Petition For Adult Adoption {29-A}

SURROGATE'S COURT OF THE STATE OF NEW YORK COUNTY OF __________________________ ------------------------------------------------------------X In the Matter of the Adoption of PETITION FOR ADULT ADOPTION ______________________________ An Adult, File No. ________________________ ------------------------------------------------------------X The Petitioner(s) respectfully allege(s) to this court that: 1. Petitioning adoptive parent is: _______________________________________________________________ (a) resides at: _______________________________________________________________________ _______________________________________________________________________ (b) is of full age, having been born on: _________________________________ (c) is (unmarried); or (married) to: ____________________________________ and living together; or living separate and apart pursuant to a decree or judgment of separation or pursuant to a separation agreement subscribed by the parties and acknowledged or proved in the form required to entitle a deed to be recorded; or living separate and apart for at least three years prior to commencement of the proceeding. 2. Petitioning adoptive parent is:________________________________________________________________ (a) resides at: ________________________________________________________________________ ________________________________________________________________________ (b) is of full age, having been born on: ____________________________________________________ Note: If the petitioning adoptive parent is married, and his/her spouse is not joining in the petition, please provide consent to the petition by such spouse. If consent cannot be obtained, please submit an affidavit explaining why the spouse's consent should be dispensed with. 3. Petitioning adoptee: _______________________________________________________, who resides at _____________________________________________________, was born on _______________________. (A certified copy of the birth certificate is annexed). 29-A (12/2016) American LegalNet, Inc. www.FormsWorkFlow.com 4. The following is information, as nearly as can be ascertained, concerning the legal parent(s) of the adoptee. (a) Full name, last known address of the adult adoptee's legal parent(s), date of birth: Parent: _________________________________________________________________________________ Parent: _________________________________________________________________________________ 5. The adoptee is seeking to change her/his name to ____________________________________ or is not seeking a name change. 6. Neither the adoptive parent nor the adoptee has been the subject of a proceeding for a Guardian under Article 81 of the Mental Hygiene Law or under Article 17-A of the Surrogate's Court Procedure Act. 7. If the adoptee is not a petitioner, his or her consent is attached. WHEREFORE, the Petitioner(s) request(s) an order granting the adoption of ___________________________ by the Petitioner(s) and directing that such adoptee _______________________________ shall be treated in all respects as the child of the Petitioner(s) and directing that [ ] the name of the adoptee be changed and henceforth be known by the name of __________________________________________________________________ together with such other and further relief as may be just and proper. Dated: _______________________ , __________. ____________________________________/__________________________________________ Adoptive Parent (Print Name) (Signature) ____________________________________/__________________________________________ Adoptive Parent (Print Name) (Signature) ___________________________________/___________________________________________ Adoptee (Print Name) (Signature) ____________________________________________________________________________________________ Signature of Attorney Print Name ____________________________________________________________________________________________ Firm Name Telephone Number ____________________________________________________________________________________________ Address of Attorney American LegalNet, Inc. www.FormsWorkFlow.com VERIFICATION STATE OF NEW YORK ) :ss. COUNTY OF _______________) ___________________________________________________________________________________________, being duly sworn, says that (he)(she)(they)(is)(are) the Petitioner(s) in the above-named proceeding and that the foregoing petition is true to (his)(her)(their) own knowledge, except as to matters wherein stated to be alleged on information and belief and as to those matters (he)(she)(they) believe(s) it to be true. __________________________________________________ Petitioner __________________________________________________ Petitioner __________________________________________________ Petitioner Sworn to before me on _________________________, ________ ___________________________________ Notary Public Commission Expires: (Affix Notary Stamp or Seal) Sworn to before me __________________________, ________ Judge of the __________________ Court American LegalNet, Inc. www.FormsWorkFlow.com