Fill and Sign the Consent of Spouse of Prospective Adoptive Parent in Adoption of Adult or Emancipated Minor Vermont Form

STATE OF VERMONT PROBATE COURT DISTRICT OF ____________ In Re the Estate of: ) DOCKET No. __________ ) __________________ ) , Deceased ) ) ) LATE OF ) ) __________________ . ) ) ) CONSENT OF SPOUSE OR PARTNER OF PROSPECTIVE ADOPTIVE PARENT IN ADOPTION OF ADULT OR EMANCIPATED MINOR 15A V.S.A. § 5-105 1. My Full Name ____________________ . 2. My Mailing Address ____________________ ____________________ ____________________ 3. My Date of Birth ____________________ . 4. Full Name of Adult or Emancipated Minor Who Is Being Adopted ____________________ 5. Full name of Prospective Adoptive Parent ______________________________ 6. (a) I State That the Prospective Adoptive Parent and I are Married and the Date of Our Marriage Was ____________________ (b) I have been the prospective Adoptive Parent's partner since ____________________ , and I consent to the adoption. 7. I consent to the adoption of the above named adult or emancipated minor by my spouse. 8. I understand the consequences the adoption may have for any right of inheritance, property, or support I have. - 1 - 9. I acknowledge that I have received a copy of this consent. 10. I do one of the following: I waive notice to me of any further proceedings in this adoption unless the adoption is contested, appealed, or denied. I do not waive notice of any further proceedings in this adoption. I swear that the factual information set forth in this consent is true and correct to the best of my knowledge and belief. Dated this ___________ day of ___________________, 20______ at _____________________ in the County of __________________, and State of _________________. ___________________________________________________________ (signature) ____________________________________________________________ (printed name) STATE OF ____________________ COUNTY OF ____________________ On the       day of __________ , 20       , ____________________ personally appeared before me and signed or confirmed in my presence that he or she freely and voluntarily signed the above consent and acknowledged that the factual information set forth therein is true and correct to the best of his or her knowledge and belief. I am one of the following: - 2 - a Judge of a court that has jurisdiction over adoption proceedings in the State of __________________; a person authorized to take acknowledgments. ___________________________________________________________ (signature) ___________________________________________________________ (printed name) Rev.3/9/98 - 3 -