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1. Date and Place: Current date and location where the letter is being executed
2. Parent/Current Guardian Information: Full legal name, address, and contact details of the parent(s) or current legal guardian(s) giving consent
3. Proposed Guardian Information: Full legal name, address, and contact details of the person(s) to whom guardianship will be granted
4. Child Information: Full legal name, date of birth, and current address of the child for whom guardianship is being arranged
5. Consent Statement: Clear and explicit statement of consent for guardianship, including the scope and nature of the guardianship
6. Duration of Guardianship: Specific timeframe or conditions of the guardianship arrangement
7. Powers and Responsibilities: Outline of the specific powers and responsibilities being granted to the guardian
8. Declaration of Sound Mind: Statement that the consenting party is of sound mind and giving consent freely
9. Signatures: Space for signatures of all relevant parties
1. Medical Authorization: Additional authorization for medical decisions, used when specific medical powers need to be granted
2. Travel Authorization: Specific permission for international travel, used when the child may need to travel abroad
3. Financial Provisions: Details of financial arrangements and responsibilities, used when specific financial powers are being granted
4. Revocation Terms: Specific conditions under which the guardianship can be revoked, used in cases where conditional guardianship is being granted
5. Language Clause: For cases involving non-native Belgian language speakers, specifying that the contents have been understood
6. Emergency Contact Information: Additional contacts for emergency situations, used when primary parties may not be immediately reachable
1. Identity Documents: Copies of official identification documents of all parties involved
2. Birth Certificate: Copy of the child's birth certificate
3. Proof of Address: Recent proof of address for all adult parties
4. Medical History: Relevant medical information about the child (if medical authorization is included)
5. Criminal Record Check: Criminal record certificate for the proposed guardian(s)
6. Witness Statements: Statements from witnesses confirming the voluntary nature of the consent
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