Waiver Of Notice Of Petition For Access To Sealed Adoption Records
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Waiver Of Notice Of Petition For Access To Sealed Adoption Records Form. This is a New York form and can be use in Adoption Statewide.
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Tags: Waiver Of Notice Of Petition For Access To Sealed Adoption Records, 27-D, New York Statewide, Adoption
D.R.L. §114
Adoption Form 27-D
(Adoption–Waiver of Notice of
Petition for Access to
Sealed Adoption Records)
(9/2006)
FAMILY COURT OF THE STATE OF NEW YORK
COUNTY OF
...........................................................................................
In the Matter of the Adoption of
A Child Whose First Name is
(Docket)(File) No.
WAIVER OF NOTICE OF PETITION
FOR ACCESS TO SEALED
ADOPTION RECORDS
...........................................................................................
1.
I am the [check applicable box]: G Adoptive Mother G Adoptive Father G Other
[specify]:
of the above-named child. I am 18 years of age or older.
2.
I am waiving the service of Notice of Petition for Access to Sealed Adoption Records in this
matter and am consenting to the release of sealed adoption records to [specify]:
Dated:______________________
________________________________
(Signature of Interested Party)
_________________________________
(Print Name)
STATE OF____________________)
COUNTY OF_________________) SS:
On the___________________ day of______________in the year_________, before me, the
undersigned,
personally appeared_________________________________, personally known to me or proved to me on
the basis of satisfactory evidence to be the individual (s) whose name (s) is/are subscribed to the within
instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity (ies), and
that by his/her/their signatures (s) on the instrument, the individual (s), or the person, upon behalf of which
the individual (s) acted, executed the instrument.
_____________________________________________________
Notary Public
(Deputy ) Clerk of Court
_____________________________________
Signature of Attorney, if any
_____________________________________
Attorney’s Name (print or type)
_____________________________________
_____________________________________
Attorney’s Address and Telephone Number
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Adoption Form 27-B Page 2
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