INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.981(a)(2), STEPPARENT ADOPTION: CONSENT OF ADOPTEE When should this form be used?This form must be completed and signed by the person being adopted, the adoptee, if he or she isover 12 years of age, unless the court, in the best interest of the minor excuses the minors consent.It must be signed in the presence of a notary public or deputy clerk and two witnesses other thanthe notary public or deputy clerk. This form should be typed or printed in black ink. After completing this form, you should file theoriginal with the clerk of the circuit court in the county where the Joint Petition for Adoptionby Stepparent, O Florida Supreme Court Approved Family Law Form 12.981(b)(1) is filed andkeep a copy for your records. Special notes...Remember, a person who is NOT an attorne called a nonlawyer. If a nonlawyer helps you filly isout these forms, that person must give you a copy of Disclosure from Nonlawyer, O FloridaFamily Law Rules of Procedure Form 12.900 (a), before he or she helps you. A nonlawyer helpingyou fill out these forms also must put his or her name, address, and telephone number on the bottomof the last page of every form he or she helps you complete.Instructions for Florida Supreme Court Approved Family Law Form 12.981(a)(2), Stepparent Adoption: Consent of Adoptee (03/04)>>>> 2 IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: Division: IN THE MATTER OF THE ADOPTION OF , Adoptee(s). CONSENT OF ADOPTEE 1. I, {full legal name} , being over the age of 12, consent to my adoption by {name} , to be his/her legal child and heir at law. 2. I have been told of my right to choose a person who does not have an employment, professional, or personal relationship with the adoption entity or prosp ective adoptive parents to be present when this affidavit is executed and to sign it as a witness. The witness I selected is: {full legal name} .3. [ / only one] ( ) I consent to my name being legally changed to {specify} . ( ) I do not consent to a name change. I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this consent and that the punishment for knowingly making a false statement includes fines and/or imprisonment. Dated: Signature of Adoptee Printed Name: Address: City, State, Zip: Telephone Number: Fax Number: Business Address: Signature of Witness Home Address: Printed Name: Business Address: Home Address: Drivers License or State ID Card No.: Signature of Witness Printed Name: Florida Supreme Court Approved Family Law Form 12.981()(2a), Stepparent Adoption: Consent of Adoptee (03/04) >>>> 3Drivers License or State ID Card No.: STATE OF FLORIDA COUNTY OF Sworn to or affirmed and signed before me on by . NOTARY PUBLIC or DEPUTY CLERK p commissioned name of notary or clerk.] Personally known Produced identification Type of identification produced IF A NONLAWYER HELPED YOU FILL OU T THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [ N fill in all blanks] I, {full legal name and trade name of nonlawyer} ,a nonlawyer, located at {street} , {city} ,{state} , {phone} , helped {name} ,who is the adoptee, fill out this form. Florida Supreme Court Approved Family Law Form 12.981()(2a), Stepparent Adoption: Consent of Adoptee (03/04)