Petition For Adoption Form Page 2
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6WHEREFORE, your petitioners pray this honorable Court for leave to adopt as their own child, the 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.
____________________________________
_____________________________________
Attorney for Petitioners
Petitioner
Address______________________________
_____________________________________
_____________________________________
Petitioner
STATE OF MINNESOTA
COUNTY OF ____________________
_______________________________________________ and ____________________________________, his
wife, being first duly sworn, on oath say that they have read the within and foregoing petition subscribed by
them, and know the contents thereof and that the same is true to their best information and belief.
____________________________________
Petitioner
____________________________________
Petitioner
Subscribed and sworn to before me this ________ day of ___________________________, _______.
____________________________________
Notary Public
___________ County, State of Minnesota
My Commission Expires ________________
***NOTE: Parent, stepparent, brother, sister, aunt, uncle, grandparent, grandchild, niece, nephew, great grandparent, great grandchild,
are within the third degree.
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