Affidavit Of Execution And Independent Legal Advice
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1ONTARIO
Court File Number
(Name of Court)
Form 34J: Affidavit of Execution
at
and Independent Legal Advice
Court office address
(Children’s Lawyer),
sworn/affirmed
My name is
(full legal name)
and I swear/affirm that the following is true:
1.
I am an authorized representative of the Office of the Children’s Lawyer in the adoption of:
Full legal name of child
Date of birth (d, m, y) and sex
2.
I explained to
about
(minor parent’s full legal name)
the nature and effect of adoption under the law of Ontario;
the nature and effect of a consent to adoption;
the right to counselling;
his/her rights and the rights of other persons with respect to the disclosure of adoption information;
the right upon request to be advised whether an adoption order has been made,
in language appropriate to his/her age to the best of my knowledge and skills.
3.
I also explained that he/she could withdraw the consent within 21 days by a written notice. I gave him/her the address
where the written notice would have to be served. I also explained that, after the 21 days had passed, he/she could
withdraw the consent only with the court’s permission but only if the child had not yet been placed with a person for
adoption and if he/she could convince the court that it would be in the child’s best interests to have the consent withdrawn.
4.
After my explanation, he/she told me that he/she wanted to sign the consent to adoption and I believe that this reflects
his/her true wishes.
5.
I was present at and witnessed the signing of the consent.
Sworn/Affirmed before me at
municipality
in
province, state, or country
Signature
on
(This form is to be signed in front of a
date
lawyer, justice of the peace, notary public
Commissioner for taking affidavits
or commissioner for taking affidavits.)
(Type or print name below if signature is illegible.)
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FLR-34J-E (2009/04)
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Parent category: Legal