Fill and Sign the Louisiana Intrafamily Adoption Form

IN RE: __________________ : _______ JUDICIAL DISTRICT COURT __________________ APPLYING FOR INTRAFAMILY ADOPTION : PARISH OF _______ , LOUISIANA : DOCKET NO. _______ PETITION FOR INTRAFAMILY ADOPTION The petition of __________________ , who is domiciled in _______ Parish, respectfully represents: 1. Petitioner desires to adopt the minor child known as __________________ . A certified copy of the child = s birth certificate is attached to this petition as Exhibit No. 1. All information required by LSA-Ch.C. Art. 1246 is attached to this petition as Exhibit No. 2. 2. Petitioner was married to __________________ on the ____ day of _______ 20 ____ and they are still married. __________________ is the mother of this child and has consented to this adoption by an authentic act of consent which is attached to this petition as Exhibit No. 3. 3. The parents of this child, __________________ and __________________ , were divorced and custody was awarded to __________________ by judgment signed on _______ ____ , 20 ____ , in the suit entitled A __________________ vs. __________________ @ , bearing Docket No. ____ , _______ Judicial District Court, Parish of _______ , State of Louisiana, a certified copy of which is attached to this petition. 4. The father of the child, __________________ , has consented to this adoption by an Authentic Act of Consent to Adoption which is attached to this petition as Exhibit 4, and also waived all rights to be served with this petition. 5. Petitioner desires to change the name of the child to __________________ , thus making the surname of the child the same as petitioner = s. 6. It is in the best interest of the child that this adoption take place. WHEREFORE, petitioner prays: . A date for a hearing be set for not less than thirty (30) days nor more than sixty (60) days after the completion of service of process. . The name of the child be changed to __________________ , thus making the surname of the child the same as petitioner = s. . After hearing, a final decree of adoption be entered pursuant to LSA-Ch.C. Art. 1255. Respectfully Submitted, _____________________________ __________________ Attorney at Law __________________ _______ , LA _______ ( ____ ) _______ La. Bar Roll No. ____ IN RE: __________________ : _______ JUDICIAL DISTRICT COURT __________________ APPLYING FOR INTRAFAMILY ADOPTION : PARISH OF _______ , LOUISIANA : DOCKET NO. _______ ORDER Considering the petition filed in this matter: IT IS ORDERED that: RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. A copy of the petition be served on the Department of Social Services. SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. The Department of Social Services study the proposed adoption and submit a confidential report of its findings to this court pursuant to LSA-Ch.C. Art. 1252, not later than the _____ day of _____________ 20 ____ . 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This matter be heard in chambers on the _____ day of _______________ 20 ____ , at ______ o = clock ___.M. ______________________________ DISTRICT JUDGE IN RE: __________________ : _______ JUDICIAL DISTRICT COURT __________________ APPLYING FOR INTRAFAMILY ADOPTION : PARISH OF _______ , LOUISIANA : DOCKET NO. _______ EXHIBIT 2 CONTAINING INFORMATION REQUIRED BY LSA-Ch.C. Art. 1246 I. PETITIONERS A. Adoptive Father 1. Name: __________________ 2. Address: __________________ , _______ , LA ____ 3. Date of Birth: _______ ____ , ____ 4. Occupation: __________________ 5. Marital Status: __________________ II CHILD 29212. Name by which child is know to petitioner: __________________ 29213. Names under which birth of child is recorded: __________________ 29214. Place of Birth of child: __________________ , Louisiana 29215. Date of birth of child: _______ ____ , 20 ____ 29216. Approximate age of child: ____ years old 29217. Name of child = s mother: __________________ 29218. Address of child = s mother: __________________ , _______ , LA ____ 8. Name of child = s father: __________________ 9. Address of child = s father: __________________ , _______ , LA ____ 10. Legal custodian of child: __________________ 11. The date and circumstances under which child entered the home of the petitioners: The child entered Petitioner = s home on _______ ____ , 20 ____ , as a result of Petitioner = s marriage to __________________ , the mother of the child. 12. Relationship between petitioner and child: __________________ IN RE: __________________ : _______ JUDICIAL DISTRICT COURT __________________ APPLYING FOR INTRAFAMILY ADOPTION : PARISH OF _______ , LOUISIANA : DOCKET NO. _______ FINAL DECREE AND JUDGMENT Considering the petition and exhibits filed in this matter, the requirements of law having been met, the court, upon considering the confidential report of the Louisiana Department of Social Services and the testimony of the parties concerning the adoption, for the reasons orally assigned at the hearing held on the _____ day of _____________ 20 ____ , and being satisfied that the adoption is in the best interest of the child. IT IS ORDERED that A. The child known to petitioners as __________________ be declared, for all legal purposes, to be the child of the petitioners to the same extent as if the child had been born of the petitioners’ marriage. B. The name of the child be formally changed to __________________ . C. The Clerk of Court of this Parish comply with the requirements of LSA-Ch.C. Art. 1182(B) and forward a certificate of this final decree to the state registrar of vital records for entry of a certificate of live birth of __________________ . D. All further contacts with the Department of Social Services be dispensed with. JUDGMENT RENDERED AND SIGNED in chambers in __________________ , Louisiana, this ____ day of _______________ 20 ____ . ____________________________ DISTRICT JUDGE