FORM 8.984. ORDER TERMINATING PARENTAL RIGHTS
(VOLUNTARY)

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.