Form 34G:
Affidavit of Adoption Licensee
(page 2)
Court File Number
or Society Employee
4.
I have made reasonable inquiries about the existence of any person — other than the person(s) who already filed a consent
— who is a “parent” of the child within the meaning of Part VII of the Child and Family Services Act. To the best of my
knowledge,
There is no other “parent”.
the other “parent(s)” is/are:
(For each person, state his or her full legal name, address and an explanation why a
consent is not yet available.)
5.
I have made reasonable inquiries about the existence of any other application for the adoption of this child. To the best of
my knowledge,
there has been no other adoption application with respect to this child.
the details of the other adoption application(s) are as follows:
(For each application, state the name and location of
the court before which the application was brought, the date of the application, the full legal name(s) of the applicant(s) and
the result of the application.)
6.
I have made reasonable inquiries whether the person(s) who filed the consent(s) in this application withdrew the consent(s)
or whether a court had set aside the consent(s). To the best of my knowledge,
no consent was withdrawn or set aside.
the details of the withdrawal or of the setting aside are as follows:
(Specify details.)
7.
The child in this adoption case
is 7 or more years old and I have therefore offered the child a chance to get counselling about the consent. This offer
of counselling
was accepted and the child received counselling.
was turned down by the child.
I also ensured that the child received independent legal advice from
(lawyer’s name)
is less than 7 years old and no counselling or independent legal advice was offered.
8.
I offered the child’s parent(s) a chance to get counselling about the consent and the offer
was accepted by
(name of parent(s) who accepted offer)
and counselling was provided.
was turned down by
(name of parent(s) who refused offer)
Put a line through any space left on this page.
FLR-34G-E (2005/09)