Fill and Sign the Judicial Powers of Non Judges the Legitimacy of Referee Form

- 1 - STATE OF MINNESOTA DISTRICT COURT COUNTY OF JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Welfare of: Court File No. , A Child, FINDING OF FACT, CO NCLU SIO NS O F L A W , ORD ER F O R J U DGM EN T A ND And the Petition of: JU DGM EN T A ND D EC REE RE: ADOPTION and , Petitioner. The a b ove-e n title d p ro ceed in g c am e o n f o r a h ea rin g b efo re t h e H onora b le __ _____ ________ , i n t h e _ ______________ C ounty C ourth ouse , l o cate d a t _ ______________, __ _____ ________ , M in neso ta , a t { T im e} o n t h e _ __ d ay o f _ ______________, 2 0_ __._______________ a n d _ ______________, t h e P etitio ners a p peare d i n p ers o n a n d t h ro ugh th eir a tto rn ey , _ ___________ ___, E sq uir e , o f _ ______ ________,l o cate d a t __ _____ _______________ _ , M in neso ta _ ___. T he c h ild , _ ______________, a ls o a p peare d i n pers o n.T he p ro ceed in g w as i n itia te d b y t h e P etitio ners f o r l e av e t o a d opt t h e m in or c h ild , __ _____ ________ , p urs u an t t o M in neso ta S ta tu te s S ectio n 2 59 a n d t h at t h e n am e o f t h e m in or c h ild be c h an ged t o _ __________ ____. A P etitio n f o r A doptio n w as d uly f ile d w ith t h e C ourt.A fte r h earin g a ll o f t h e e v id en ce a d duced a t t h e h earin g, b ein g f u lly a d vis e d i n t h e p re m is e s, an d u pon t h e c o m ple te f ile s, r e co rd s a n d p ro ceed in gs h ere in , t h e C ourt m ak es t h e f o llo w in g - 2 - Fin din gs o f F act, C onclu sio ns o f L aw , a n d O rd er f o r J u dgm en t. - 3 - FIN DIN G S O F F A CT 1. The P etitio ners f u ll n am es a re _ ______________an d _ ______________; t h e Pe titio ner, _ _____________ _ i s p re se n tly _ _________ _____ ( _ __) y ears o ld , h av in g b een b orn o n __ _____ ________ , _ __ ; t h e P etitio ner, _ ______________ i s p re se n tly _ ______________ ( _ __) ye ars o ld , h av in g b een b orn o n _ ______________, _ __; a n d t h e P etitio ners ' p re se n t a d dre ss i s __ _____ ________ , i n t h e C ity o f _ ______________, C ounty o f _ ________________,S ta te o f Min neso ta .2 . The P etitio ners a re h usb an d a n d w if e h av in g b een m arrie d o n _ ______________, 19 _ __, i n t h e C ity o f _ ____ __________, C ounty o f _ ________________, S ta te o f M in neso ta , a n d ev er s in ce s a id d ate h av e l iv ed t o geth er c o ntin uously .3. The P etitio ners h av e r e sid ed i n t h e S ta te o f M in neso ta f o r m ore t h an o ne ( 1 ) y ear im med ia te ly p re ced in g t h e f ilin g o f t h is P etitio n.4. Neith er o f t h e P etitio ners o w e a n y C ourt o rd ere d c h ild s u pport f o r a n y o th er c h ild no t n ow l iv in g i n t h eir h om e.5 . Neith er o f t h e P etitio ners h av e b een r e fu se d a n a d optio n b y a n y C ourt o r A gen cy .6. Both P etitio n ers a re i n g ood p hysic al a n d m en ta l h ealth a t t h e p re se n t t im e. B oth Petitio ners a re f in an cia lly a b le a n d e m otio nally q ualif ie d t o a ssu m e a p are n t/c h ild r e la tio nsh ip .7. The P etitio ners a re r e la te d t o t h e c h ild , _ ______________, a s S te p pare n t a n d P are n t.8 . The P etitio ner, _ ______________, a cq uir e d p hysic al c u sto dy o f _ ______________ fro m _ ______________ , p u rs u an t t o a J u dgm en t a n d D ecre e, o n _ ______________, 1 9___, a n d th at s a id c h ild h as l iv ed w ith t h e P etitio ner, _ ______________, s in ce s a id d ate . S ubse q uen t t o t h e Pe titio ners ' m arria g e o n _ __ ____________, 1 9___, s a id c h ild h as l iv ed i n t h e P etitio ners ' h om e.9 . The m oth er o f t h e c h ild , _ ____________ __, i s _ ______________ a n d t h at t h e f a th er is _ ______________ ; a n d t h e g uard ia n o f s a id c h ild i s _ ______________.1 0. The n atu ra l p are n ts o f t h e c h ild , _ ______ ________, h av e c o nse n te d t o t h e a d optio n an d b oth n atu ra l p are n ts , n am ely , _ ______________ a n d _ ______________, s ig ned t h e " C onse n t o f Pa re n t t o A do ptio n a n d W aiv er o f N otic e o f H earin g." - 4 - 11. The a ctu al n am e o f t h e c h ild a n d a n y k n ow n a lia se s a re _ ______________ a n d h e wa s b orn i n t h e C ity o f _ ____ __________, C ounty o f _ ______________, S ta te o f M in neso ta o n _______ ________ , 1 9 ___. T he c h ild d oes n ot h av e a n y p hysic al o r m en ta l d is a b ilitie s a t t h e p re se n t ti m e.1 2. The c h ild , _ _ _____________, d oes n ot o w n a n y r e al o r p ers o nal p ro perty , s to ck s o r bo nds, o r a n y b an k a cco unts .1 3. The P etitio ner, _ ______________, a n d t h e c h ild h av e d ev elo ped m utu al l o ve a n d affe ctio n f o r e ach o th er. T he P etitio ner's , _ ___________ ___, f a m ily a n d f rie n ds a ccep t a n d g et al o ng w ell w ith t h e c h ild , _ _ _____________.1 4. The P etitio ner, _ ______________, u nders ta n ds t h at i f t h e a d optio n i s a llo w ed , t h e Pe titio ner, _ _____________ _, w ill a cq uir e r ig hts w hic h a re c o m ple te ly e q ual t o h ers i n t h e e v en t o f div orc e, d eath o r o th erw is e .1 5. The P etitio ner, _ ______________, h as n o c o nflic t w ith t h e r e lig io us t r a in in g, i f a n y, th at t h e c h ild , _ __________ ____, w ill b e r e ceiv in g.16. The P etitio ners d esir e t h at t h e r e la tio nsh ip o f p are n ts a n d c h ild b e e sta b lis h ed betw een t h e P etitio ners a n d t h e c h ild . T he P etitio ners ' h om e i s l a rg e e n ough t o a cco m modate t h e ch ild .17. It i s i n t h e b est i n te re st o f t h e c h ild f o r t h e c h ild t o b e a d opte d b y t h e P etitio ners .1 8. The P etitio ners d esir e t o h av e t h e n am e o f t h e c h ild c h an ged t o _ ______________.1 9. The c h ild 's n atu ra l f a th er, _ ______________, m ay s e n d p re se n ts , c ard s, a n d/o r co nta ct t h e c h ild , _ _______ _______, a t t h e P etitio ners ' d is c re tio n, a n d t h at t h e P etitio ners w ill n ot pr e v en t _ _____ _________ f ro m c o nta ctin g _ ______________ i f _ ______________ s o c h oose s. C O NCLU SIO NS O F L A W The P etitio ners a re g ra n te d a J u dgm en t a n d D ecre e p ro vid in g a s f o llo w s:1 . Adoptio n . T he r e la tio nsh ip o f p are n ts a n d c h ild i s h ere b y e sta b lis h ed b etw een t h e P etitio ners a n d t h e c h ild . T he c h ild , _ ______________, s h all b e d eem ed a n d t a k en t o b e t h e c h ild an d h eir o f t h e P etitio ners , _ ______________ a n d _ ____ __________, i n a ll r e sp ects , a s t h ough - 5 - bo rn t o t h em i n l a w fu l w ed lo ck . 2. Nam e C han g e. T he c h ild , _ __________ ____, i s h ere b y g ra n te d t h e n am e a n d s h all h ere afte r b e k now n a s _ ____ ___________________. ( A LL C A PS) O RD ER F O R J U DGM EN T LET J U DGM EN T B E E N TER ED A CCO RD IN GLY . B Y T H E C O URT:__ _____ _______________ __ ________________________Ju dge o f D is tr ic t C ourt Fam ily C ourt D iv is io n I h ere b y c ertif y t h at t h e f o re g oin g C onclu sio ns o f L aw h ere in c o nstitu te t h e J u dgm en t a n d Decre e o f t h is C ourt. D IS T R IC T C O URT A DM IN IS T R A TO R: B y: _ _______________________ D ep uty