Fill and Sign the Alabama Consent or Relinquishment of Minor for Adoption Release of Parental Rights Form

CONSENT OR RELINQUISHMENT OF MINOR FOR ADOPTION THE STATE OF ALABAMA ______________COUNTY KNOW ALL MEN BY THESE PRESENT, that: 1. I, ________________________________________ (name of person consenting or relinquishing) the _______________________________________ of (parents, legal guardian, agency) (a) a minor _____________________________ ______ (state any names by which the minor has been known) born ____________, 19__. (or) (b) an unborn child whose expected date of birth is ______________, do hereby: (a) consent to the adoption of the said minor by ______________________________ __ (name of petitioners, unless identity waived) (or) (b) relinquish the said minor for the purpose of adoption to ________________________ (name and address of agency) in order that said minor may have all the privileges which may be accorded to (him) (her) by the laws of Alabama upon (his) (her) legal adoption; 2. I am executing this document voluntarily and unequivocally thereby [consenting to the adoption of] [relinquishing] said minor; 3. I understand that by signing this document and the subse quent court order to ratify the consent, I will forfeit all rights and obligations and that I understand the [consent to the adoption] [relinquishment] and execute it freely and voluntarily; 4. I understand that the [consent to the adoption] [relinquishment] may be irrevocable, and I should not execute it if I need or desire psychological or legal advice, guidance or counseling; 5. I have received or been offered a copy of this document; 6. I waive the right to know the identity of each petitioner who petitions to adopt the said minor child; 7. [I waive further notice of the adoption proceedings by the execution of this relinquishment to the named agency]; (or) [I waive further notice of the adoption proceedings by the execution of this consent, unless there is a contest or appeal of the adoption proceedings]; 8. I understand that notice of withdrawal of [consent] [relinquishment] must be mailed to [________________________________, (c ounty where consent or petition is filed if known) Probate Court at the following address _______________] or [___________________________ (name and address of agency with whom document is filed or the ____________________] petitioners or their attorney if county where petition is filed is unknown) and that such withdrawal must be mailed within five days after the birth of said minor or the execution of this document whichever comes last; 9. I do hereby request that the judge of probate make all such orde rs and decrees as may be necessary or proper to legally effectuate said adoption. Given under my hand at ____o'clock, ______ day of ____________, 19__, at _____________ (address of filing) __________________________(SEAL) Affiant's Signature I ___ ____________, sign my name to this instrument this _____ day of__________, 19__, and being first duly sworn, do hereby declare to the undersigned authority that I execute it as my free and voluntary act for the purposes therein expressed, and that I am ___ __ years of age or older, of sound mind, and under no constraint or undue influence. ____________________________(SEAL) Affiant's Signature STATE OF ALABAMA COUNTY OF _______ Subscribed, sworn to and acknowledged before me by ________________, this_______________day of _______, 19__. SEAL (Signed) ____________________ ____________________________ (Official Capacity of Officer) I acknowledge receipt of two copies of this document. ___________________________ Signature __________________ Date WITHDRAWAL OF CONSENT TO ADOPTION I _____________________________, on this _______ day of ____________, 19__, at _____________ a.m ./p.m. in the presence of the two witnesses whose signatures and addresses are subscribed below, hereby withdraw the adoption [consent] [relinquishment] previously signed by me. __________________________________ Signature ________________________ __________ Witness __________________________________ Address __________________________________ Witness ___________________________________ Address AL -02018