Affidavit Of Adoption Page 3
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1
2
3Form 34G:
Affidavit of Adoption Licensee
(page 3)
Court File Number
or Society Employee
9.
The parent(s) received independent legal advice from
(name of lawyer(s))
10. To the best of my knowledge, no person has given, received or agreed to give or receive any payment or reward of any kind
in connection with
(a) The adoption of this child;
(b) This child’s placement for adoption;
(c) The giving of any consent to this child’s adoption; or
(d) Any negotiations or arrangements leading up to this child’s adoption,
except for what is permitted by the Child and Family Services Act and the regulations made under that it.
Sworn/Affirmed before me at
municipality
in
Signature
province, state or country
(This form is to be signed in front of a
on
lawyer, justice of the peace, notary public or
date
Commissioner for taking affidavits
commissioner for taking affidavits.)
(Type or print name below if signature is illegible.)
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FLR-34G-E (2005/09)
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Parent category: Legal