Director'S Consent To Adoption

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Court file number
(Name of Court)
Form 34E: Director’s Consent to
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).
(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
Birth registration number
My name is
and I am
(full legal name)
appointed as a Director under the Child and Family Services Act.
The child in this adoption case became a Crown ward on
and was placed into the care of
(full legal name of children’s aid society)
There are no outstanding access orders to this child.
I consent to this child’s adoption by the applicant(s).
Date of signature
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FLR-34E-E (2011/05)


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Parent category: Legal