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Affidavit Change Of Circumstances Since Certification As Qualified Adoptive Parent 21-E - New York
| Affidavit Change Of Circumstances Since Certification As Qualified Adoptive Parent Form. This is a New York form and can be used in Adoption Statewide . |
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D.R.L. § 115-c S.C.P.A.§ 1725 Form 21-E (Temporary Guardianship) 12/97 COURT OF THE STATE OF NEW YORK COUNTY OF In the Matter of the Temporary Guardianship of A Child Whose First Name is (Docket)(File) No. AFFIDAVIT (Change of circumstance since certification as qualified adoptive parent) STATE OF NEW YORK COUNTY OF ) :ss.. ) , being duly sworn depose(s) and say(s): 1. Deponent(s)(was) (were) certified as (a) qualified adoptive parent(s) by order of the 20 ; Court, County of , dated 2. The following change(s) in circumstance relevant and material to such certification (has) (have) taken place since that date: Dated: Petitioner Print or type name Signature of Attorney, if any Attorney's Name (Print or Type) Attorney's Address and Telephone Number Sworn to before me this day of , 20 . American LegalNet, Inc. www.FormsWorkFlow.com
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