Form 150A (Rev. 05/12) The Family Court of the State of Delaware In and For New Castle Kent Sussex County PETITION FOR ADOPTION OF AN ADULT In the Matter of: Petitioner Name Street Address P.O. Box Number City/State/Zip Code Attorney Name 2nd Petitioner (if any) Name Street Address P.O. Box Number City/State/Zip Code Attorney Name File Number Marital Status: Interpreter needed? Language Married Yes Single No Marital Status: Married Interpreter needed? Yes Language Single No In the interest of the following person: Name Date of Birth Gender (Check One) Male Female 1. The Petitioner(s) desire to adopt the above named person (hereinafter the "adoptee.") As such, I/we have attached the following to this petition: Consent of Petitioner(s) to Adult Adoption 2. The adoptee consents to being adopted by the Petitioner(s). As such I/we have attached the following to this petition: Consent of adoptee to Adult Adoption 3. The adoptee will assume the following name(s) upon adoption: 4. I/we have attached a certified copy of the adoptee's birth certificate. WHEREFORE, Petitioner(s) seeks to adopt the above-named individual. Petitioner/Petitioner's Attorney Date Sworn to and subscribed before me this day of Clerk of Court/ Notary Public Petitioner 2, if any Date Sworn to and subscribed before me this day of Clerk of Court/ Notary Public 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Form 150A (Rev. 05/12) AFFIDAVIT OF TRUTH I, correct to the best of my knowledge. , state the information in this Petition for Adoption is true and Affiant Sworn to subscribed before me this day of , Clerk of Court/ Notary Public 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com