Fill and Sign the Louisiana Adoption by Adopter of Adoptee Form

© 2016 - U.S. Legal Forms, Inc. LOUISIANA ADOPTION BY ADOPTER OF ADOPTEE [Adult Adoption of Individual Over the Age of Seventeen] Control Number: LA-737 -M I. NOTARIAL ADOPTION AND AFFIDAVIT OF DISTRICT ATTO RNEY The first document is a notarial act of adoption, u sed when a person eighteen years or older adopts another over the age of seventeen i n accordance with R.S. 9:461 et seq. (The statute makes special requirements where the pe rson to be adopted is interdicted or is older than the adopting parent.) Two adoptive p arents may execute the same notarial adoption. Note that R.C.C. 214 provides that one m arried person cannot adopt without the consent of the other. R.S. 9:462 allows a change o f name to be included in the adoption, in which case R.S. 40:75 requires consent to the na me change by the District Attorney having jurisdiction over the adopted person's domici le. The second document evidences consent by the District Attorney. II. EXPLANATION OF TERMS: WORD KEY EXPLANATION [Adopter] Full name of adopting person. [Adoptee] Full name of person adopted. [Parish] Parish in which act is executed. [Date] Date act is executed. [Notary] Notary public before whom act is executed. [Husband and Wife] As appropriate. [Spouse] Full name of spouse of adopting person. [Adopter Parish] Parish of adopting person's domici le. [Adopter Address] Address of adopting perso n. [he, she] As appropriate. [himself, herself] As appropriate. [Adoptee Parish] Parish of adopted person's domicil e. [Adoptee Address] Address of adopted person. [TIN] Tax Identification Number of adopted person. [Birthdate] Birthdate of adopted person. [Mother] Full name of adopted person's mother. [Father] Full name of adopted person's father. ]New Name] New name of adopted person. [City, Parish] City and parish of execution. [D.A. Parish] Parish in which District Attorney's c onsent is executed. [D.A.] Name of District Attorney. [Judicial District] Indicate judicial district and parish. [Assistant] Name of assistant district attorney exe cuting consent. [Adoption Date] Date act of adoption executed. [Adoption Notary] Notary before whom adoption execut ed. [D.A. Date] Date consent executed. III. TIPS ON COMPLETING THE FORMS The form(s) in this packet may contain “form fields” created using Microsoft Word or Adobe Acrobat (“.pdf” format). “Form fields” facilitate completion of the forms using your computer. They do not limit your ability to print the form “in blank” and complete with a typewriter or by hand. It is also helpful to be able to see the location of t he form fields. Go to the View menu, click on Toolbars, and then select Forms. This will o pen the Forms toolbar. Look for the button on the Forms toolbar that resembles a shaded letter “a”. Click this button and the form fields will be visible. By clicking on the appropriate form field, you will be ab le to enter the needed information. 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Adoption Page 1 of 3 ADOPTION UNITED STATES OF AMERICA BY STATE OF LOUISIANA [Adopter] OF PARISH OF [Adoptee] BE IT KNOWN, that on before me, , [Date] [Name of Notary] a Notary Public duly commissioned and qualified in and for the state and parish indicated, and in the presence of the witnesses hereinafter named and undersigned, personally came and appeared: , husband of , [Adopting Party] [Adopting Party’s Spouse] being domiciled in Parish , whose present mailing address is ; [Address of Adopting Party] who declared that he desires to avail himself of the laws of the State of Louisiana, relative to the adoption of persons over seventeen years of age, an d especially R.S. 9:461 and 9:462, and does desire to and does hereby adopt: , a single woman domiciled in [Party Being Adopted] Parish, having as her whose mailing address and having Tax Identification Number ; born to and [Date of Birth] [Mother] , the said [Father] [Person Being Adopted] to have all of the rights of an adopted child. And to these presents intervenes the said , [Person Being Adopted] who fully consents to her adoption by [Adopting Party] and the change of name provided for below. In accordance with R.S. 9:462, the parties declare that that the birth name of the adoptee is changed to and request that, upon [New Name of Person Being Adopted] submission of the affidavit of the District Attorne y as required by R.S. 40:75, the Louisiana Registrar of Vital Records alter the birth certific ate of the adoptee to show her name to be . [New Name of Person Being Adopted] And to these presents appeared , who [Spouse of Adopting Party] consents to the adoption and name change provided for herein . THUS SIGNED ON the date indicated above at the City of , Parish of , State of Louisiana, in the presence of the undersigned Notary Public, qualified in said State and Parish, and the undersigned competent witnesses, who have signed with the parties after due reading of the wh ole. Adoption Page 2 of 3 WITNESSES: Witness Adopter Print or Type Name Print or Type Name Witness Spouse of Adopter Print or Type Name Print or Type Name Adoptee, hereafter known as Adoptee’s New Name Notary Public Print or Type Name Adoption Page 3 of 3 STATE OF LOUISIANA PARISH OF BEFORE ME, the undersigned authority, duly commiss ioned and qualified in and for the parish and state indicated, PERSONALLY CAME AND APPEARED: , District Attorney in and for Judicial District , State of Louisiana, herein represented by , duly authorized Assistant District Attorney; who after being duly sworn, did depose and say: Affiant has been presented with and has fully exam ined a certified copy of that Notarial Act of Adoption by of , [Adopter] [Adoptee] Tax Identification Number , executed before [Date Executed] before , Notary Public; and [Adoption Notary] Affiant has no objection to the change of the adop tee's birth name to and consents to the alteration and reissuance of th e [New Name] original birth record in accordance with La. R.S. 40:75 to show the birth name of the adoptee as . [New Name] District Attorney BY: Assistant District Attorney Sworn and Subscribed to before me on . Notary Public