Petition For Adoption Form Page 2
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27. That the petitioners desire that the relationship of parent and child be established between the petitioners and the
child herein, and that it is for the best interest of said child that it be adopted by said petitioners.
WHEREFORE, Your Petitioners pray for an order directing the entry of a decree for adoption of said child by
petitioner in accordance with the Statutes in such cases made and provided and that the name of the child be
changed to ____________________________________________________________ and for such other orders as
the Court may deem advisable.
Dated:________________________________
_____________________________________
_______________________________________
Petitioner
_____________________________________
_______________________________________
Attorney and Address
Petitioner
STATE OF MINNESOTA
)
VERIFICATION
)ss
COUNTY OF __________________)
_________________________________________ and _____________________________________ his wife,
being first duly sworn on oath state that they have read the foregoing petition subscribed by them, and that they
know the contents thereof, and that the same is true to their best information and belief.
Subscribed and sworn to before me this _________
______________________________________
Day of ________________________, 20________.
Petitioner
_________________________________________
______________________________________
Notary Public, ______________________ County
Petitioner
State of Minnesota
My Commission expires________________________
Note:
*#2. Is for private agency or Department-strike one not pertinent.
**#3. If child has property add “Excepting as stated on Exhibit ‘A’ attached.
***#4. Name may be “Baby Boy ‘Jones’” or “unknown” or full name may be known-use proper fact.
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