Adoption Petition (Page 2 of 5) in pdf

Adoption Petition Page 2

g. The child has no property of significant value, except:

Includes money in bank accounts, ANCSA Corporation shares, real property, jewelry etc.

[

]

Description of Property

Estimated Value

h. Does the child qualify as an Indian child? (Child is a member of an Indian tribe; or child is

eligible for membership in a tribe and either of the child's biological parents is a member of

an Indian tribe.)

No.

Yes. Fill out P-450, Report of Indian Adoptive Placement.

To my knowledge and belief, there

are

are not

any other court cases

involving this child now pending in a state or tribal court in Alaska or in another state

(including tribal courts).

Type of Court Case

Where

Case No., if known

III.

Petitioner Information

a. Name of Adopting Parent(s):

b. Marital Status:

not married.

married. Spouse’s name:

Marriage occurred on

, in

(date)

(city)

(state)

c. Address:

d. Number of years you have lived in the above city:

e. Telephone Number:

I/we have a place to live and resources suitable to provide for the nurture and care of

the child and I/we desire to establish the relationship of parent and child with this child.

Page 2 of 5

AS 25.23.080

P-405 (12/16)(cs)

Adoption Rule 6

PETITION FOR ADOPTION

Adoption Petition Page 2