Consent Of Stepparents Spouse {PC 139} | Pdf Fpdf Docx | Vermont

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Consent Of Stepparents Spouse {PC 139} | Pdf Fpdf Docx | Vermont

Consent Of Stepparents Spouse {PC 139}

This is a Vermont form that can be used for Probate Court within Statewide.

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10/04 SMLFORM 139. CONSENT OF STEPPARENT'S SPOUSE(BIOLOGICAL PARENT) STATE OF VERMONT PROBATE COURT DISTRICT OF Docket No. IN RE ADOPTION OF (a minor) CONSENT OF STEPPARENT'S SPOUSE (BIOLOGICAL PARENT)15A V.S.A. 247 4-404 1.My Full Name 2.My Mailing Address 3.My Date of Birth 4.Full Name of Minor Who Is Being Adopted 5.Date of Birth of Minor Who Is Being Adopted 6.Full Name, Address and Telephone Number of the Attorney Representing the ProspectiveAdoptive Parent(s) With Whom I have Placed, or Intend to Place my Minor Child for Adoption: 7.I state that I have legal and physical custody of my above-named minor child. I voluntarily andunequivocally consent to the adoption of my said minor child.8.I understand and agree that the adoption will not terminate the relationship of parentalrelationship between my minor child and me. 9.I understand and agree that the adoption will terminate the relationship of parent and childbetween my minor child and the minor child's other parent. 10.I understand and agree that the adoption will terminate any existing court order for custody,visitation, or communication with the minor child. 11.I understand and agree that notwithstanding the adoption: A. the minor and any descendent of the minor will retains rights of inheritance from and throughthe minor's other parent; American LegalNet, Inc. www.FormsWorkFlow.com B. a court order for visitation or communication with the minor by me, or by a person related tothe minor through me, or an agreement or order concerning another person which is approved bythe court under 15A V.S.A. 247 4-112, survives the decree of adoption, but failure to comply withthe terms of the order or agreement is not a ground for revoking or setting aside this consent orthe adoption; C. the other parent remains liable for arrearages of child support unless relieved of thatobligation by me, and any guardian ad litem of the minor and by a governmental agencyproviding public assistance to the minor. 12.This consent is not, and cannot be, a waiver of any further notice to me of the proceeding foradoption of the minor child by the person seeking to adopt. 13.I swear that the factual information set forth in this consent is true and correct to the best of myknowledge and belief. Dated this date of , at in the County of and State of . (signature) (printed name) STATE OF COUNTY OF On day of , , personally appeared before meand signed or confirmed in my presence that he or she freely and voluntarily signed the above consentand acknowledged that the factual information set forth therein is true and correct to the best of his orher knowledge and belief. I am one of the following: a Judge of a court that has jurisdiction over adoption proceedings in the State of ; a person appointed by a Probate Judge to take consent or relinquishments; a commissioned officer on active duty in the military service of the United States and the personsigning the consent is in the military service; an officer of the foreign service or a consular officer of the United States in another country, to wit:, and the person executing this consent appeared before me in that country; a person authorized to take acknowledgments. (signature) (printed name) American LegalNet, Inc. www.FormsWorkFlow.com

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