SUPERIOR COURT OF THE DISTRICT OF COLUMBIA FAMILY COURT DOMESTIC RELATIONS BRANCH ADOPTION EX PARTE IN THE MATTER OF : Adoption Case No. A - : THE PETITION OF : : : : : JUDGE RONNA LEE BECK FOR ADOPTION OF [Childs Full Name] : : FINAL DECREE OF ADOPTION 1 Upon consideration of the Petition for Adoption filed by [petitioners f ull name] for 2 the adoption of a minor child, currently named [childs full name], born [date], in [place], and upon the report and recommendation of the Child and Family Services Agency of the District of Columbia [or other appropriate agency], it appears to the sa tisfaction of the court: (1) That the court has jurisdiction pursuant to D.C. Code Ann. 16-301 (2001); (2) That the adoptee is physically, mentally, and otherwise suitable for adoption by the petitioner; (3) That the petitioner is fit and able to give the adopte e a proper home and education; (4) That the adoption will be for the best interests of the adoptee; (5) That the adoptee has resided with the petitioner since [date] [if this is a foreign readoption, replace with: That the adoptee has been in the legal care and control of petitioners by virtue of an adoption [or, if applicable, a guardianship] in [place] on [date], and has 1 If there are two petitioners, modify the order appropriately throughout . 2 Use "currently named" only if petitioner desires to change the childs name. Otherwise, delete the commas and use named. 1 American LegalNet, Inc. www.USCourtForms.com>>>> 2resided with them since that date], which is more than six months preceding the date of this Final Decree; (6) That the adoption form has been completed pursu ant to Section 10 of the Vital Records Act of 1981, D.C. Code Ann. 7-209 (Supp. 2003); and (7) That there has been compliance with the applicable provisions of the Interstate Compact on Placement of Children Authorization Act of 1989, D.C. Code Ann. 4-1421 to 4-1424 (2001 & Supp. 2003). Accordingly, it is now by the court this _______ day of ___________, 2004, ORDERED, ADJUDGED, AND DEC REED : 1. That a Final Decree of Adoption be and is hereby entered establishing th e legal relationship of natural parent and natural child for all purposes between [petitioners name], the adopter, and [childs current name], the adoptee, to the same extent as if the adoptee had been naturally born to the adopter; 2. That the name of the adoptee be and is hereby legally changed to [new name of child] [or that the name of adoptee shall remain [current name of child]]; and 3. That the Clerk of the court is hereby authorized and directed to furnish four certified copies of this Final Decree of Adoption to the adopter through the adopters counsel of record in this matter or to the adopter directly, if adopter is pro se. _________________________ ____ JUDGE RONNA LEE BECK (Signed in Chambers) 2 American LegalNet, Inc. www.USCourtForms.com>>>> 3Copies to: Counsel for Petitioner(s) William S. Johnson, LICSW Adoption Resources Program Child and Family Services Agency th 400 6 Street, SW Washington, DC 20024 [or, if the agency is not CFSA, the address of the appropriate agency contact person] 3 American LegalNet, Inc. www.USCourtForms.com