IN THE CHANCERY COURT OF COUNTY, MISSISSIPPI
,
NATURAL FATHER/MOTHER AND NEXT NO.
FRIEND OF THE MINOR CHILD NAMED
HEREIN AND
PLAINTIFFS
VS.
DEFENDANT
COMPLAINT TO TERMINATE PARENTAL RIGHTS
AND FOR ADOPTION OF MINOR CHILD
COME NOW, Plaintiffs and , and file their Complaint to Terminate Parental
Rights and for the Adoption of against the Defendant and would show unto the Court in
support thereof, the following:
I.
Plaintiffs, and , are bona fide resident citizens of County, Mississippi, residing
at , , Mississippi and have been residents of the State of Mississippi for more than ninety
(90) days immediately preceding the date of the filing of this Complaint, and the minor child
sought to be adopted resides with Plaintiffs in County, Mississippi.
II.
The natural father/mother of the child sought for adoption herein is and she is
presently married to the Plaintiff and joins herein as next friend of the aforesaid minor child
and consents to the adoption of the aforesaid minor child by Plaintiff, as natural father/mother
and next friend of the minor child who is the subject of this Complaint.
III.
The Defendant, , is the putative natural FM4 of the child sought for adoption and is a
non-resident of the State of Mississippi, or not to be found therein, whose residence, post office,
and street address is unknown to Plaintiffs after diligent search and inquiry to ascertain same, but
whose last known address was . That Defendant may be served with process of this Court by
publishing a summons pursuant to Miss . Code Ann . Sections 13-3-19 and -21 (1972).
IV.
That said minor child, , was born unto said natural mother and , the putative
natural father, on , . A copy of the birth certificate of the minor child is attached hereto as
Exhibit " ".
COUNT I
V.
Plaintiff would show that the Defendant, , has had no contact whatsoever with the
minor child, , since of . That Defendant has not communicated with Plaintiff or the
minor child since that date. That Defendant's last known residence was located in , but
Plaintiff is unsure of the Defendant's current whereabouts.
VI.
Plaintiff petitions this Court to terminate the parental rights of the Defendant, ,
pursuant to Miss . Code Ann . Section 93-15-103 (Supp. 1989), as Defendant has abandoned said
child and made no contact with said child for a period of over two (2) years and Defendant has
not contributed to the support of said child since the early part of . Plaintiff, , further
requests this Court to appoint him/her the guardian ad litem of said minor child for the purposes
of the termination of parental rights.
COUNT II
VII.
Plaintiff, , who seeks the adoption of the aforesaid minor child, has had the care,
custody and control of , since , , when Plaintiff and the natural father/mother of the
minor child were married. Plaintiff has grown to love the child as his/her own, and now seeks
the adoption of such minor child, who has no property or estate, as evidenced by Exhibit
" ", but who is physically and mentally fit to be adopted as shown by the doctor's certificate
attached hereto as Exhibit " ".
VIII.
Plaintiff, , would show unto the Court that he/she is a fit, suitable and proper person
to adopt said minor child and that he/she proposes to rear, train and educate said child and that
he/she is financially able to afford the care of said child. Plaintiff would show that when the
minor child came to live in his home that the place of residence of said child became established
in County, Mississippi and that this Court has jurisdiction of this Cause.
IX.
That the Plaintiff, , desires that the minor child shall inherit from and through him/her
and that likewise, shall inherit from and through said minor child, and that the minor child
shall inherit from and through any children born to said and husband/wife , , now and in
the future, and that such children born to said Plaintiff and husband/wife , shall inherit from and
through the minor child all to the same extent and under the same condition as provided for
inheritance between parents and between brothers and sisters in full blood in accordance with the
laws of decent and distribution of the State of Mississippi, all such inheritance between said
parties to be the same extent as if the minor child herein had been born to the adopting parent as
a child of his/her body born in lawful wedlock; and, further that the minor child, the adopting
parent and the adopting kindred shall be vested with all of the rights, powers, duties and
obligations, respectively, as if the minor child had been born to and husband/wife , , in
lawful wedlock, including all rights existing by virtue of Miss . Code Ann . Section 93-17-13
(1972).
X.
That a Final Judgment of Adoption may be entered herein at the discretion of the Court
without the necessity for an Interlocutory Decree under the provisions of Miss . Code Ann .
Section 93-17-13 (1972), if the Chancellor shall exercise such discretion and shall determine
from all the proceedings and evidence that the six (6) months waiting period is not necessary or
required for the benefit of the Court, the Plaintiffs or the child to be adopted, and shall so
adjudicate in the Judgment entered in this cause and in such event, a Final Judgment of Adoption
may be entered without any delay and without any interlocutory decree, the Court finding and
adjudicating that such is proper in the premises.
WHEREFORE, PREMISES CONSIDERED, Plaintiffs pray that this cause shall come
on for hearing at any time or place convenient to this Court in term time or in vacation and upon
a hearing hereon, that a Judgment terminating the parental rights of Defendant, , be entered
and Plaintiff, , shall be permitted to adopt the minor child herein, and that a Final Judgment
of Adoption shall be entered by this Court, which Judgment shall state that the name of the
minor child shall be and that a birth certificate shall be issued by the Bureau of Vital
Statistics to this effect; and, that the adopted child shall inherit from the adopted parent, and the
adopted parent from the adopted child; and the adopted parent, and the adopted child and any
other child or children born to and , all to the same extent and under the same conditions
as provided for inheritance by and between parents and children and between brothers and sisters
of full blood in accordance with the laws of descent and distribution of the State of Mississippi,
and that the adoptive kindred shall be vested with all of the rights, powers, duties and obligations
respectively, including all rights existing by virtue of Miss . Code Ann . Section 93-17-13, (1972),
all as if the adopted child had been born to , the adopting parent in lawful wedlock, and
further said Judgment shall provide that the natural parent, Defendant, , shall not inherit by or
through the minor child herein and that all parental rights and parental duties of the natural
parent, Defendant, , shall be terminated.
Plaintiffs pray that process will issue to the putative father of the minor child by
publication in accordance with the law, requiring him/her to plead or answer to this Complaint,
and that a hearing be held at any time either in term time or in vacation that is convenient with
this Honorable Court.
Plaintiffs pray for such other and further relief either general or special, as the Court shall
find right and just in the premises.
______________________________
______________________________ ____________________________
ATTORNEY FOR PETITIONER ,
NATURAL FATHER/MOTHER AND NEXT
FRIEND OF MINOR CHILD
STATE OF MISSISSIPPI
COUNTY OF
PERSONALLY appeared before me, the undersigned authority in and for the county and
state aforesaid, the within named , Plaintiff, who acknowledged that all matters, facts and
things contained in the Complaint for Adoption are true and correct as therein stated.
GIVEN under my hand and official seal this the day of , 20 .
______________________________
NOTARY PUBLIC
My Commission Expires:
STATE OF MISSISSIPPI
COUNTY OF
PERSONALLY appeared before me, the undersigned authority in and for the county and
state aforesaid, the within named , Plaintiff and Natural Father/Mother and Next Friend of the
Minor Child Herein, who acknowledged that all matters, facts and things contained in the
Complaint for Adoption are true and correct as therein stated.
GIVEN under my hand and official seal this the day of , 20 .
______________________________
NOTARY PUBLIC
My Commission Expires:
AFFIDAVIT
STATE OF MISSISSIPPI
COUNTY OF
BEFORE ME, the undersigned authority in and for the county and state aforesaid, this
day personally appeared the within named , the natural father/mother of , who, being by
me first duly sworn, states on his/her oath that said minor child is presently in the care of
Affiant, , and his/her husband/wife , , and that said child owns no property of any kind or
character whatsoever.
______________________________
SWORN TO AND SUBSCRIBED BEFORE ME this the day of , 20 .
______________________________
NOTARY PUBLIC
My Commission Expires:
EXHIBIT " "
AFFIDAVIT
STATE OF MISSISSIPPI
COUNTY OF
PERSONALLY appeared before me the undersigned authority, in and for the county and
state aforesaid, the within named , M.D. who, being by me first duly sworn on his/her oath,
states as follows:
"I, , M.D., being a duly licensed and practicing physician of County,
Mississippi, do hereby certify that I have examined the minor child, , born ,
, to and , and presently in the care of and husband/wife , , and
from said examination, I am able to and do hereby certify that the said child is in
excellent physical and mental condition, having no handicaps of any character as
far as can be ascertained."
______________________________
, M.D.
SWORN TO AND SUBSCRIBED BEFORE ME this the day of , 20 .
______________________________
NOTARY PUBLIC
My Commission Expires:
Exhibit " "
IN THE CHANCERY COURT OF COUNTY, MISSISSIPPI
, NATURAL FATHER/MOTHER AND
NEXT FRIEND OF THE MINOR CHILD NAMED HEREIN
AND PLAINTIFFS
VS. NO.
DEFENDANT
NON-RESIDENT SUMMONS
THE STATE OF MISSISSIPPI
TO:
You have been made a Defendant in the suit filed in this Court by the Plaintiffs named in
said Complaint for Termination of Parental Rights and for Adoption, seeking a judgment that
you have abandoned, neglected, and deserted said minor child and that your parental rights to
said minor child should be terminated and that said minor child should be adopted by the
Plaintiff, .
You are required to mail or hand deliver a written response to the Complaint filed against
you in this action to , Attorney for Plaintiffs, whose address is .
Your response must be mailed or delivered not later than thirty (30) days after , 20
, which is the date of the first publication of this summons. If your response is not so mailed or
delivered, a judgment by default will be entered against your for the relief demanded in the
Complaint.
You must also file the original of your response with the Clerk of this Court within a
reasonable time afterward.
___________________________________
CHANCELLOR