State of Minnesota County Judicial District: Court File Number: Case Type: District Court Adoption ­ Stepparent In Re the Petition of: , Petitioner/Parent and , Petitioner/Stepparent To Adopt: , (child's current name) , (child's current name) . (child's current name) Affidavit of Petitioners in Support of Motion to Waive Post-Placement Assessment State of Minnesota County of Petitioners, ) ) SS ) [parent's name] [hereinafter "parent"] and [stepparent's name] [hereinafter "stepparent"], state as follows: 1. We make this affidavit in support of our request that the Court waive the requirement of a post-placement assessment and report and allow the filing of our Petition for Stepparent Adoption. 2. We understand that even if the Court waives the post-placement assessment, the Court must still direct the appropriate agency to conduct a background study, including a fingerprint check, of all adults in the home age 13 or older. 3. We are in a committed relationship having been married on and the minor child(ren) has/have resided with us since 4. Parent is the parent of the following child(ren): [child's name] who was born on [date of birth] and stepparent is a person related to the child as defined in Minnesota Statutes § 245A.02, subd. 13. [child's name] who [date of birth], and [date], [date]. was born on ADO209 State ENG Rev 7/15 www.mncourts.gov/forms Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com stepparent is a person related to the child as defined in Minnesota Statutes § 245A.02, subd. 13. [child's name] who [date of birth], and stepparent is a person related to the child as defined in Minnesota Statutes § 245A.02, subd. 13. was born on 5. The decision for Stepparent to adopt the child(ren) was a mutual decision in which we both participated equally. We agree to co-parent the child(ren) and to share all parental and financial responsibility regarding the child(ren). 6. We have co-parented the child(ren) since the child(ren) began living with us, and we have each developed a parent-child relationship with the child(ren). 7. The child(ren) is/are being raised in a loving and warm environment. 8. Parent is employed as employed as [occupation], and stepparent is [occupation]. 9. We own/rent our home, which is located at [address] in the City of _____________________, County of ________________________, State of Minnesota. 10. We have listed each other as beneficiaries of our life insurance policies and have executed wills leaving our estates to the survivor. 11. We wish to legalize stepparent's parental relationship with the child(ren) because it is in the child(ren)'s best interests. The child(ren) deserves the legal protection that will result from an adoption. 12. If parent dies while the child(ren) is/are a minor, we do not want his/her life disrupted by guardianship or custody proceedings. 13. We also want stepparent as a legal parent to the child(ren), to be able to obtain medical treatment for the child as needed and to communicate with the child's school as the child's parent. 14. The adoption of the child(ren) by the stepparent will also ensure that the child has a right to inherit from the estate of stepparent , and to enforce all other claims which arise out of the parent-child relationship, such as recovery in tort for the wrongful death of stepparent, survivor benefits under the social security laws, and the right to claim continuing financial support from stepparent . ADO209 State ENG Rev 7/15 www.mncourts.gov/forms Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com 15. We fully understand and accept the legal responsibilities and consequences of the adoption. We firmly believe that the adoption of the child(ren) by stepparent is in the child(ren)'s best interests for all of the reasons set forth above. Further affiants sayeth not except that this affidavit is made in good faith in support of their motion for waiver of the requirements of a post-placement assessment. I declare under penalty of perjury that everything I have stated in this document is true and correct. Minn. Stat. § 358.116. Dated: Petitioner/Parent Dated: Petitioner/Stepparent VERIFICATION AND ACKNOWLEDGEMENT The above-named Petitioner/Parent, [parent's name], states that Petitioner has read the foregoing Affidavit subscribed by him/her, that Petitioner knows the contents thereof, and that the same is true to Petitioner's best information and belief. [parent's name] Petitioner / Parent [signature] The above-named Petitioner/Stepparent, [stepparent's name], states that Petitioner has read the foregoing Affidavit subscribed by him/her, that Petitioner knows the contents thereof, and that the same is true to Petitioner's best information and belief. [stepparent's name] Petitioner / Stepparent [signature] ADO209 State ENG Rev 7/15 www.mncourts.gov/forms Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com