Breen v. McMillin et al.

ADOPTION PETITION

ADOPTION : JUDICIAL DISTRICT COURT

OF : PARISH OF , LOUISIANA

: DOCKET NO.

FIRST AMENDING AND SUPPLEMENTAL PETITION

NOW INTO COURT, through undersigned counsel, comes who moves the court to amend the original Petition filed herein in the following regards:

1.

By amending the Petition for Adoption by changing the opening paragraph to read as follows:

AThe petition of and who are domiciled in Parish, Louisiana, respectfully represent. @

2.

By amending Paragraph 1 of the Petition to read as follows:

A1

Petitioners want to adopt one (1) child under seventeen years of age, born to and , the name of the minor child being , whose birth is recorded under the above-mentioned name. (See copy of attached Birth Certificate marked as Exhibit AA@)

3.

By amending Paragraph 3 of the Petition to read as follows.

A3

The above-named child has been continuously living in the home of the Petitioners since of 20.

4.

By amending Paragraph 4 of the Petition to read as follows.

A4

All necessary information concerning Petitioner, , and the child is set out in Exhibit AB@ annexed hereto.

5.

By amending Paragraph 6 of the Petition to read as follows.

A6.

Petitioners ask that the minor child=s name be changed to , so that the child will have the same surname as Petitioners, and consents to the change in the child=s name.

7.

By amending the Prayer of the Petition to read as follows:

AWHEREFORE, petitioners pray:

1. That a copy of this petition be served on the State Department of Community Services;

2. That a hearing in this matter be fixed on a date not less than 30 days nor more than 60 days from the date of the filing of this petition and exhibits in accordance with the Children=s Code article 1253; and

3. That there be a final decree of adoption rendered, declaring the child, to be the child of Petitioners to the same extent as if the child had been born of the Petitioners= marriage, and changing the minor child=s name to .

WHEREFORE, Petitioner prays that the amending Petition be filed and served according to law.

Respectfully Submitted,

PLEASE SERVE:

THE STATE DEPARTMENT OF SOCIAL SERVICES

AMENDED EXHIBIT NO. 2

I. PETITIONERS

A. Adoptive Father

1. Full Name

2. Address

3. DOB

4. Occupation

5. Marital Status

B. Adoptive Mother

1. Full Name

2. Address

3. DOB

4. Occupation

5. Marital Status

II CHILD

1. Name of which child is known to petitioners:

2. Name under which birth of child is recorded:

3. Place of birth of child:

4. Date of birth of child:

5. Approximate age of child:

6. Name of child=s mother:

7. Address of child=s mother:

8. Name of child=s father:

9. Address of child=s father:

10. Legal custodian of child:

11. The date and circumstances under which the child entered the home of the petitioner:

12. Relationship between petitioner and child: