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Petition For Adoption Of An Adult Form. This is a New Hampshire form and can be use in Probate Court Statewide.
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Tags: Petition For Adoption Of An Adult, NHJB-2519-P, New Hampshire Statewide, Probate Court
THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us
Court Name:
Case Name:
In the adoption of
Case Number:
(if known)
PETITION FOR ADOPTION OF AN ADULT
(RSA 170-B)
A CERTIFIED COPY (LONG FORM) OF THE ADOPTEE'S BIRTH CERTIFICATE AND
ASSENTS MUST BE FILED WITH THIS PETITION.
1.
Petitioner Name
Date of Birth
Petitioner Name
Date of Birth
Mailing Address
Residence
Telephone
How long has petitioner(s) been resident(s) of this city/town?
2.
Attorney Name
Telephone
Mailing Address
3.
Marital status of petitioner(s):
Bar ID #
Married
Civil Union
Single
Other
If married or civil union, date and place of ceremony
4.
Petitioner(s) relationship to adoptee
5.
Adoptee Birth Name
Date of Birth
Telephone
Place of Birth
Residence Address
6.
Birth Mother Name
Telephone
Mailing address
7.
Birth Father Name
Telephone
Mailing address
The petitioners declare that it is the desire of the petitioners to establish the relationship of parent and
child with the adoptee. Therefore, the petitioners ask that this adoption be decreed and that the
name of the adoptee be as follows: (Check all appropriate boxes. See Instructions for more
information.)
Change the name on the adoptee’s birth certificate to
The adoptee’s legal name will be
Date
Petitioner Signature (Must be signed in presence of notarial officer.)
Date
Petitioner Signature (Must be signed in presence of notarial officer.)
NHJB-2519-P (03/10/2010)
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Case Name: In the adoption of
Case Number:
PETITION FOR ADOPTION
State of
, County of
This instrument was acknowledged before me on
by
Date
My Commission Expires
Affix Seal, if any
Petitioner Name
Signature of Notarial Officer / Title
ASSENTS
ADOPTEE’S ASSENT
I am the adoptee mentioned in this petition. I give my assent to the adoption and the change of my
name as described in this form.
Date
Adoptee’s Signature
Signed in the presence of
Presiding Judge
ASSENT OF PETITIONER’S SPOUSE WHO IS PARENT OF ADOPTEE
I am the spouse of the petitioner and parent of the adoptee, and will maintain all those parental rights
along with the petitioner. I give my assent to the petitioner’s adoption of the adoptee named in this
petition and to the change of the adoptee’s name as described in this petition.
Date
Parent Signature
ASSENT OF PETITIONER’S SPOUSE TO ADOPTION OF ADULT
I am the spouse of the petitioner, and assent to the petitioner’s adoption of the adoptee named in this
petition.
Date
Spouse Signature
ASSENT OF ADOPTEE’S SPOUSE
I am the spouse of the adoptee, and I assent to this adoption.
Date
Spouse Signature
DECREE
Petition for adoption is granted.
Petition for adoption is denied.
Date
NHJB-2519-P (03/10/2010)
Judge
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