Fill and Sign the Consent Parent Adoption Form

STATE OF MINNESOTA DISTRICT COURT COUNTY OF             JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Marriage of: Court File No.             , Petitioner, CONSENT OF PARENT TO ADOPTION AND WAIVER OF NOTICE OF HEARING AND       , Respondent, STATE OF MINNESOTA ) )SS COUNTY OF ________ ) I, __________________ , being first duly sworn upon oath, depose and say: 1. That I am __________________ (__) years of age and a resident of __________________ , County of __________________ , State of       . 2. That I am the parent of __________________ , a female/male child born the ____ day of ________________ , 20 ___ at __________________ . 3. (That I contacted my ex-wife, __________________ , and informed her that I wished to allow her present husband, __________________ , to adopt my child, __________________ .) I believe it is in __________________ 's best interest that __________________ be allowed to adopt __________________ . I believe that __________________ is and has been an excellent role model for __________________ and also a great father to __________________ . 4. That after being fully advised of all premises herein, and with a view to the future welfare of my child, I, __________________ of my own free will hereby consent to the adoption of said child by my ex-wife, __________________ , and her present husband, __________________ , the Petitioners herein, and hereby waive notice of hearing upon the adoption petition. 5. (That I may send presents, cards, and or contact __________________ at the Petitioners' discretion, and that they will not prevent __________________ from contacting me if __________________ so chooses.) 6. That I understand: I may for any reason, withdraw this consent to adoption within the next ten working days from the date hereof; My withdrawal of consent must be in writing and must be received by this agency no later than the tenth working day following the date upon which this consent is executed and acknowledged; My consent will become irrevocable on the day following the tenth working day from the date hereof, except upon an order of the court of competent jurisdiction after findings that the consent was obtained by fraud. In the presence of: _________________________ ______________________________ (Witness) (Parent) _________________________ (Witness) On this ___ day of ____________ 20 ___ , before me personally appeared the person described herein and who executed the foregoing witnesses named herein who was present when the parent executed the foregoing Consent to Adoption. _________________________________ Notary Public On this ____ day of _____________ 20____, before me personally appeared the consent and waiver and acknowledgment that such consent was freely given. _________________________________ Notary Public