IN THE COURT OF COMMON PLEAS OF CHESTER COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: {use initials only} Case Number: ___________________________ Petition For Adoption By Unmarried Couple FINAL DECREE AND NOW, this ____ ______ day of ______________ _________, 20__, upon consideration of the within Petition and after the hearing had ther eon, the Court having made an investigation to verify the statement of the Petiti on and ot her facts to give the Court full knowledge as to the desirability of the proposed adoption: The Court, being satisfied, finds that the statements made in the Petition are true, that the welfare of the person proposed to be adopted will be promoted by this adoption, and that the petitioner has demonstrated by clear and convinc ing evidence good caus e for non-compliance with §2701(7) and §2711(d) of the Adoption Act and the petitioner is excused from complying with §2701(7) and §2711( d) of the Adoption Act and that all other requirements of the Adoption Act and the Judicial Change of Name Provisions (54 Pa.C.S.A. §701) have been met; and it is hereby ORDERED, ADJUDG ED and DE CREED that _____ _________________, the person proposed to be adopted, shall have all t he rights of child and heir of ___________________________, the adopting parent, shall be subject to all the dutie s of such child; and shall hereafter assume the name ____________________________. BY THE COURT: ______________________________________ J. American LegalNet, Inc. www.FormsWorkFlow.com