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Consent By Institution | Pdf Fpdf Docx | Legal Forms

Last updated: 11/14/2017

Consent By Institution

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Description

CONSENT BY INSTITUTION The ( Institution) , as represented by , its duly authorized representative, by virtue of the authority vested in it by (State) , in regard to ( Name ), a ( Male/Female) child who was born (Date) , and who was lawfully relinquished to the above - referenced institution on (Date) , for the purpose of placing the above - named child with a suitable family for adoption, does hereby consent to (His/Her) adoption by and , husband and wife. In witness whereof, I have signed this instrument in my capacit y as the duly authorized representative of (Institution) on , . Signature and Title This document was signed in the presence of the following: Signature Date Signature Date 2001 251 Americ an LegalNet, Inc.

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