31 C.F.R. § 360.63
(b) The request must appear on the back of the bond in one of the following forms:
(1) Request by parent:
I certify that I am the mother of John C. Jones (with whom he resides) (to whom legal custody has been granted). He is __ years of age and is not of sufficient understanding to make this request. Mary Jones on behalf of John C. Jones
(2) Request by other person:
I certify that John C. Jones does not reside with either parent and that I furnish his chief support. He is __ years of age and is not of sufficient understanding to make this request. Alice Brown, grandmother, on behalf of John C. Jones