§ 48-3-703. Content of relinquishment; mandatory provisions.
§48‑3‑703. Content of relinquishment; mandatory provisions.
(a) A relinquishmentexecuted by a parent or guardian under G.S. 48‑3‑701 must be inwriting and state:
(1) The date and placeof the execution of the relinquishment;
(2) The name, date ofbirth, and permanent address of the individual executing the relinquishment;
(3) The date of birth orthe expected delivery date, the sex, and the name of the minor, if known;
(4) The name and addressof the agency to whom the minor is being relinquished;
(5) That the individualvoluntarily consents to the permanent transfer of legal and physical custody ofthe minor to the agency for the purposes of adoption, and
a. The placement of theminor for adoption with a prospective adoptive parent selected by the agency;or
b. The placement of theminor for adoption with a prospective adoptive parent selected by the agencyand agreed upon by the individual executing the relinquishment;
(6) That the individualexecuting the relinquishment understands that after the relinquishment issigned and acknowledged in the manner provided in G.S. 48‑3‑702, itmay be revoked in accord with G.S. 48‑3‑706 but that it isotherwise final and irrevocable except under the circumstances set forth inG.S. 48‑3‑707;
(7) That therelinquishment shall be valid and binding and shall not be affected by any oralor separate written agreement between the individual executing the consent andthe agency;
(8) That the individualexecuting the relinquishment understands that when the adoption is final, allrights and duties of the individual executing the relinquishment with respectto the minor will be extinguished and all other aspects of the legalrelationship between the minor child and the parent will be terminated;
(9) That the individualexecuting the relinquishment has not received or been promised any money oranything of value for the relinquishment of the minor, and has not received orbeen promised any money or anything of value in relation to the relinquishmentor the adoption of the minor except for lawful payments that are itemized on aschedule attached to the relinquishment;
(10) That the individualexecuting the relinquishment waives notice of any proceeding for adoption;
(11) That the individualexecuting the relinquishment has provided the agency with the written documentrequired by G.S. 48‑3‑205, or that the individual has provided theagency with signed releases that will permit the agency to compile theinformation required by G.S. 48‑3‑205; and
(12) That the individualexecuting the relinquishment has:
a. Received or beenoffered an unsigned copy of the relinquishment;
b. Been advised thatcounseling services are available through the agency to which therelinquishment is given; and
c. Been advised of theright to employ independent legal counsel. (1995, c. 457, s. 2.)