Fill and Sign the Mn Adoption Form

STATE OF MINNESOTA DISTRICT COURT COUNTY OF JUDICIAL DISTRICT FAMILY COURT DIVISION In Re Welfare of: Court File No. , A child, PETITION IN ADOPTION And the Petition of: PROCEEDINGS and , Petitioners, The Petitioners herein respectfully represent and show to the Court: 1. That they are husband and wife and were married on , at , Minnesota; that their full names are and ; that their respective ages are (       ) and (       ) years; that their place of residence is , in the City of , County of , State of Minnesota; that they have resided in the State of Minnesota for more than one year immediately preceding the filing of this Petition; that they are related to the child as Stepparent and Parent. 2. That acquired physical custody of from , pursuant to a Judgment and Decree, on , 20       , and that said child has lived with the Petitioner, , since said date. Subsequent to the Petitioner's marriage on , 20       , said child has lived in the Petitioner's home. 3. That said child was born in the City of , County of , State of Minnesota on , 20       . 4. That the mother of said child is and that the father is ; that the guardian of said child is . 5. That the actual name of the child and any known aliases are . 6. That your Petitioners desire to have the name of the child changed to - 1 - . 7. That the description and value of any real or personal property owned by said child are as follows: None. 8. That your Petitioners desire that the relationship of parents and child be established between Petitioners and the child, and that it is to the best interests of the child for the child to be adopted by them. 9. That , the child's natural father, may send presents, cards, and/or contact the child, , at the Petitioner's discretion, and that the Petitioners will not prevent from contacting if so chooses. 10. That the parents have consented to the adoption as shown by the Consent of Parent to Adoption and Waiver of Notice of Hearing signed by and which have been filed with the Court. WHEREFORE, your Petitioners pray this honorable Court for leave to adopt as their own child, said in accordance with the statute in such case made and provided and that the name of said child be changed to and that such other orders may be made as law and justice may require. ____________________________________________ ____________________________________________ DATED: _________________ ATTORNEY ________________________________ (Name) (Address) (Address) (City, State, Zip) (Phone Number) (Fax Number) - 2 - STATE OF MINNESOTA ) )SS. COUNTY OF ) and , his wife, being first duly sworn, on oath say that they have read the within and foregoing Petition by them subscribed, and know the contents thereof and that the same is true. ______________________________________ ______________________________________ Dated: Subscribed and sworn to before me this ____ day of _____________________, 20______. _________________________________ NOTARY PUBLIC - 3 -