Fill and Sign the Final Decree Adoption 497301733 Form

SUPERIOR COURT OF THE DISTRICT OF COLUMBIA FAMILY COURT DOMESTIC RELATIONS BRANCH – ADOPTION EX PARTE IN THE MATTER OF THE PETITION OF [Petitioners' Initials] FOR ADOPTION OF MINOR CHILD(REN) ) ) ) ) ) ) ) ) ADOPTION CASE NO. A-_______ JUDGE RONNA LEE BECK LIMITED CONSOLIDATION WITH IN THE MATTER OF [Child's Name] DOB: [date] RESPONDENT(S) ) ) ) ) ) ) ) ) NEGLECT CASE NO. N-_______ SOCIAL FILE NO. ________ NEGLECT REVIEW CALENDAR JUDGE [name] NOTICE OF ISSUANCE OF FINAL DECREE OF ADOPTION PLEASE TAKE NOTICE that on this date in the above-captioned adoption case, the court has issued and signed a Final Decree of Adoption for the child (name of child) , date of birth (dob) . In an Order issued (date) , the court waived the consent of the child’s [mother and/or father] pursuant to D.C. Code Ann. § 16-304 (2001). [Also, if applicable: In an affidavit signed (date) , the child’s (mother and/or father) consented to the adoption of (child's name) by the petitioner(s) or relinquished parental rights as to (child's name).] . 1 The [mother and/or father have/has] 1 the right to file an appeal within thirty days of the docketing of the Final Decree of Adoption, which shall be docketed on the same date as this Notice. Accordingly, it is now, hereby, this       day of       , 2005, ORDERED that the Clerk of the court shall file the Final Decree of Adoption and this Notice of the Issuance of Final Decree of Adoption in the above-captioned adoption case. This notice will be sent to the counsel, social workers, and persons listed below in the distribution list to advise them as to the status of the child [and of appeal rights]. 2 _____________________________ JUDGE RONNA LEE BECK (Signed in Chambers) 1 Whichever has not consented to the adoption or relinquished parental rights. 2 A consenting parent does not have the right to appeal. Delete this phrase if both parents consented or relinquished parental rights. 2 Copies to: Counsel for Petitioner(s) Counsel for Mother Counsel for Father Guardian ad litem Johnna Faber, Esquire Assistant Attorney General Child and Family Services Agency 400 6 th Street, SW Washington, DC 20024 William S. Johnson, LICSW Adoption Resources Program Child and Family Services Agency 400 6 th Street, SW Washington, DC 20024       , Social Worker Adoption Resources Program Child and Family Services Agency 400 6 th Street, SW Washington, DC 20024 Neglect Review Judge if not the Assigned Judge 3