adoption or through the Interstate Compact on the Placement of Children from
a licensed CPA in another state.

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Adoption Assistance
Adoption assistance is assistance provided on behalf of an eligible child to offset the costs
associated with adopting and meeting the on-going needs of the child. Adoption assistance
can be provided in the form of payments, medical coverage and reimbursement of nonrecurring expenses.
Biological Father
A male who impregnated the biological mother resulting in the birth of the child. He may or may
not also be the legal father.
Child Placing Agency (CPA)
An agency that places children in foster and adoptive resource homes for individualized care,
supervision and oversight. Child placing agencies are responsible for assessing the placement
regarding the appropriateness of the room, board and watchful oversight that the prospective
foster and adoptive families will provide. The CPAs employees and their foster and adoptive
parents work as a team to provide a stabilizing and nurturing environment that promotes safety,
well-being and permanency.
Evaluator
The person or agency that conducts a family evaluation when a child is to be adopted by a
(non-relative) third party. An evaluator shall be a licensed child-placing agency, the Department,
or a licensed professional with at least two years of adoption related professional experience,
including a licensed clinical social worker, licensed master social worker, licensed marriage and
family therapist, or licensed professional counselor. In instances where none of the foregoing
evaluators are available, the court may appoint a guardian ad litem or court appointed special
advocate to conduct the family evaluation.
Legal Father
The Official Code of Georgia defines a legal father as a male, who has not surrendered or had
terminated his rights to the child, and who:
1. Has legally adopted a child; or
2. Was married to the biological mother at the time the child was conceived or was born,
unless paternity was disproved by a final order; or
3. Married the legal mother after the child was born and recognized the child as his own,
unless paternity was disproved by a final order; or
4. Has been determined to be the father by a final paternity order [pursuant to Article 3 of
Chapter 7 of Title 19]; or
5. Has legitimated the child by final order [pursuant to O.C.G.A. 19-7-22]; or
6. Has legitimated the child [pursuant to O.C.G.A. 19-7-21.1].
Legal Mother
The female who is the biological or adoptive mother of the child and who has not surrendered or
had her rights to the child terminated.
Putative Father
The alleged or possible biological but not legal father. A putative father may or may not be a
registrant of the putative father registry.

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Statutory Overnight Delivery

The delivering entity is either the United States Postal Service or a commercial firm, such as
United Parcel Service or Federal Express, engaged in the business of document or package
delivery. That entity engages to deliver not later than the next business day after it receives the
article. The sender receives from the entity a receipt acknowledging delivery, signed by the
addressee.
Termination of Parental Rights
The legal process for severing the relationship between a child and his/her parents. Court
orders terminating parental rights shall be without limit as to duration. Once issued and not
overturned by appeal, the order is permanent. The parent lose all parental rights to the child
however, remains obligated to pay child support until a final order of adoption is entered. The
child loses all rights to the parent (and extended family), including the rights of inheritance.
Sibling and extended family maintain relationship until a final order of adoption for the purposes
of placement and visitation.
Third Party
This is someone outside the home that is not in a caretaker role with the child(ren) in question.
Voluntary Acknowledgement of Legitimation
A voluntary declaration that the mother and biological father consent and agree that the
relationship between the child and father shall be considered legitimate for all purposes
under the law.
Voluntary Acknowledgement of Paternity
When both the mother and father have freely signed a voluntary acknowledgement of
paternity and the acknowledgement is filed with the Putative Father Registry a legal
determination of paternity is established, provided the acknowledgement is not rescinded
within the sixty (60) day rescission period.
FORMS AND TOOLS
Acknowledgement by Grandparent(s) and/or Guardian(s)
Acknowledgement by Grandparent(s) and/or Guardian(s) Instructions
Acknowledgment of Surrender of Rights
Acknowledgment of Surrender of Rights - Spanish
Acknowledgment of Surrender of Rights - Instructions
Adoptive Mothers Affidavit
Adoptive Mothers Affidavit - Instructions
Affidavit of Department Representative
Affidavit of Department Representative - Spanish
Affidavit of Department Representative - Instructions
Disclaimer, Denial and Surrender of Rights Final Release for Adoption
Disclaimer, Denial and Surrender of Rights Final Release for Adoption - Spanish
Disclaimer, Denial and Surrender of Rights Final Release for Adoption Instructions
Ex-Parte Petition and Order Confirming Voluntary Surrender Order - Model
Mothers Affidavit
Mothers Affidavit - Spanish
Mothers Affidavit Instructions
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Surrender of Rights Final Release for Adoption (Biological Not Legal Father)
Surrender of Rights Final Release for Adoption (Biological Not Legal Father) Spanish
Surrender of Rights Final Release for Adoption (Biological Not Legal Father) Instructions
Surrender of Rights Final Release for Adoption (Legal Parent)
Surrender of Rights Final Release for Adoption (Legal Parent) - Spanish
Surrender of Rights Final Release for Adoption (Legal Parent) - Instructions
Withdrawal of Surrender
Withdrawal of Surrender - Instructions
Voluntary Surrender Documents Sample

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