Petition For Adoption Form Page 4
Download a blank fillable Petition For Adoption Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Petition For Adoption Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6DISTRICT COURT, COUNTY OF _________________________________, STATE OF MINNESOTA
CONSENT OF FATHER TO ADOPTION AND WAIVER OF NOTICE OF HEARING
The undersigned, being the father of the child mentioned in the foregoing petition, after being fully
advised of all the premises herein, and with a view to the future welfare of the child, hereby consents to the
adoption of the said ___________________________________ by _______________________________ and
__________________________________ , his wife, petitioners herein, and hereby waives notice of hearing
upon the foregoing petition.
A parent’s consent to the adoption may be withdrawn for any reason within 10 working days after the
consent is executed and acknowledged by written notification to the Commissioner of Human Services or his
agent, thereafter consent shall be irrevocable, M.S. 259.24, Subd. 6a.
THIS AGENCY WILL SUBMIT YOUR CONSENT TO ADOPTION TO THE COURT. THE CONSENT
ITSELF DOES NOT TERMINATE YOUR PARENTAL RIGHTS. PARENTAL RIGHTS TO A CHILD
MAY BE TERMINATED ONLY BY AN ADOPTION DECREE OR BY A COURT ORDER
TERMINATING PARENTAL RIGHTS. UNLESS THE CHILD IS ADOPTED OR YOUR PARENTAL
RIGHTS ARE TERMINATED, YOU MAY BE ASKED TO SUPPORT THE CHILD.
In Presence of:
___________________________________
(Witness)
___________________________________
______________________________________
(Witness)
STATE OF MINNESOTA
COUNTY OF ____________________
On this ______________ day of _________________________, _______, before me personally
appeared ________________________ , to me known to be the person described in, and who executed, the
foregoing consent and waiver, and acknowledged that he executed the same as his free act and deed.
____________________________________
Notary Public
___________ County, State of Minnesota
______________________________________
My Commission Expires ________________
Commissioner of Human Services, his agent or
Representative of Licensed Child-Placing Agency
STATE OF MINNESOTA
COUNTY OF ____________________
On this ___________ day of ______________________, _____, before me personally appeared
__________________________________, to me known to be the Commissioner of Human Services, his agent,
or a representative of a Licensed Child-Placing Agency and known to me to be personally present when
________________________________ executed the foregoing consent.
____________________________________
Notary Public
___________ County, State of Minnesota
My Commission Expires ________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal