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Statement Of Adoptive Parent Expenses 137 - Vermont
| Statement Of Adoptive Parent Expenses Form. This is a Vermont form and can be used in Probate Court Statewide . |
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FORM 137. STATEMENT OF ADOPTIVE PARENT EXPENSES STATE OF VERMONT PROBATE COURT DISTRICT OF _________________________ DOCKET NO: ______________ IN RE ADOPTION OF:___________________________________ Adoptive Parent Expenses 15A V.S.A. 3-702 Childs Name: Name(s): Address: Birthparents Names (if known): Telephone #: Date Name of Recipient Address of Recipient Purpose of Payment TOTALSI/we swear and affirm that the expenses listed above are the only disbursements we have made in connection with the adoption of the child listed above. Signed: Adoptive Parent Date Signed: Adoptive Parent Date Sworn before me on ____________________ in ___________________ in the County of , State of __________________________. My commission expires on: Notary Public
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