Adoption Petition (Page 3 of 5) in pdf

Adoption Petition Page 3

IV.

Adoption Information

a. What kind of adoption is this?

Agency adoption (Office of Children Services does not count as an agency adoption)

Name of Agency:

Independent adoption

Relative

Nonrelative

Stepparent adoption

b. Is this an adoption of an Indian child?

No.

Yes.

I/we should be the adoptive parent because:

I am a member of the child’s extended family.

I am another member of the child’s tribe.

I am a member of another Indian tribe.

I believe there is good cause to deviate from the Indian Child Welfare Act’s

adoptive placement preferences. (See 25. U.S.C. 1915(a).)

c. Consent.

1. All the following persons whose consent is required by Alaska Statute 25.23.040

have consented to this adoption:

The mother of the minor.

The father of the minor.

The minor, if the minor is age 10 or older.

Any spouse of the child to be adopted.

Any other person who is lawfully entitled to custody of the child or empowered

to consent. Person or agency's name:

Consent forms from each of the above persons accompany this petition. I

understand that consent or relinquishment must be signed in a hearing in

the presence of a judge or a special master when: the consenting parents are

the parents of an Indian child, the consenting parent is a minor, or the consenting

child to be adopted is over the age of 10.

Page 3 of 5

AS 25.23.080

P-405 (12/16)(cs)

Adoption Rule 6

PETITION FOR ADOPTION

Adoption Petition Page 3