Fill and Sign the Putative Father Form 497303127

IN THE CIRCUIT COURT OF THE ________________JUDICIAL CIRCUIT, IN AND FOR ____________________________COUNTY, FLORIDA Case No.:____________________________ Division: ____________________________ IN THE MATTER OF THE ADOPTION OF _______________________________________, {use name to be given to the minor child} Adoptee. ORDER GRANTING MOTION FOR SEARCH OF THE PUTATIVE FATHER REGISTRY Upon consideration of Petitioner’s Motion for Search of the Putative Father Registry, this Court fnds: 1. This is an action for adoption of a minor by the child’s stepparent, Petitioner, who is proceeding pro se. 2. Section 63.054, Florida Statutes, requires that in every adoption, a search of the Putative Father Registry maintained by the Department of Health, Ofce of Vital Statistics be conducted. Section 63.0541, Florida Statutes, makes information maintained by the Registry confdential and exempt, except that it may be disclosed to adoption entities, registrant unmarried biological fathers, the birth mother, and the court, upon issuance of a court order concerning a petitioner acting pro se. NOW, THEREFORE, IT IS ORDERED THAT: 1. The Ofce of Vital Statistics, Department of Health shall conduct a search of the Putative Father Registry upon receipt of a completed application and payment of any authorized fee. 2. The State Registrar shall issue a certifcate indicating the results of such search which shall be fled in this proceeding by transmitting the certifcate to the clerk of court. DONE and ORDERED on: ____________________in __________________________, Florida. ______________________________________ Circuit Judge Florida Supreme Court Approved Family Law Form 12.981(a)(7), Order Granting Motion for Search of Putative Father Registry(03/15) I certify that a copy of the {name of document(s)} _____________________________________________ was ( ) mailed ( ) faxed and mailed ( ) e-mailed ( ) hand-delivered to the parties and to any other persons or entities listed below on {date} ___________________________________________. __________________________________________ By: Clerk of Court, Designee, or Judicial Assistant Petitioner (or his or her attorney) Other: ______________________ State Registrar, Ofce of Vital Statistics Florida Supreme Court Approved Family Law Form 12.981(a)(7), Order Granting Motion for Search of Putative Father Registry(03/15)