Legal Forms > Family Related
Consent By Institution - Legal Forms
|Consent By Institution Form. This is a Legal Forms form and can be used in Family Related .||
|Get this form for FREE as a print-only pdf|
CONSENT BY INSTITUTION The ______________________________________________ ( Institution), as represented by __________________________________, its duly authorized representative, by virtue of the authority vested in it by _________________________________ (State), in regard to ___________________________________(Name), a ___________ (Male/Female) child who was born ____________(Date), and who was lawfully relinquished to the above-referenced institution on ___________(Date), for the purpose of placing the above-named child with a suitable family for adoption, does hereby consent to _______ (His/Her) adoption by _________________________ and ______________________________, husband and wife. In witness whereof, I have signed this instrument in my capacity as the duly authorized representative of ____________________________________ (Institution) on ____________, _____. ___________________________________________________ Signature and Title This document was signed in the presence of the following: ___________________________ Signature ___________________________ Signature _____________ Date _____________ Date 2001 © American LegalNet, Inc.