Parent'S Consent To Adoption By Spouse
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1
2ONTARIO
Court File Number
(Name of Court)
Form 34I: Parent’s Consent to
at
Adoption by Spouse
Court office address
Applicant(s)
(The first letter of the applicant’s surname may be used)
Full legal name & address for service — street & number, municipality,
Lawyer’s name & address — street & number, municipality, postal
postal code, telephone & fax numbers and e-mail address (if any).
code, telephone & fax numbers and e-mail address (if any).
Respondent(s)
(If there is a respondent, the first letter of the respondent’s surname may be used)
Full legal name & address for service — street & number, municipality,
Lawyer’s name & address — street & number, municipality, postal
postal code, telephone & fax numbers and e-mail address (if any).
code, telephone & fax numbers and e-mail address (if any).
Child
(Child’s full legal name. If this person is a Crown ward or was placed by a licensee or children’s aid society, you may use an
initial for the surname.)
Date of birth
Sex
Birth registration number
1.
My name is
(full legal name)
I was born on
and I live
(date of birth)
at
(address)
2.
The applicant is my “spouse” within the meaning of Part VII of the Child and Family Services Act.
3.
I am a parent of the child within the meaning of Part VII of the Child and Family Services Act because I am
(Check
appropriate paragraph below.)
the child’s mother.
an individual who, during the 12 months before
the child was placed for adoption, has
the child’s father.
acknowledged parentage of the child and has
provided for the child’s support.
the person presumed to be the child’s father under
section 8 of the Children’s Law Reform Act.
an individual who is required to provide for the
child or who has custody of or access to the child
an individual having lawful custody of the child.
under a written agreement or a court order.
an individual who, during the 12 months before the
an individual who has acknowledged parentage
child was placed for adoption, has demonstrated a
of the child under section 12 of the Children’s
settled intention to treat the child as a member of
Law Reform Act.
his/her family.
4.
I consent to the adoption of the child by my spouse.
5.
I understand the nature and effect of this consent. I understand that I may withdraw my consent by ensuring that the
proposed applicant receives my written notice of withdrawal within 21 days after my consent
FLR-34I-E (2009/04)
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