FAMILY COURT ________ CIRCUIT STATE OF HAWAI‘I CASE NUMBER FC-A NO. ADOPTION DECREE BY OTHER THAN STEPPARENT BY STEPPARENT In the Matter of Adoption of A [ ]MALE [ ]FEMALE CHILD, Born on: A [ ]MALE [ ]FEMALE CHILD, Born on: A [ ]MALE [ ]FEMALE CHILD, Born on: A [ ]MALE [ ]FEMALE CHILD, Born on: by [ ]ATTORNEY FOR PETITIONER(S) [ ]PETITIONER(S) PRO SE Name Address City, State, Zip Code [ ]the legal spouse of [ ]and Telephone Number [ ]the child(ren)'s legal parent [ ]husband and wife [ ]an unmarried person Petitioner(s). PRESIDING JUDGE HEARING DATE EFFECTIVE DATE OF DECREE This action was heard in this court on the date indicate above. Following the hearing and after full consideration of the evidence, the court found the material allegations of the petition for adoption to be for the best interest of the child(ren), and the court to have jurisdiction in this matter. IT IS ORDERED, ADJUDGED AND DECREED that: CHILD’S NAME AFTER ADOPTION BIRTHDATE CHILD’S NAME AFTER ADOPTION BIRTHDATE As of the effective date of this decree, the child(ren) is/are decreed to be the petitioner(s)’s child(ren). As of the effective date of this decree, the adopted child(ren) and adopting parent(s) shall sustain the legal relationship of child(ren) and parent(s) and shall have all rights and be subject to the duties of that relationship, as if the child(ren) were the natural child(ren) of the adopting parent(s). All rights and duties between the child(ren) and Any other person having a parental relationship to said child(ren) shall be deemed to have ceased. Any person other than the legal spouse of the petitioner shall be deemed to have ceased. However the full reciprocal legal rights and duties, including the right of inheritance existing between the child(ren) and their legal parent, who is now married to the petitioner, shall continue, subject only to the rights acquired by and the duties imposed upon the petitioner by this decree. The effective date of this decree of adoption is indicated above. DATE 08/07/01 SIGNATURE OF JUDGE ADOPTION DECREE American LegalNet, Inc. www.FormsWorkflow.com