Fill and Sign the Adopt Consent Form

IN THE ___________COURT OF _______________ (County), ___________________ (State) IN THE MATTER OF THE ADOPTION OF (Name of Minor) ____________________________ CAUSE NO. __________________ Petition to Adopt Child Comes now ___________________________________________________ (Names of Petitioners) , the Petitioners herein, who respectfully submit as follows: 1. Petitioners are husband and wife, of lawful age and under no legal disability. Petitioner, _________________________ (name of husband), has been residing in _________________ _________________________________ (name of city, county and state) for a period of ________ (number) years immediately preceding the filing of this Petition. Petitioner, ___________________________ (name of wife) has been residing in ___________________ _________________ (name of city, county and state) for a period of ______ (number) years immediately preceding the filing of this Petition. 2 . Petitioners desire to adopt ________________________ (Name of Minor), a ____________________ (state male or female) minor child aged ________ (number), who was born on ________________________ (date), at _________________________________ _____________________________________ (street address, city, county, state, zip code) . The child is in the custody of and resides with Petitioners. 3. The biological mother is ___________________________ (Name). She was never married to the biological father. The name of the biological father of the child is _____________ ____________ (Name) and his whereabouts are unknown. The biological father is of lawful age and under no legal disability. 4. The biological father of the child abandoned and deserted the child for a period in excess of ________ (number) months immediately preceding the filing of this Petition, and he has failed to maintain a reasonable degree of interest, concern, or responsibility for the child's welfare. The father is, therefore, an unfit person and his consent to this adoption is unnecessary. 5. No orders affecting the custody, adoption, or parental rights of Petitioners to the child have previously been entered in any court. 6. Petitioners are reputable persons of good moral character with sufficient ability and financial means to rear, nurture, and educate the child in a suitable and proper manner. WHEREFORE, Petitioners make, _____________________ (name of minor), a minor and ____________________________ (name of biological father) , the biological father and the unknown father and all whom it may concern, parties' defendant to this cause, and request that the Court: A. Appoint a guardian ad litem to represent the interests of the minor sought to be adopted in this proceeding; B. Appoint some suitable agency or person to investigate this matter as required by law and report the results of the investigation in writing to this Court; C. Grant Petitioners leave to adopt, as their own child, the minor and for leave to change the child's name to ________________________ (Name); and D. Award such further relief and the entry of such additional orders as may be necessary or appropriate in this matter. Respectfully submitted: ____________________________ Names of Petitioners By________________________________________________________ Name & Signature of Attorney Of Counsel: _______________________________ _______________________________ _______________________________ _______________________________ Name, Address, Phone No. and State Bar No. of Attorney STATE OF _________________________ COUNTY OF _______________________ Personally appeared before me, the undersigned authority at law in and for the aforesaid jurisdiction, ______________________________________________ (Names of Petitioners), who, after being first duly sworn, stated that the matters and things set forth in the above and foregoing Petition are true and correct as therein stated. ____________________________ Petitioner's signature ____________________________ Petitioner's signature SWORN to and subscribed before me, this the day of _____________, 20____. Notary Public My Commission Expires: ____________________ (Oath/Acknowledgement may vary by State)