CHECKLIST Petition to Confirm Consent 23 Pa. C.S.A. § 2504 (Documents to be attached to the Petition in the order they appear): _____ Preliminary Decree – Rule 15.1A(4) _____ Final Decree _____ Important Notice – 23 Pa. C.S.A. 2513(b) _____ Petition to Confirm Consent ____ ____ ____ ____ ____ _____ Attorney Caption Signed by Attorney for Petitioner Verified by Petitioner Petitioner is Adopting Parent or Intermediary Filed at least thirty (30) days after signing consent Original Statutory Consent of Birth Parent – 23 Pa. C.S.A. § 2711(d) ____ Birth Parent – 72+ hours after birth of child ____ Putative Father – any time after receiving notice of the expected or actual birth of child ____ Name, address, date of execution by Consenter ____ Name, address, relationship of at least two witnesses _____ Original Long Form Birth Certificate – Rule 15.1A(6) _____ Out-of-County Decrees Certified _____ Foreign Documents Translated _____ Notice(s) Pursuant to 23 Pa.C.S.A. §2513(b) ____ at least ten (10) days notice by personal service, OR ____ Registered Mail, OR ____ By such means as the Court may require (See, Pa.R.C.P. 430) ____ Proof(s) of Notice – to be filed at or before the hearing American LegalNet, Inc. www.USCourtForms.com