C Pra1 0224

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Parental Responsibility Agreement Keep this form in a safe place

Section 4(1)(b) Children Act 1989 Date recorded at The Central Family
Court:
Read the notes on the other side
before you make this agreement.
This is a Parental Responsibility Agreement regarding

the Child Full Name
Gender Date of birth Date of 18th birthday

Between
the Mother Name
Address
and the Father Name
Address
We declare that we are the mother and father of the above child and we agree that the child’s father shall have
parental responsibility for the child (in addition to the mother having parental responsibility).
Signed (Mother) Signed (Father)
Date Date
Certificate The following evidence of identity The following evidence of identity

was produced by the person signing above: was produced by the person signing above:
of witness
Signed in the presence of: Signed in the presence of:

Name of Witness Name of Witness
Address Address
Signature of Witness Signature of Witness
[A Justice of the Peace] [Justices’ Clerk] [A Justice of the Peace] [Justices’ Clerk]
[An assistant to a justices' clerk] [An officer [An assistant to a justices' clerk] [An Officer
of the court authorised by the judge to of the Court authorised by the judge to
administer oaths] administer oaths]
C(PRA1) (02.24) Click here to print form © Crown copyright 2024

Notes about the Parental Responsibility Agreement
Read these notes before you make the agreement.
About the Parental Responsibility Agreement

The making of this agreement will affect the legal position of the mother and the father. You should both seek legal advice
before you make the Agreement. You can obtain the name and address of a solicitor from the Children Panel
(020 7242 1222)
or from • a local office of the family court
• a Citizens Advice
• a Law Centre
• a local library.
You may be eligible for legal aid.
When you fill in the Agreement

Please use black ink (the Agreement will be copied). Put the name of one child only. If the father is to have
parental responsibility for more than one child, fill in a separate form for each child. Do not sign the Agreement.
When you have filled in the Agreement

Take it to a local office of the family court, or The Central Family Court (the address is below).
A justice of the peace, a justices’ clerk, an assistant to a justices' clerk, or a court official who is authorised by the judge
to administer oaths, will witness your signature and he or she will sign the certificate of the witness. A solicitor cannot
witness your signature.
To the mother: When you make the declaration you will have to prove that you are the child’s mother so take to the court
the child’s full birth certificate.
You will also need evidence of your identity showing a photograph and signature (for example, a
photocard, official pass or passport). Please note that the child's birth certificate cannot be accepted
as sufficient proof of your identity.
To the father: You will need evidence of your identity showing a photograph and signature
(for example, a photocard, official pass or passport).
When the Certificate has been signed and witnessed

Make sufficient copies of the Agreement form for each person who has signed the form. You do not need to copy these
guidance notes.
Sufficient copies of the Agreement form for each child, with copies of the original certificates (marriage, birth, name deed,
death) need to be sent with the original form to: The Central Family Court, First Avenue House, 42–49 High Holborn,
London, WC1V 6NP.
The Court will record the agreement and retain the original form. The copies will be stamped with the seal of the court and
sent back to every person with parental responsibility who has signed the Agreement form and to the step-parent. The
Agreement will not take effect until it has been received and recorded at The Central Family Court.
Ending the Agreement

Once a parental responsibility agreement has been made it can only end
• by an order of the court made on the application of any person who has parental responsibility for the child
• by an order of the court made on the application of the child with permission of the court
• when the child reaches the age of 18.
C(PRA1) (Notes) (02.24)

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Click here to reset form Click here to print form

Parental Responsibility Agreement Keep this form in a safe place

This is a Parental Responsibility Agreement regarding

Gender Date of birth Date of 18th birthday

and the Father Name

Signed (Mother) Signed (Father)

Certificate The following evidence of identity The following evidence of identity

Signed in the presence of: Signed in the presence of:

Signature of Witness Signature of Witness

C(PRA1) (02.24) Click here to print form © Crown copyright 2024

About the Parental Responsibility Agreement

When you fill in the Agreement

When you have filled in the Agreement

When the Certificate has been signed and witnessed

Ending the Agreement

C(PRA1) (Notes) (02.24)

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