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Termination Order (Voluntary Relinquishment) - Pennsylvania

Termination Order (Voluntary Relinquishment) Form. This is a Pennsylvania form and can be used in Orphans Court Westmoreland Local County .
 Fillable pdf Last Modified 4/2/2014
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IN THE COURT OF COMMON PLEAS OF WESTMORELAND COUNTY, PA ORPHANS' COURT DIVISION IN RE: ADOPTION OF : (Adoptee's name as on birth certificate) : : : : No: ATTORNEY: TERMINATION ORDER (Voluntary Relinquishment) AND NOW, this ________ day of _______________, 20 , after review of the record and after an evidentiary hearing following due notice, the Court makes the following findings and judicial determination. 1. 2. 3. The Petitioner(s) is/are . The Petitioner(s) is/are the natural parent(s) of the above captioned ADOPTEE. The Petitioner(s) has/have knowingly, deliberately and voluntarily relinquished all of his/her/their parental rights to the ADOPTEE. 4. ALL OF THE PETITIONER(S) PARENTAL RIGHTS TO THE ADOPTEE ARE HEREBY FOREVER TERMINATED AND ADOPTEE MAY BE ADOPTED WITHOUT FURTHER CONSENT OF OR NOTICE TO PETITIONER(S). 5. The custody of ADOPTEE is hereby transferred to: a) OR b) an approved Agency and such Agency is hereby authorized to give consent to the adoption of ADOPTEE. The Adoptive Parent(s) is/are directed to file his/her/their Petition for Adoption within sixty (60) days after the conclusion of the appeal period. BY THE COURT: _ _____________________________________, J. ATTEST: American LegalNet, Inc.
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