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Release Of Child For Adoption Form. This is a Hawaii form and can be use in Family Court Statewide.
Tags: Release Of Child For Adoption, Hawaii Statewide, Family Court
FAMILY COURT
_________ CIRCUIT
STATE OF HAWAI‘I
RELEASE OF
CHILD FOR ADOPTION
CASE NUMBER
FC-A NO.
Full Legal Name of Mother:
Date Mother’s Child Expected to be born:
Full Legal Name of Alleged Natural Father:
I, the above-named alleged natural father hereby states that I have been advised that the
mother above-identified has named me as the natural father of her expected child.
[ ]
I hereby acknowledge that I am or may be said child’s father. I consent to the adoption of aid
child
by
adoptive
parents
to
be
selected
as
directed
by
and waive further notice of any condition of or action respect to said child. In order to facilitate
the care and well-being of said expected child. I release any parental interest and consent to
the termination of any parental rights I may be deemed or believed to have in said child.
[ ]
I am without sufficient information to acknowledge or deny that I am said expected child’s
father. However, in order to facilitate the care and well-being of said expected child, I release
any parental interest and consent to the termination of any parental rights I may be deemed
or believed to have in said child and I consent to the child’s adoption by parents to be selected
as directed by ______________________________.
[ ]
I hereby deny that I am the natural father of said (expected) child. However, in order to
facilitate the care and well-being of said expected child, I release any parental interest and
consent to the termination of any parental rights I may be deemed or believed to have in said
child and I consent to the child’s adoption by parents to be selected as directed by
.
I do not wish to receive any further contact or notification of any action in respect to said child.
If after the child reaches the age of majority, said child wishes to locate me, I
do;
do
not;
am undecided in respect to whether I wish to have my identity disclosed to said child. In any
event, I understand that it is my responsibility to advise the Court as to my whereabouts if I wish such
disclosure to be made to this child upon his or her reaching adulthood and initiating such a request.
08/07/01
PAGE 1 OF 2 PAGES
RELEASE OF CHILD FOR ADOPTION
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FAMILY COURT
______ CIRCUIT
STATE OF HAWAI‘I
RELEASE OF
CHILD FOR ADOPTION
CONFIDENTIALITY PURSUANT TO HRS §578-15:
1.
I have been advised of the requirements of Section 578-15 of the Hawai‘i Revised Statutes regarding
confidentiality of the court's adoption file.
2.
When my child becomes 18 years old, my child or the adoptive parents can request, in writing, to see
the court's file regarding this adoption.
3.
If I do not want the Family Court to reveal my identity to my child or the adoptive parents, I must file an
affidavit requesting confidentiality with the Family Court (on this island that the adoption occurred)
within ninety (90) calendar days before my child's 18th birthday. This affidavit is good for ten (10)
years.
4.
After that, I can file an affidavit every ten (10) years or I can file an affidavit to keep my identity
confidential for the rest of my life.
5.
All affidavits must be filed within ninety (90) days prior to the expiration of the previous affidavit.
6.
After my child reaches 18 years old, I can request to see the court's adoption file, too, but my child has
the same rights as I do the keep the file confidential.
7.
My decision to keep my information confidential or not applies to only me and does not apply to the
other natural parent.
8.
I can agree to open up the adoption file at any time and my child can to after turning 18 years old.
9.
It will be my responsibility to keep the Family Court informed of my current address if I want disclosure
to be made.
10.
The Family Court has no responsibility to notify the child, adoptive parent(s) or the natural parent(s) of
any deadlines or expiration dates.
SIGNATURE
On this day, before me personally appeared
, to me known to be person
named in and who executed the foregoing document and acknowledged that said document was read and is
understood by said person and was executed as the free act and deed of said person.
State of Hawai‘i, County of
Honolulu:
Date
08/07/01
PAGE 2 OF 2 PAGES
Signature:
Printed Name of Notary Public:
Commission
Expires:
NotaryPublic, State of Hawaii
RELEASE OF CHILD FOR ADOPTION
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