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Form 26A Affidavit and Report

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PETITION FOR EXTENSION OF EXPIRED CERTIFICATION (Private Placement)

D.R.L. §§ 115, 115-d(9)

Form 26

(Certification Petition

for Extension of Expired

Certification - Private

Placement)

9/99

(Docket)(File) No.

In the Matter of the Adoption of

A Child whose First Name is

by Adoptive Parent(s)

The Petitioner(s) respectfully allege(s) to this Court that:

1. (He)(She)(They) filed a petition to adopt the above-described child in this Court on

2. Petitioner(s) (was)(were) certified as a qualified adoptive parent(s), by order of the Court, County of , dated , which order expired on , within one year prior to the filing of the adoption petition.

3. The following change(s) in circumstances relevant and material to such certification (has)(have) taken place since issuance and expiration of the last certification:

4. Submitted herewith is written verification of any such change in circumstances or lack thereof by , a disinterested person as defined in section 115-d(4) of the Domestic Relations Law.

WHEREFORE, Petitioner(s) (prays) (prays) for an order extending the termination date of the earlier certification until eighteen months from the date of filing of the adoption petition, that is,

/
Adoptive Parent: typed or printed name/ signature

/
Adoptive Parents: typed or printed name/ signature

/
Attorney: typed or printed name/ signature


Attorney's Address and Telephone Number

Form 26 page 2

VERIFICATION

STATE OF NEW YORK

)

COUNTY

ss:

)

being duly sworn, says that (he)(she) (they)(is)(are) the Petitioner(s) in the above-named proceeding and that the foregoing petition is true to (his)(her)(their) own knowledge, except as to matters therein stated to be alleged on information and belief and as to those matters (he)(she) (they) believe(s) it to be true.

/
Adoptive Parent: typed or printed name/ signature

/
Adoptive Parent: typed or printed name/ signature

Sworn to before me this

day of


(Deputy)Clerk of the Court
Notary Public

Resworn to before me this

day of


Judge of the Court

Enter text

What the Form 26A Affidavit and Report Is

Form 26A Affidavit and Report is a sworn written statement used to record facts, events, or findings and to present them as evidence or official record. It combines an affidavit section (sworn facts) with a short report summarizing context, supporting documentation, and attachments that substantiate the sworn statements. Organizations use it for dispute documentation, administrative investigations, property incidents, compliance reporting, and other matters where a concise, signed, and often notarized factual record is required under U.S. practice.

Why a Clear Form 26A Matters

A correctly completed Form 26A improves evidentiary value, reduces later disputes by documenting facts under oath, and streamlines administrative review. When prepared to legal standards it supports admissibility and recordkeeping while making subsequent verification, notarization, and e-submission more straightforward.

Why a Clear Form 26A Matters

Typical Users and Signers

Who prepares and signs Form 26A varies by context and industry.

  • Investigators and compliance officers preparing factual reports for internal or regulatory review.
  • Property managers, real estate agents, or contractors documenting incidents or condition findings.
  • Attorneys and paralegals assembling sworn statements for litigation support or administrative filings.

Ensure the signer has authority to swear the affidavit and that supporting evidence is attached and referenced in the report.

Step-by-Step: Complete Form 26A Accurately

Follow these sequential steps to prepare a clear, verifiable affidavit and report.

  • 01
    Collect Evidence: Gather documents, photos, and witness statements that support each factual claim.
  • 02
    Draft Facts: Write numbered, first-person facts tied to specific exhibits or timestamps.
  • 03
    Add Metadata: Fill effective date, location, and affiant title fields in MM/DD/YYYY format.
  • 04
    Sign and Notarize: Have the affiant sign before a notary or follow state RON procedures if permitted.

Digital Workflow Settings for Online Completion

Configure a repeatable online workflow to standardize data capture, authentication, and record retention.

Field Configuration
Template Name Form 26A Affidavit and Report template with required fields
Authentication Method Email link or SMS code; consider KBA or ID check for higher assurance
Attachment Handling Require uploaded exhibits and enforce filename and format rules (PDF preferred)
Audit Trail Retention Capture IP, timestamps, and action log for long-term evidence

Typical Submission and Routing Flow

A consistent routing process helps ensure proper review, notarization, and filing of the completed form.

  • Prepare: Populate template, attach exhibits, and validate required fields.
  • Authenticate: Send signer verification link or require multi-factor authentication.
  • Sign: Signer executes signature; notarization step occurs if required.
  • File: Route completed record to designated custodian and store per retention policy.

Platform and File Requirements for Electronic Use

Ensure your chosen platform supports required eSignature, authentication, and storage capabilities for sworn statements.

  • File Formats: PDF, DOCX accepted
  • Integrations: CRM, cloud storage, and DMS connections
  • Security Controls: TLS in transit; AES-256 at rest

Confirm the platform can produce an immutable audit trail, support notarization or RON workflows where permitted, and export signed records for legal retention.

Core Components of a Professional Form 26A

A well-structured Form 26A contains discrete sections that ensure clarity, traceability, and legal utility.

Affidavit Header

Contains affiant identification, capacity, and a short oath clause stating the affiant swears or affirms the facts presented under penalty of perjury.

Numbered Facts

Each factual assertion is numbered and written in the first person, making it straightforward to reference supporting evidence and witness testimony.

Report Summary

Concise narrative tying facts together, explaining sequence, context, severity, and any immediate actions taken or recommended.

Exhibits List

A cross-referenced index of attachments (photos, documents, logs) labeled as Exhibit A, B, etc., with filenames and brief descriptions.

Notary Block

Notarial acknowledgment or jurat formatted per state requirements; includes notary signature, seal, commission expiration, and record of oath.

Signature Panel

Affiant signature, printed name, title, date, and contact information plus any witness signatures where state law requires them.

Security and Compliance Considerations

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest
Audit Trail: Detailed timestamped signing events and IP addresses
Regulatory Compliance: ESIGN and UETA adherence
Healthcare Data: HIPAA support with BAA option
FDA Records: 21 CFR Part 11 controls available
Certifications: SOC 2 Type II and ISO 27001

Potential Penalties and Risks

Perjury Risk: Criminal penalties possible
Document Rejection: Invalid formatting may void filing
Delay Costs: Processing delays increase liability
Civil Exposure: Damages or indemnity claims possible
Loss of Evidence: Missing exhibits undermine affidavit
Authentication Failure: Weak signer verification reduces admissibility

Common Preparation Mistakes to Avoid

  • Using vague phrases or opinions instead of precise, numbered factual statements makes the affidavit less persuasive and more likely to be challenged.
  • Failing to label or attach exhibits properly breaks the reference chain between sworn facts and supporting evidence, reducing admissibility.
  • Mismatched names or incorrect dates on the signature block can invalidate notarization and complicate later enforcement or verification efforts.
  • Skipping required witness or notary steps, or using the wrong state acknowledgment language, can render the affidavit legally ineffective in that jurisdiction.

Typical Timing Considerations and Deadlines

Timing for completing and submitting Form 26A depends on the underlying event, legal deadlines, and any agency or contract-imposed timeframes.

Immediate Filing:

Some incidents should be documented and sworn as soon as practicable to preserve evidence.

30-Day Review Window:

Internal review or supplemental reporting often occurs within 30 days of the incident.

Notary Scheduling:

Allow time for appointment availability, especially for in-person notarization or RON procedures.

Retention Start Date:

Retention typically begins on the effective or signing date of the affidavit.

Agency Deadlines:

Follow any specific deadlines set by the requesting authority or regulatory body.

Representative eSignature Pricing and Capability Comparison

Below is a concise comparison of starting price, trial availability, bulk send, audit trail, HIPAA support, and envelope caps across common eSignature vendors.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Free trial available Free trial available Free trial available Free trial available
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year No cap No cap No cap

Common Questions and Practical Answers

Answers address frequent concerns about validity, notarization, corrections, retention, and cross-jurisdictional use of Form 26A.


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