Revised: JANUARY, 2005 FOREIGN ADOPTION REGISTRATION PACKET PLEASE NOTE: NO CHARGE FOR PACKET. FEES ARE PAID WHEN PETITION IS FILED. ORPHANS’ COURT DIVISION COURT OF COMMON PLEAS CHESTER COUNTY, PENNSYLVANIA Revised: JANUARY, 2005 GUIDELINES Foreign Adoption Registration Packet is for reference ONLY. The forms are NOT to be used as fill-ins. All forms must be typewritten or printed on 8½” x 11” paper. Original of the Foreign Adoption Decree, related documents and English translation must be submitted separately, not attached to the Petition. All Originals will be returned. A self-addressed, stamped envelope must be provided for the return of the Original documents. A copy of the Foreign Adoption Decree and related documents must be attached to the Petition {see item #6 on FORM 1} Certificate of Adoption (H105.091-Revised 08/1998) Must be submitted separately, not attached to the Petition. Must be typed or printed. The form will not be accepted by Vital Records if it contains corrections, erasures or white-outs in areas concerning the child’s name after adoption or the adoptive parents information. Complete all pertinent information in Parts I, II and III. Part IV will be completed by the Clerk of the Orphans’ Court. The H105.091 form will be submitted to Vital Records by the Clerk of the Orphans’ Court. Statement of Citizenship and Residency form must be completed by the Petitioners and submitted with the H105.091. If this form is not included, Vital Records will contact the Petitioners or Attorney for the information. In accordance with 35 P.S. §450.604, following the filing of the Certificate of Adoption and Statement of Citizenship and Residency, application must be made to the Division of Vital Records to obtain a Pennsylvania Certification of Birth. Applications are available from the Clerk of the Orphans’ Court. CONTENTS Foreign Adoption Checklist FORM 1: Petition to Register and Docket Foreign Decree of Adoption FORM 2: Verification FORM 3: Final Decree Certificate of Adoption - H105.091 Statement of Citizenship and Residency CHECKLIST Petition to Register and Docket Foreign Decree of Adoption 23 Pa.C.S.A. §2908 Documentation to be assembled in the following order: ____ Final Decree ____ Petition to Register and Docket Foreign Decree in Accordance with 23 Pa.C.S.A. §2908 ____ ____ ____ ____ ____ Attorney Caption Signed Petitioner is Adopting Parent Petitioner is Resident of Chester County Verified by Petitioner ____ Original Foreign Decree and Related Documents ____ Copy of Foreign Decree and Related Documents ____ English Translation – Certified ____ Original Birth Certificate ____ Copy of Birth Certificate ____ English Translation – Certified ____ Form H105.091 ____ Statement of Citizenship and Residency NOTE: A HEARING SHALL NOT BE SCHEDULED FOR THIS PETITION Revised: JANUARY, 2005 SAMPLE ONLY - NOT TO BE USED AS A FILL - IN FORM FORM 1 IN THE COURT OF COMMON PLEAS OF CHESTER COUNTY, PENNSYLVANIA ORPHANS’ COURT DIVISION ADOPTION OF (initials of birth name) ADOPTION NO. (to be assigned) PETITION TO REGISTER AND DOCKET FOREIGN DECREE OF ADOPTION IN ACCORDANCE WITH 23 Pa.C.S.A.§2908 1. Petitioner(s) is/are ________________________________________________________ NAME(S) OF PETITIONER(S) who reside(s) at __________________________________________________________ FULL ADDRESS 2. Petitioner(s) file this petition pursuant to 23 Pa.C.S.A.§2908 and relevant Chester County Orphans’ Court Rules. 3. The adoptee was placed with the adopters in (state, territory, country, etc.) on (date). 4. The placement of the adoptee was arranged by (agency or individual(s)). 5. Petitioner(s) adopted the minor formerly known as (birth name) who was born on (date of birth) in (state, territory, country, etc). The adoption took place on (date of foreign adoption decree). 6. A COPY of the Foreign Adoption Decree and related documents are attached hereto as Exhibit “A”. 7. The TRANSLATION INTO ENGLISH of the Foreign Adoption Decree and related documents, certified by counsel to be true and correct, is attached hereto as Exhibit “B”. 8. Originals of the Foreign Adoption Decree and related documents are submitted under separate cover. WHEREFORE, Petitioner(s) request(s) that this Court enter a decree authorizing the registration and docketing of the attached foreign decree with the Clerk of the Orphans’ Court and make a finding that (birth name of adoptee) shall be henceforth known as (name after adoption) and shall have all the rights of a child and heir of (Petitioner(s)). ____________________________________ ____________________________________ (MUST BE SIGNED BY PETITIONER(S)) SAMPLE ONLY - NOT TO BE USED AS A FILL - IN FORM Revised: JANUARY, 2005 SAMPLE ONLY - NOT TO BE USED AS A FILL - IN FORM FORM 2 VERIFICATION _______________________________________________________________________________ (PETITIONER(S) NAME(S)) verify that the facts set forth in the foregoing petition are true and correct to the best of my/our knowledge, information and belief. I/We understand that false statements made herein are subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsification to authorities. MUST BE SIGNED BY PETITIONER(S) (DATE) SAMPLE ONLY - NOT TO BE USED AS A FILL - IN FORM Revised: JANUARY, 2005 SAMPLE ONLY - NOT TO BE USED AS A FILL - IN FORM FORM 3 IN THE COURT OF COMMON PLEAS OF CHESTER COUNTY, PENNSYLVANIA ORPHANS’ COURT DIVISION ADOPTION OF (initials of birth name) ADOPTION NO. (to be assigned) Petition to Register and Docket Foreign Decree in Accordance with 23 Pa.C.S.A. §2908 FINAL DECREE AND NOW, this _____________ day of ___________________________________, ____________, it is hereby ORDERED AND DECREED that the Petition of __________________________________________________ (PETITIONER(S) NAME(S)) is granted and that this Court authorizes the registration and docketing of the foreign decree entered on (date of foreign decree) by (foreign court, registrar, executive etc. who granted the adoption) in (state, territory, country, etc.) It is further ORDERED AND DECREED that the above foreign decree of adoption shall be enforceable as if this Court had entered the decree and that henceforth (birth name of adoptee) shall be known as (name of adoptee after adoption) and shall have all the rights of a child and heir of _________________________________. (PETITIONER(S) NAME(S)) BY THE COURT: ____________________________________ J. SAMPLE ONLY - NOT TO BE USED AS A FILL - IN FORM