Consent Of Stepparents Spouse (To Adoption) {139}

700 - 00139 Consent of Custodial Biological Parent to Adoption (Stepparent /Partner Adoption (0 4 /201 7 ) Page 1 of 2 STATE OF VERMONT SUPERIOR COURT PROBATE DIVISION Unit Docket No. In re Adoption of: CONSENT OF CUSTODIAL BIOLOGICAL PARENT TO ADOPTION (Stepparent or Partner Adoption ) 15A V.S A. 2474 - 104 I swear or affirm under oath that the facts set forth below are true and I consent to the adoption of the minor child named below. Information about Custodial Biological Parent signing the Consent: My Name: Date of Birth: Address: Email Address: City/State/Zip: Daytime Phone: Name of Attorney: Address of Attorney: City/State/Zip: Information about the M inor to be A dopted: Name: Date of Birth: Information about the Attorney Who R epresents the P rospective A doptive P arents: Name of Attorney: Phone: Address : City/State/Zip: Agreements : I understand and agree that: ( Check All That A pply ) The adoption will not terminate the parental relationship between the minor and me . The adoption will terminate the parental relationship between the minor and the other parent of the minor . The adoption will terminate any existing court order for custody (parental rights and responsibilities) , visitation (parent child contact) or co mmunication with the minor . The adoption does not terminate the following rights and obligations : A . T he m i nor and any descendant of the m i nor w ill retain ri g hts of inheritance from and throu g h the parent of the m i nor who is no t li v in g w it h th e stepparent ; and B. A court approved agreement for visitation or communication with the minor after the adoption if the court determines that the agreement is in the best interests of the child. Failure to comply with the court ordered agreement is not g rounds for revoking consent or setting aside the adoptio n ; and American LegalNet, Inc. www.FormsWorkFlow.com 700 - 00139 Consent of Custodial Biological Parent to Adoption (Stepparent /Partner Adoption (0 4 /201 7 ) Page 2 of 2 C . T h e paren t w h o i s no t li v in g w it h th e st e pparen t re m a in s liabl e fo r arreara g e s o f child support unless released from that obli g ation by the parent who li v es with the child and by a ny g o v e rn m ental a g ency pro v iding financial assistance to the m i nor. This consent is not, and cannot be, a waiver of any further notice to me of the proceeding for adoption of the minor by the person seeking to adopt. Voluntary Consent: I state that I have legal and physical custody of this minor. I voluntarily and unequivocally consent to the adoption of this minor child. I swear or affirm that the facts set forth in this consent are true and correct to the best of my knowledge and belief. Date At: Signature City, County and State Printed Name Signed and confirmed in the presence of the Judge or in the presence of a person directed by the Judge Date Signature Printed Name of Judge or Other Person Authorized by Judge American LegalNet, Inc. www.FormsWorkFlow.com