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Statement Of Payments To Agency Of Attorney In Connection With Adoption 138 - Vermont
| Statement Of Payments To Agency Of Attorney In Connection With Adoption Form. This is a Vermont form and can be used in Probate Court Statewide . |
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FORM 138. STATEMENT OF PAYMENTS TO AGENCY OF ATTORNEY IN CONNECTION WITH ADOPTION STATE OF VERMONT PROBATE COURT DISTRICT OF ___________________ DOCKET NO:_____________ IN RE ADOPTION OF:___________________________ Agency Payments to Agency or Attorney in Attorney Connection with Adoption 15A V.S.A. 3- 702 Organization: Childs name: Birthmothers name (if known): Address: Birthfathers name (if known): Telephone #: Date Names of Persons Who Have Paid Fees: Persons Who Have Agreed to Pay Fees: Purpose of Payment TOTALSI swear and affirm that the expenses listed above are the only payments or compensation made or agreed to be made to this agenc y or attorney in connection withthe adoption of the child listed above. Signed: Agency or Law Firm DateSworn before me on ____________________ in ___________________ in the County of , State of __________________________. My commission expires on .<<<<<<<<<********>>>>>>>>>>>>> 2Notary Public
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