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Petition To Adopt Minor By Stepparent 131B - Vermont
| Petition To Adopt Minor By Stepparent Form. This is a Vermont form and can be used in Probate Court Statewide . |
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FORM 131B. PETITION TO ADOPT MINOR BY A STEPPARENT STATE OF VERMONT DISTRICT OF ______________ PROBATE COURT DOCKET NO. ____________________________ IN RE: ADOPTION OF ______________________________________ PETITION TO ADOPT MINOR BY STEPPARENT 15A V.S.A. § 4-107 1. 2. 3. 4. My Full Name Is: ________________________________________________________ My Date and Place of Birth Are: ____________________________________________ (Date) (Place) The City or Town Where I Reside is: ________________________________________ My Mailing Address Is: ______________________________________________ ______________________________________________ ______________________________________________ 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. The Length of Time I Have Lived at My Current Residence Is: ____________________ My Relationship to the Minor Child Being Adopted Is: __________________________ My Occupation is: _______________________________________________________ My Approximate Income Is: _______________________________________________ I State That I Do Have the Facilities and Resources to Provide for the Care and Support of the Minor. My Spouse's Occupation Is: ________________________________________________ My Spouse's Approximate Income Is: ________________________________________ Full Birth Name, Or Legal Name of Minor Who Is Being Adopted: ______________________________________________________________________ Name by Which Minor Will be Known After Adoption: ______________________________________________________________________ Sex of the Minor Who Is Being Adopted: _____________________________________ Date of Birth and Time (or Approximate Time) of Birth of Minor Who Is Being Adopted: _______________________________________________________________________ 10/04 SML American LegalNet, Inc. www.FormsWorkflow.com 16. 17. 18. Place of Birth of Minor Who Is Being Adopted: ________________________________ The Minor ____ Is or ____ Is Not (Check One) An Indian Child as Defined in the Indian Child Welfare Act, 25 U.S.C. § 1901 et seq. The Following Is A Description And Estimate of Value of Any Known Property of the Minor: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ I state that to the best of my knowledge and belief, any law governing interstate or intercountry placement which applies to this adoption has been complied with. Names and Mailing Addresses of the Biological Parents of the Person to be Adopted: Name Mailing Address 1. ________________________________ ___________________________________ ___________________________________ 2. ________________________________ ___________________________________ ___________________________________ The Following Persons Have Executed a Consent, Relinquishment, Or A Disclaimer of Parental Interest With Respect to This Adoption: Name Relationship Type of Document Executed _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ A Consent or Relinquishment From Each of the Following Persons, Whose Parental Relationship with the Minor Has Not Been Terminated, May Be Required: Name Relationship _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ With Respect to the Persons Named in the Immediately Preceding Section, The Following Facts And Circumstances May Excuse The Lack of Their Consents: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ I Have Either: ____ Filed a previous Petition to Adopt in another court. If so, the disposition of the Petition was as follows: _______________________________________________________________________ _______________________________________________________________________ ____ Not filed a previous Petition to Adopt in another court. 19. 20. 21. 22. 23. 24. 25. The Following Is A Description of Any Previous Court Order or Court Proceeding American LegalNet, Inc. www.FormsWorkflow.com Known to Me Concerning Child Support for the Minor or Concerning Custody of or Visitation With the Minor (Use Additional Sheets, If Necessary): Name of Court Docket Number Type of Proceeding _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ 26. 27. My Marital Status Is: ____ Married ____ Single If I Am Married: A. The Date of My Marriage Was: __________________ . B. The Place of My Marriage Was: __________________ . C. The Place of Birth of My Spouse Was: __________________ . D. The Date of Birth of My Spouse Was: __________________ . E. If My Spouse Is Incompetent, the Date When a Court Declared Him or Her Incompetent Was: __________________ . If My Spouse is Deceased: A. The Date of His or Her Death Was: __________________ . B. The Place of His or Her Death Was: __________________ . C. The Cause of His or Her Death Was: __________________ . The Minor Child Has been Residing with Me and My Spouse Since: ________________ __________________ . If the Minor Is Not in My and My Spouse's Physical Custody: A. The Reason Why We Do Not Have Physical Custody Is As Follows: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ B. The Date We Intend To Obtain Physical Custody Is: __________________________ My Spouse And I Have Had Legal Custody of the Minor Since ____________________ The Circumstances Under Which We Obtained Legal Custody Are As Follows: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ I request that I be permitted to adopt the minor as my child. I Request the Following Additional Relief From the Court: _____________
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