Fill and Sign the Adult Adoption Petition Form

STATE OF VERMONT PROBATE COURT DISTRICT OF ____________ In Re the Estate of: ) DOCKET No. __________ ) __________________ ) , Deceased ) ) ) LATE OF ) ) __________________ . ) ) ) ADULT ADOPTION PETITION 15A V.S.A. § 5-105 Part 1. The undersigned petitioners represent that: 1. The person to be adopted is: Name: _________________________________________________ Address: ______________________________________________ Place of Birth: _______________________________________ Date of birth: ________________________________________ Current marital status: _______________________________ If married, please state the place and date of marriage: _______________________________________________________ Full name by which the adoptee is to be known if the petition is granted: _________________________________________________ 2. The adopting parent(s) is: Name: __________________________________________ Address: _______________________________________ Length of residence at present address: __________________________________________ Place of Birth: __________________________ Date of birth: ___________________________ Current marital status: __________________ If married, please state the place and date of marriage: __________________________________________ Name: ____________________________________ Address: ________________________________ Length of residence at present address: __________________________________________ Place of Birth: __________________________ Date of birth: ___________________________ Current marital status: __________________ 3. Please state the duration and nature of the relation between the prospective adoptive parent and the adoptee: __________________________________________ Part 2. The prospective adoptive parent and adoptee certify the following: 1. The prospective adoptive parent(s) and the adoptee desire to assume the legal relationship of parent and child and to have all of the rights and be subject to all of the duties of that relationship. 2. The adoptee understands that a consequence of the adoption will be to terminate the adoptee's relationship as the child of an existing parent, but if the adoptive parent is the adoptee's stepparent, the adoption will not affect the adoptee's relationship with a parent who is the stepparent's spouse, but will terminate the adoptee's relationship to the adoptee's other parent, except for the right to inherit from or through that parent. 3. The adoptee and the prospective parent(s) understand the consequences the adoption may have for any right of inheritance, property or support from adoptive and biological parents. Part 3. Persons Interested in Adoption Proceeding 1. Please state the full name and last known address of any other person whose consent to this adoption is required: __________________________________________ __________________________________________ __________________________________________ 2. Please state the name, age, and last known address of each biological or adopted child of the prospective adoptive parent(s). If adopted, please state the date and place of adoption: __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ 3. Please state the name, age, and last known address of each living parent or child of the adoptee: __________________________________________ __________________________________________ Part 4. Documents Required 1. Certified copy of the adoptee's birth certificate and the adoptive parent's. 2. Any required consent that has been executed. 3. Filing fee of $75.00. Dated at ______________ Vermont, this ___ day of ____________ , 20 __ . _____________________________________________ , Petitioner(s) ___________________________________________ _, Adoptee Subscribed and sworn to this _______ day of _______________ , 20 ___ , before me, _______________________________________________ , Notary Public Subscribed and sworn to this _______ day of _______________ , 20 ___ , before me, _______________________________________________ , Notary Public * Consent to the adoption of an adult or emancipated minor is required only of spouse of the prospective adoptive parent. (See attached form). Rev.3/1/97