Affidavit (Change Of Circumstance Since Certification As Qualified Adoptive Parent) (Private Placement)
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Affidavit (Change Of Circumstance Since Certification As Qualified Adoptive Parent) (Private Placement) Form. This is a New York form and can be use in Adoption Statewide.
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Tags: Affidavit (Change Of Circumstance Since Certification As Qualified Adoptive Parent) (Private Placement), 1-Ca, New York Statewide, Adoption
D.R.L. 247115, 115-dForm 1-Ca(Affidavit - Change ofCircumstance) Private-Placement 9/99 COURT OF THE STATE OF NEW YORKCOUNTY OF In the Matter of Adoption of (Docket)(File) No.A Child Whose First Name Is AFFIDAVIT(Change of circumstance since certification as qualified adoptive parent)(Private-Placement) STATE OF NEW YORK) :ss..COUNTY OF ) , being duly sworn depose(s) and say(s):1. Deponent(s) (was)(were) certified as (a) qualified adoptive parent(s) by order of the courtCounty of , dated , ;2. The following change(s) in circumstance relevant and material to such certification (has)(have)taken place since that date:Date: PetitionerPrint or type nameSignature of Attorney, if anyAttorney222s Name (Print or Type)Attorney222s Address and Telephone NumberSworn to before me this day of , . Form 1-Ca page 2
