Fill and Sign the Petition for Validation of Adoption Finalized in a Foreign Country Form

NHJB-2191-FP (02/3/2012) Page 1 of 2 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) In the adoption of PETITION FOR VALIDATION OF ADOPTION FINALIZED IN A FOREIGN COUNTRY (RSA 170-B:27) 1. Petitioner name Telephone Petitioner name Telephone Mailing address 2. Attorney name Telephone Mailing address 3. Child Birth Name Date of Birth Place of Birth (town/city and country) 4. The following document is attached to validate this international adoption: An attested or certified copy of the adoptee’s Certificate of Citizenship issued by the U.S. Citizenship and Immigration Services. An attested or certified copy of the adoptee’s passport issued in his/her country of birth, with the U.S. Visa stamp affi xed indicating IH-3 status. An attested or certified copy of the adoptee’s passport issued in his/her country of birth, with the U.S. Visa stamp affix ed indicating IR-3 status. An attested or certified copy of the adoptee’s passport issued in his/her country of birth, with the U.S. Visa stamp affi xed indicating IR-2 status. An attested or certified copy of the adoptee’s Certificate of Adoption indicating a full and final adoption from his or her co untry of birth with the U.S. Visa stamp affixed indicating an IR-4 status. Pursuant to the laws of the State of New Hampshire, I/we ask the court to validate this adoption and that the name of the child be Case Name: In the adoption of Case Number: PETITION FOR VALIDATION OF ADOPTION FINALIZED IN A FOREIGN COUNTRY NHJB-2191-FP (02/3/2012) Page 2 of 2 I/We request a hearing be held. I/We do not request a hearing be held. Date Petitioner Signature Date Petitioner Signature ORDER Petition is granted; New Hampshir e Certificate of Adoption to be issued. The name of the child shall be Petition is denied for the following reason(s): Date Judge